Approach to Low Ferritin and Iron Deficiency Anemia - a podcast by NOSMSS

Podcaster:
Caitlyn Vlasschaert


Medical Discipline/Topic:
Hematology, Internal Medicine


Intended Audience
Year 1, Year 2, Year 3, Year 4


Brief Synopsis/Key Takeaways:
1. Ferritin below 15 equals iron deficiency. In the setting of chronic inflammation, ferritin below 30 and transferrin saturation below 20% can be used as cutoffs. Iron deficiency can cause anemia and non-anemic fatigue. Treatment is appropriate in both cases.
2. Treat underlying causes when possible. Causes can be split into decreased iron intake and increased blood loss. Think about decreased iron intake with vegetarianism, autoimmune gastritis, H. pylori gastritis, celiac disease, gastric bypass, as well as blood loss – commonly GI (including malignancy) and heavy menstrual bleeding. 
3. To replete iron deficiency, aim to restore 1-1.5 g of iron, whether that is more rapidly with iron infusions or over a few months with oral iron supplements. Pay attention to amount of elemental iron in what you’re prescribing. Oral iron should be taken at least 2 hours after meals with Vitamin C and without calcium or PPIs. Check for response to iron supplementation in 4-6 weeks.

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