If a patient’s symptoms and blood test results have confirmed that they are iron deficient, there are a number of treatment options that are available to help improve their symptoms and quality of life.
One non-pharmacological treatment option is to educate the patient on how to increase iron intake within their diet. This can include encouraging them to eat more iron rich foods such as oysters, red meat, liver, iron-enriched cereals and leafy greens.1 Also, patients can be advised to eat vitamin C-rich foods1 as they enable the absorption of iron. Tea,1 coffee,2 and calcium-rich foods2 inhibit iron absorption so it is best that they are not consumed at the same time as the iron-rich foods.2 The table below provides further examples of dietary iron sources and the foods that help and hinder iron absorption.
|Iron Sources (Animal-Based)4||Iron Sources (Plant-Based)5|
|Red meat e.g. Beef||Beans|
|Turkey or chicken giblets||Spinach|
|Dried fruit (e.g. dried apricots, prunes and raisins)|
|Iron-enriched cereals and grains (see the packaging for details of iron content)4|
|Foods that help Iron Absorption||Foods that inhibit Iron Absorption|
|Meat/ sources of haem iron3||Tea and herbal infusions in general9|
|Vitamin C e.g. citrus fruits8||Coffee7|
*Calcium, such as that found in milk and dairy products can negatively affect the absorption of both haem and non-haem iron, unlike the other inhibitors that only affect the absorption of non-haem iron.6
If the patient has coeliac disease, Inflammatory Bowel Disease (IBD), or has had gastric surgery, then they may require further nutritional counselling to inform them of the most suitable foods for them to eat to increase their iron intake.
If the patient requires more iron than they would be able to ingest or absorb from their food, supplemental iron treatments could be prescribed. These include:
- Oral iron supplements1
- Intravenous iron7
- A blood transfusion8–11
Certain treatment options may be more suitable for a particular patient than others, depending on their level of iron deficiency and whether they have any other medical conditions. For example, if the patient is iron deficient due to eating a restrictive diet, oral iron supplements may be sufficient to solve their iron deficiency.12
If the patient has a condition that leads to malabsorption of nutrients, for example coeliac disease, IBD, or if they have had bariatric surgery, oral iron preparations may not be well tolerated or very efficient so an alternative such as intravenous iron may have to be considered.13,14 The amount of time it takes for the patient’s iron levels and symptoms to improve may differ depending on the prescribed treatment.11,15
It is important to follow up with patients to ensure that their iron levels have improved. Adherence to oral iron therapy is one particular challenge. Gastrointestinal side effects such as abdominal discomfort, nausea, vomiting, changes in bowel movements, and black stools16 can reduce a patient’s adherence when taking their medication.2