Understanding the management of iron deficiency anaemia

Abstract

Iron deficiency, the most common cause of anaemia, is seemingly easy to manage. However, in many cases the nutritional deficiency is complicated by concurrent gastro-intestinal disease and/or inefficient absorption. In addition, iron absorption and mobilisation from physiological storage sites is regulated by the peptide hormone hepcidin, which is upregulated in anaemia associated with chronic inflammation. Successful patient management requires the continuous evaluation of iron status as well as monitoring of haemoglobin levels to measure treatment outcomes. Iron requirements change with patient physiological status and this must be taken into consideration when making clinical decisions. Provided that there is no underlying problem most patients respond rapidly to oral iron therapy. In non-responsive patients, and patients with concurrent gastro-intestinal disease, parenteral therapy must be considered. This brief review provides a summary of some of the problems that may be encountered with the management of iron deficiency and iron deficiency anaemia.