(1) Selection of iron preparations Oral iron supplementation is the first choice for patients with iron deficiency anemia. This is because iron supplements are effective, cheap, and easy to apply. The main side effects of iron supplements include nausea, vomiting, upper abdominal discomfort and other gastrointestinal reactions. However, if taken during or after a meal, the gastrointestinal reactions will be significantly reduced.

Commonly used oral iron preparations include ferrous sulfate (0.3g per tablet, containing 60mg of iron), ferrous fumarate (0.2g per tablet, containing 66mg of iron), ferrous gluconate ( 0.3g per tablet, containing 34.5mg of iron), polysaccharide iron complex (containing 150mg of iron per tablet), ferrous succinate (0.1g per tablet, containing 22mg of iron), etc. The daily required amount of iron supplement is 150-200 mg per day based on iron element.

In addition to oral administration, iron supplementation can also be obtained through injection. However, because injectable iron supplements have serious side effects and may lead to overdose, we recommend that you take oral iron supplements.

Only when the patient has one of the following three conditions, we recommend parenteral iron supplementation (ie, iron injection).

(1) Used for patients with severe gastrointestinal reactions who cannot tolerate oral iron.

(2) Iron loss is too rapid, including late pregnancy, heavy blood loss, etc. Oral iron cannot compensate for the loss.

(3) Those with gastrointestinal diseases and unable to absorb iron, etc.

The main side effects of iron injections include pain at the injection site, headache, dizziness, fever, urticaria, joint pain, myalgia, hypotension, shortness of breath, and occasionally anaphylactic shock (in this case, should be rescued immediately).

The supplementary amount of iron injection is calculated according to the formula:

(Normal hemoglobin - patient's hemoglobin) Body weight (kg) 0.33

The result calculated by this formula For the total amount of iron supplement, the first dose starts with 50mg and is injected into deep muscle. If there is no obvious reaction, 100mg can be injected every day or every other day until the total dose is reached.

(2) Treatment time Under normal circumstances, patients with iron deficiency anemia will have an increase in peripheral blood reticulocytes 5 to 10 days after treatment with iron, and the hemoglobin concentration will increase after 2 weeks, until the hemoglobin It will take about 2 months to return to normal.

(3) After the hemoglobin returns to normal at the time of drug withdrawal, the patient needs to continue treatment for 3 to 6 months to replenish the amount of stored iron. Serum ferritin reaching 50 μg/L can also be used as a drug withdrawal indicator.

4. What should patients with iron deficiency anemia pay attention to when taking iron supplements?

The correct method of taking medication can enable patients to receive scientific treatment and their condition will be improved as soon as possible.

The same is true for the treatment of iron deficiency anemia. During treatment, attention should be paid to these four aspects: ① When starting iron treatment, a small dose should be taken first, and then the amount should be gradually increased to a sufficient amount; ② Iron supplements should be taken with or after meals to reduce gastrointestinal reactions; ③ For patients with anemia due to achlorhydria, 10% dilute hydrochloric acid and vitamin C should be taken together with iron supplements to help the absorption of iron. Vitamin C itself also has the function of promoting hematopoiesis; ④ For patients with non-iron deficiency anemia, taking iron supplements blindly will only cause waste and even be harmful to the body. Therefore, we remind everyone that iron supplements must not be used as ⑤ When taking iron supplements, you need to pay attention to dietary taboos, because some foods or medicines are not conducive to the absorption and utilization of iron, such as tea, milk, cereals, certain medicines, etc.