Treatment for iron deficiency anaemia usually involves taking iron supplements to replace the missing iron and making any necessary changes to address the underlying cause.
Iron supplements
Your GP will prescribe an iron supplement to restore the iron that is missing from your body. The most commonly prescribed supplement is ferrous sulphate, which is taken orally (by mouth) two or three times a day.
Most people will not experience any side effects when taking iron supplements. However, in some cases, ferrous sulphate may upset your stomach and can cause:
- nausea (feeling sick)
- sickness
- abdominal (tummy) pain
- heartburn
- constipation (feeling unable to empty your bowels)
- diarrhoea
- black stools (faeces)
These side effects should settle down over time. Taking ferrous sulphate with food or shortly after eating may help to minimise any side effects. Your GP may also recommend that you only take one or two tablets a day, instead of three, if you are finding the side effects difficult to cope with.
If ferrous sulphate is not suitable for you because of the side effects, you may be prescribed a different iron supplement called ferrous gluconate. This supplement should produce fewer side effects because it contains a less concentrated dose of iron. However, it may take longer for the iron levels in your body to be restored.
Storing iron supplements
If you have young children, it is very important to store your iron supplements out of their reach. This is because an overdose of iron supplements in a young child has a toxic effect, which can be fatal.
Dietary advice
If a lack of iron in your diet is thought to contribute to your iron deficiency anaemia, your GP will advise you how to include more iron in your diet.
Iron-rich foods include:
- dark-green leafy vegetables, such as watercress and curly kale
- iron-fortified bread
- beans
- nuts
- meat
- apricots
- prunes
- raisins
To ensure you have a healthy, well-balanced diet, include foods from all the major food groups in your diet. If you have iron deficiency anaemia, eat plenty of iron-rich foods, such as those listed above.
Some foods and medicines can make it harder for your body to absorb iron. These may include:
- tea and coffee
- wholegrain cereals
- calcium, found in dairy products such as milk
- antacids (medication to help relieve indigestion)
- proton pump inhibitors (PPIs), which affect the production of acid in your stomach
If you are finding it difficult to include iron in your diet, you may be referred to a dietitian (a health professional who specialises in nutrition). They can give you more detailed, personalised guidance about how you can change your diet.
Underlying causes
Your GP will also need to ensure that the underlying cause of your anaemia is treated so that anaemia does not become a recurrent problem.
For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe an alternative type of medicine, which will help minimise the risk of stomach bleeding.
Heavy periods (menorrhagia) can also be treated in a number of different ways, using both medicines and special internal devices.
If you have been diagnosed with another condition as well as iron deficiency anaemia, see the relevant Health A-Z topic to find out how it will be treated.
Monitoring
Your GP will ask you to return for a check-up two to four weeks after you have started taking your iron supplements. At this appointment, your GP will be able to assess whether you have responded to the treatment. They will do this by taking a blood sample and testing it for the level of haemoglobin (a protein that transports oxygen).
If the result of the blood test shows an improvement, you will be asked to return in two to four months for a further blood test to ensure that your haemoglobin levels have returned to normal.
Once your haemoglobin levels and red blood cells (cells that contain haemoglobin) are normal, your GP will usually recommend that you continue taking iron supplements for three months to help replenish the iron stores in your body.
After this, depending on the cause of your iron deficiency anaemia, you should be able to stop taking the supplements. Your condition will then be monitored every three months for one year.
Continuing treatment
In some people, after the iron stores in the body have been replenished, they start to fall again. This could happen if:
- you do not eat an iron-rich diet
- you are pregnant
- you have heavy periods (menorrhagia)
In these circumstances, you may be prescribed an ongoing iron supplement. This will usually take the form of one tablet a day. This will prevent you from becoming iron deficient and will stop your anaemia returning.
If treatment fails
If your iron levels do not improve, your GP will ask you how regularly you have been taking your iron supplements. Some people are put off taking the medication because of the side effects (see above). However, not taking the supplements will mean that your condition will not improve.
If you have been taking the supplements as prescribed and your iron levels have still not improved, your GP may refer you for an assessment with a specialist.
