Iron-deficiency anaemia Q&As
Published by Bupa's health information team, October 2008.
Answers to questions about iron-deficiency anaemia
This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.
- Will my anaemia need to be monitored? How often should I go back to see my GP?
- I get an upset stomach when I take iron tablets, what should I do?
- I've heard that taking too many iron tablets can be harmful, why is this?
- What is hookworm infection and how does it cause iron-deficiency anaemia?
Will my anaemia need to be monitored? How often should I go back to see my GP?
Once you have been diagnosed with iron-deficiency anaemia and started treatment, you will need to go back to see your GP for further blood tests to make sure that your blood count and iron levels have returned to normal.
Explanation
The most common treatment for iron-deficiency anaemia is a course of iron tablets, such as ferrous sulphate (eg Feospan). Usually, you will need to take these two to three times a day. However, this can vary, so you should take them as directed by your GP. Always read the patient information leaflet that comes with your medicine.
You will be asked to go back for a blood test (full blood count) two to four weeks after starting your iron tablets to check that they are having an effect. You will then need to return two to four months later to ensure that the blood count has returned to normal.
Once your GP is happy that your blood count is normal, you will be instructed to continue taking your tablets for a further three months. This is to make sure that your body iron stores are completely topped up. When you stop taking your tablets, you will need to return to your GP for a blood test after a few months. If your blood count and iron level fall again you will be given another course of iron tablets.
If you don't respond to the iron tablets prescribed by your GP, you may be referred to a haematologist for further investigation. A haematologist is a doctor who specialises in treating blood disorders. It's very important to understand why you have iron-deficiency anaemia because it's usually caused by blood loss. In women this is most often menstrual bleeding, but in men and older women the possibility of bleeding from the stomach or bowel must be investigated.
If you have any questions or concerns about iron tablets or iron-deficiency anaemia, talk to your GP.
Sources
- Anaemia - iron deficiency. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 5 August 2008
- Guidelines for the management of iron-deficiency anaemia. British Society for Gastroenterology. www.bsg.org.uk, accessed 6 August 2008
I get an upset stomach when I take iron tablets, what should I do?
Some people find that they get an upset stomach when taking iron tablets, but it's important to continue taking the tablets as directed by your doctor if at all possible. If needed, you can take over-the-counter medicines to ease your symptoms until they settle by themselves.
Explanation
When taking iron supplements, some people find that their digestive system is disturbed. This can cause:
- stomach pain
- constipation or diarrhoea, often with black stools
- heartburn
- nausea
Usually these symptoms settle down quickly, so there is no need to stop taking your tablets. In the meantime, there are medicines you can buy from your pharmacy to relieve your symptoms, for example, antacids for heartburn (eg Gaviscon) or medicines for constipation (eg Fybogel).
You could also try taking your tablets with or after food rather than on an empty stomach, and as one daily dose instead of spreading them out through the day.
It's important to follow your GP's advice and keep taking your iron tablets as directed. If they are causing you a lot of discomfort and your symptoms don't settle, go back to see him/her before you stop taking them. He/she will be able to advise you on alternative brands or formulations to try.
If you have any questions or concerns about iron tablets, talk to your GP.
Sources
- Anaemia - iron deficiency. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 5 August 2008
I've heard that taking too many iron tablets can be harmful, why is this?
Taking an overdose of iron tablets (a large number taken at one time) is extremely dangerous, and can be fatal. It can cause damage to your gut and acute liver or heart failure. Taking iron tablets over a long period of time when you don't need them can also be harmful.
Explanation
Taking an overdose of iron tablets is harmful to the body for two reasons. Firstly, it can have a corrosive effect on your gut, and secondly, it's highly toxic to organs such as the heart and liver and may cause irreversible damage.
Symptoms of iron overdose occur in four stages.
Stage 1 occurs within hours of taking the tablets. Symptoms include:
- feeling sick or actually being sick (this may contain blood)
- diarrhoea
- stomach pain
- bleeding from your bottom
- shock (in severe cases)
Stage 2 usually happens six to 12 hours later and lasts for 24 hours. Your initial symptoms disappear and you feel better.
