Iron-Deficiency Anemia (IDA) TREATMENT Hematology & Oncology

Iron-deficiency anemia is primarily treated with oral iron, most commonly ferrous sulfate, which is inexpensive and effective. The recommended therapeutic dose is ۳-۶ mg/kg of elemental iron daily, with a maximum of ۱۵۰-۲۰۰ mg. It is ideally taken between meals, though this is not essential. Oral intolerance is uncommon in children but may cause gastrointestinal discomfort in adolescents; adjusting dosage often helps. If absorption is impaired or adherence is poor, intravenous preparations such as iron sucrose, ferric carboxymaltose, or iron dextran may be considered, though oral therapy remains safer and cheaper. Certain factors reduce absorption, including calcium, fiber, and tea. Heme iron from animal sources is absorbed much better than non-heme iron. Excessive cow's milk intake should be limited, and dietary counseling is usually required. In adolescent females, menorrhagia-related anemia should be managed with iron therapy and, if needed, hormonal control. Clinical response is predictable: reticulocytosis appears within ۲-۴ days, and hemoglobin rises ۱-۲ g/dL in about a month. Therapy should continue for ۲-۳ months after normalization to restore iron stores. If the response is poor, alternative diagnoses, malabsorption, or poor adherence should be investigated. Blood transfusion is rarely required and should be reserved for severe anemia with ongoing bleeding or imminent heart failure, given slowly to avoid complications. Overall, effective management combines appropriate iron therapy, dietary adjustments, and monitoring to ensure recovery and prevent recurrence.