Anemia And Iron-based Preparations

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Last Medical Review: April 5, 2020
Medically Reviewed by Dr. Elisabeth Vincent Hamelin

Iron deficiency is the most common cause of anemia both in Italy and worldwide. Iron is an indispensable element for life; enters the composition of hemoglobin, the substance, present in the red blood cells, responsible for the transport of oxygen from the lungs to all other parts of the body. When the concentration of hemoglobin in the blood decreases, due to insufficient food intake of iron or due to loss or destruction of red blood cells, it is called iron deficiency anemia. Although a better dietary intake has reduced its prevalence and severity, in western countries it continues to be a rather frequent problem, especially in some age groups, or in the first two years of life, in adolescents between 11 and 18 years of age and in women between 15 and 45 years old. The conditions in which anemia can occur are pregnancy, excessive menstrual losses, intestinal bleeding, reduced dietary intake or impaired intestinal absorption. Iron salts are used to treat this form of anemia.  

The iron salts

The intake of iron salts is generally able to normalize the situation. Iron-based drugs should be taken by mouth, accompanied by a glass of water; since food reduces their absorption, they should be taken on an empty stomach. However, if gastrointestinal complaints arise, they can be taken together or immediately after meals. The solution preparations should be diluted with water or fruit juice and preferably taken with a straw to avoid staining the teeth (brush them immediately after taking the product). Gastroprotective tablets should not be broken or chewed before taking. The duration of therapy is typically several months, as the body’s iron stores are replenished fairly slowly. Intravenous iron therapy can be associated with serious adverse reactions and should be reserved for particular situations. Intramuscular administration is not recommended

Side effects

Iron salts are generally well tolerated; however, gastrointestinal complaints may sometimes occur such as: stomach pain, nausea, vomiting, constipation or diarrhea. These effects can be reduced by starting therapy with reduced doses or by taking iron salts on a full stomach or with meals. Prolonged intake can cause constipation. The iron salts cause dark coloring of the stool, not to be confused with the presence of blood and impart a brown color to the urine. Report to the doctor any other effects believed to be attributable to taking the drug.  

What to say to the doctor

When prescribing iron preparations, it is good to inform your doctor of all the medications you are taking. Report if you have severe kidney or liver disease or suffer from gastric (e.g. ulcer), intestinal (e.g. ulcerative colitis) or blood diseases, if you have suffered from ” allergies ” to medications in the past (including iron salts) or diseases such as eczema, asthma, urticaria.  

Some suggestions

Iron is present in good quantities in foods such as red meat, eggs, fish and legumes. The other vegetables, fruit and milk are low in iron. The belief that spinach is a good source of iron as it contains it in the form of non-absorbable compounds is to be dispelled. By eating foods containing high quantities of vitamin C (e.g. orange juice, kiwi), iron absorption is promoted. Instead, avoid drinking milk or eating cheese, yogurt, eggs, tea, coffee and foods rich in fiber (e.g. wholemeal bread) at the same time as taking iron salts, as they would reduce their absorption. If antacid drugs are to be taken, distance their intake from that of iron salts by at least 2 hours. Children are particularly sensitive to iron salts intoxication: in case of accidental ingestion, it is necessary to contact the emergency room immediately, even in the absence of symptoms, taking the bottle of the drug with you.  

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