Iron deficiency is one of the most common causes of anaemia in adults. ? We conducted a review of the literature using the standard Prescrire methodology to determine the best treatment for adults with iron-deficiency anaemia. ? Iron-deficiency anaemia is usually hypochromic, microcytic and aregen-erative. In patients without chronic inflammatory disease, infection or cancer, and without liver or kidney disease, a low serum ferritin concentration confirms iron deficiency. In the absence of obvious blood loss, such as heavy periods in women, occult blood loss should be sought first, focusing on the gastrointestinal or genital tract. Some manifestations point to inadequate dietary iron intake or to iron malabsorption due to a gastrointestinal disorder. In addition to treating the underlying cause, when possible, treatment of iron-deficiency anaemia is based on iron intake.The oral route has the best harm-benefit balance, delivering 100 mg to 200 mg of elemental iron per day as ferrous salts. Iron-deficiency anaemia is usually corrected after 6 to 8 weeks of oral iron supplementation. Treatment may be continued for 3 to 6 months in order to replenish iron stores. Alternatively, iron supplementation may be suspended once a normal haemoglobin concentration has been achieved. Oral iron has frequent gastrointestinal adverse effects, including abdominal pain, nausea, vomiting, diarrhoea and constipation. Gastrointestinal tolerability can be improved by dividing the daily dose, taking the iron supplement during or just after a meal, reducing the dose, or sometimes trying a different commercial brand. ? Given the risk of fatal acute intoxication, products sold in unsafe packaging should be avoided, and iron supplements, like all drugs, should be kept out of children's reach. In practice, patients with iron-deficiency anaemia need iron supplementation to replenish their iron stores, preferably by the oral route. Patients should be aware of how to minimise the gastrointestinal adverse effects of oral iron supplements.
展开▼
