Iron deficiency anaemia - Treatment 

Treating iron deficiency anaemia 

Treatment for iron deficiency anaemia usually involves taking iron supplements and changing your diet to increase your iron levels, as well as treating the underlying cause.

Iron supplements

Your GP will prescribe an iron supplement to restore the iron missing from your body. The most commonly prescribed supplement is ferrous sulphate, which is taken as a tablet two or three times a day.

Some people can experience side effects when taking iron supplements, including:

These side effects should settle down over time, although your GP may advise taking the tablets with food or shortly after eating to help minimise side effects, if they are severe. Your GP may also recommend you only take one or two tablets a day, instead of three, if you are finding side effects difficult to cope with. 

If you cannot take ferrous sulphate because you get severe side effects, you may be prescribed a different iron supplement called ferrous gluconate. This supplement should cause fewer side effects, as it contains a less concentrated dose of iron. However, it may take longer for iron levels in your body to be restored.

In a few cases – for example, if you have chronic kidney disease (CKD)  iron injections may be recommended instead of tablets.

Storing iron supplements

As with all medications, it's important to store iron supplements out of the reach of children. This is because an overdose of iron supplements in a young child 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 tell 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 cereals or bread
  • brown rice 
  • pulses and beans
  • nuts and seeds
  • white and red meat
  • fish
  • tofu
  • eggs
  • dried fruit, such as dried apricots, prunes and raisins

You should also try and include foods from all major food groups in your diet, to ensure it is healthy and well-balanced. In particular, you should try to include foods and drinks containing vitamin C, as vitamin C can help your body to absorb iron.

However, high levels of some foods and drinks, as well as certain medicines, may make it harder for your body to absorb iron. These include:

  • tea and coffee
  • calcium, found in dairy products such as milk
  • antacids and proton pump inhibitors (PPIs), which are medications sometimes used to relieve indigestion
  • wholegrain cereals  although wholegrains are a good source of iron themselves, they contain phytic acid, which can stop your body absorbing iron from other foods and pills

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 detailed, personalised advice about how you can improve your diet.

Treating the underlying cause

Your GP will also need to ensure the underlying cause of your anaemia is treated, so it doesn't happen again.

For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding.

Heavy periods can be treated with medication and, in particularly severe cases, surgery. Read more about treating heavy periods

Monitoring

Your GP will ask you to return for a check-up two to four weeks after you have started taking iron supplements, to check how well you have responded to the treatment. Your haemoglobin levels will be checked in a blood test.

If the result of the blood test shows an improvement, you will be asked to continue taking your iron supplements and return in two to four months for another blood test.

Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend you continue taking iron supplements for three months to help build up the iron levels 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, over the course of a year, and again a year later.

Continuing treatment

In some people, after iron levels in the body have been replenished, they start to fall again.

This could happen if you don't get enough iron in your diet, you are pregnant or you have consistently heavy periods.

If this happens, you may be prescribed an ongoing iron supplement to help stop your anaemia returning. This will usually be in tablet form, which you will have to take once a day. 

If treatment is ineffective

If your iron levels do not improve, your GP will ask 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, your condition will not improve if you don't take the supplements.

If you have been taking the supplements as prescribed and your iron levels have still not improved, your GP may refer you to a specialist for a assessment.

Page last reviewed: 24/03/2014

Next review due: 24/03/2016

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Comments

The 5 comments posted are personal views. Any information they give has not been checked and may not be accurate.

User827552 said on 15 December 2013

Jim, I think addressing long-term dietary intake is important. The foods discussed in the article will benefit her; red meats provide the most readily absorbed form of iron and vitamin C promotes uptake, while wheat-cereals can inhibit it.

Kimmy and Matty, sounds like a discussion with your GP is required regarding managing your son's anaemia, and a thyroid function test?


Chris Gall, it isn't misinformation. Spinach contains high levels of iron but also contains oxalates that inhibit the uptake of iron by binding to the inorganic iron molecule prior to absorption compromising uptake. It may not seem "possible", but that's the beauty of bioscience.
You may find lots of misinformation on the internet, but, in this instance, and as far as is currently understood, that is not the case here.

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Jim the red said on 28 September 2013

My Wife has been diagnosed as anaemic, and this has put back a pending operation, she is receiving treatment of GP, is there any other treatment available or diet advice.
An old friend has recomended a can of stout each night, would this help?

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kimmyandmatty said on 16 January 2013

Hi my son is 4 yèars old and he has iron deficiency and he's now under treatement, he started school in september 2012 but the school are worried because he's falling asleep during school time and the teacher isnt happy. Is it because the iron level is to low or what else can it be as he's sleeping really well night time. Hope someone can help. Many thanks kathy xx

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ChrisGall said on 15 May 2010

This article is confusing as it states that Spinach, known to be high in iron, is also an iron inhibitor...? How is that possible!?
Also, there is no mention of liver being one of the best sources of iron the body can take...so the information here is, overall, confusing and incomplete and is a prime example of the raft of mis-information prevelant on the internet as it is.
Sorry...not helpful at all.

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jwolf said on 30 October 2009

Spinach is harder to absorb from most vegetables and fruits instead of non vegan sources, however most should find with a healthy diet, they’ll be eating without trying, plenty of high iron foods.
Sources for iron include:
Kale, Spinach, broccoli, peas, pumpkin seeds, figs, dates, dried apricots and perhaps the best source, lentils.
Absorption Inhibitors...
Definitely: Red Wine, Coffee & Tea Whole grains and bran
Apparently: Vegetables: Spinach, chard, beet greens, rhubarb and sweet potato Soy products.
Absorption enhancers...
Definitely:
Fruits: Orange, Orange Juice, cantaloupe, strawberries, grapefruit etc
Vegetables: Broccoli, Brussels sprouts, tomato, tomato juice, potato, green & red pepper.
Apparently: White wine
“Note on spinach:
You do not need to give it up if you are a spinach lover! Simply eat spinach with any foods containing iron absorption enhancers.”
The things written under “apparently” are from:
http://www.healthcastle.com/iron.shtml

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