The American Journal of Medicine
Volume 121, Issue 11 , Pages 943-948, November 2008

Individualized Treatment for Iron-deficiency Anemia in Adults

  • Michael Alleyne, MD

      Affiliations

    • The National Cancer Institute, National Institutes of Health, Bethesda, Md
    • The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md
  • ,
  • McDonald K. Horne, MD

      Affiliations

    • Hematology Service and Department of Laboratory Medicine, WG Magnuson Clinical Center, National Institutes of Health, Bethesda, Md
  • ,
  • Jeffery L. Miller, MD

      Affiliations

    • The National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md
    • Corresponding Author InformationReprint requests should be addressed to Jeffery L. Miller, MD, Chief, Section on Molecular Genomics and Therapeutics, Molecular Medicine Branch, NIDDK, National Institutes of Health, Building 10, Room 9N311, 10 Center Drive, Bethesda, MD 20892-1801

Abstract 

Iron deficiency is one of the most common disorders affecting humans, and iron-deficiency anemia continues to represent a major public health problem worldwide. It is especially common among women of childbearing age because of pregnancy and menstrual blood loss. Additional patient groups include those with other sources of blood loss, malnutrition, or gut malabsorption. Iron-deficiency anemia remains prevalent despite the widespread ability to diagnose the disease and availability of medicinal iron preparations. Therefore, new approaches are needed to effectively manage these patient populations. In this review, the diagnosis and treatment of iron-deficiency anemia are discussed with emphasis placed on consideration of patient-specific features. It is proposed that all patients participate in their own care by helping their physician to identify a tolerable daily iron dose, formulation, and schedule. Dosing cycles are recommended for iron replacement based on the tolerated daily dose and the total iron deficit. Each cycle consists of 5000 mg of oral elemental iron ingested over at least 1 month with appropriate follow-up. This approach should assist physicians and their patients with the implementation of individualized treatment strategies for patients with iron-deficiency anemia.

Keywords: Anemia, Dosing cycles, Hepcidin, Iron

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 Funding: This research was supported by the Intramural Research Program of the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

 All authors had access to the data, a role in writing the article, and no conflicts of interest.

PII: S0002-9343(08)00703-1

doi:10.1016/j.amjmed.2008.07.012

The American Journal of Medicine
Volume 121, Issue 11 , Pages 943-948, November 2008