Stage 3 - during this stage symptoms may include:
- headaches
- confusion
- convulsions
- coma
Stage 4 happens within three days of taking the tablets and may result in your developing acute liver failure. If this happens, you usually develop jaundice, which appears as a yellowy tinge to your skin and the whites of your eyes.
If you have taken too many iron tablets or you suspect someone has, it's vital to go to the hospital as quickly as possible - suspected iron overdose is a medical emergency. Treatment is best started within one hour of taking the tablets, so immediate action is critical.
Iron overdose is the commonest form of childhood poisoning, usually by tablets meant for adults. Iron tablets are often brightly coloured and sugar-coated, so can be mistaken as sweets by children. It's extremely important to ensure that all medicines and tablets are kept out of the reach of children.
Always read the patient information leaflet that comes with your tablets or medicines and follow the recommended dose, unless you have been instructed otherwise by your doctor.
Taking a normal dose of iron tablets over a long period of time when you don't need them can also be harmful, leading to iron deposition in various organs such as the liver, pancreas and heart, eventually causing damage and ultimately problems such as liver cirrhosis. It's particularly important to avoid taking unnecessary iron tablets in certain inherited conditions such as genetic haemochromatosis or thalassaemia.
If you have any questions or concerns about iron overdose, talk to your GP.
Sources
- Toxicity, Iron. eMedicine. www.emedicine.com, accessed 6 August 2008
- Iron poisoning. GP Notebook. www.gpnotebook.co.uk, accessed 6 August 2008
- Joint Formulary Committee, British National Formulary. 55th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:32
What is hookworm infection and how does it cause iron-deficiency anaemia?
Hookworm infection occurs when a parasitic worm (hookworm) gets into your gut and feeds on your intestine wall. This may result in chronic blood loss and is a common cause of iron deficiency in certain parts of the world.
Explanation
Hookworms are parasitic worms that you can pick up from eating contaminated foods or through your skin, usually the soles of your feet. They are commonly found in developing, tropical countries. It's estimated that over 740 million people in the world have hookworm infection.
Once inside your body, the hookworms pass into your lungs. They are then coughed up and swallowed down into your gut (gastrointestinal tract). Once there, they attach themselves to the wall of your intestine and feed on your blood.
Most hookworm infections are mild and there are usually no symptoms. However, if the infection is more severe, the blood lost from your gut (sucked by the worms) can lead to iron-deficiency anaemia. Other symptoms can include an allergic reaction in a specific part or all over your body, and stomach pain. These symptoms can be caused by many conditions, not just hookworm. It's important that you see your GP to get the correct diagnosis.
Once your GP has examined you and asked about your symptoms, he or she will ask you for a stool sample. This is because, once in your intestine, hookworms pass their eggs out through your faeces. You will also be asked to take a blood test. These will both be sent to a laboratory for analysis. Once diagnosed, your GP may refer you to a specialist in tropical diseases for treatment.
Treatment for hookworm infection is with a medicine called mebendazole (eg Vermox). You will need to take it twice daily for three days. You will also need treatment for your iron-deficiency anaemia. This is usually with a course of iron tablets, such as ferrous sulphate (eg Feospan). Always read the patient information leaflet that comes with your medicine.
If you have any questions or concerns about hookworm infection or iron-deficiency anaemia, talk to your GP.
Sources
- Hookworm. GP Notebook. www.gpnotebook.co.uk, accessed 7 August 2008
- Hookworm. eMedicine. www.emedicine.com, accessed 7 August 2008
- Joint Formulary Committee, British National Formulary. 55th ed. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, 2008:357
- Anaemia - iron deficiency. Clinical Knowledge Summaries. www.cks.library.nhs.uk, accessed 5 August 2008
Related topics
- Iron-deficiency anaemia
- Anaemia
- Constipation
- Indigestion
- Laxatives
- Treatments for indigestion
- Type 1 diabetes
- Type 2 diabetes
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: October 2008
Iron-deficiency anaemia factsheet
Visit the iron-deficiency anaemia health factsheet for more information.
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