Health encyclopaedia - Alphabetical Topic List
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Treatment of Anaemia
Iron deficiency anaemia is managed by treating the underlying cause and replacing the iron that is missing from the body.
Taking iron tablets is the usual way of building up normal levels of iron again and should be taken until the blood level is back to normal and then for a further three months to build up the iron stores.
A different iron preparation or a lower dose (taken for longer) may be an option if the standard treatment produces side effects such as an upset stomach, constipation or diarrhoea.Stools (faeces) may be black when iron is taken. Tests may be advised if the cause of the anaemia is not clear.
The adverse effects of iron tablets are mainly feeling sick (nausea), abdominal pain, diarrhoea or constipation. These are directly related to the amount of iron in the intestine.
Another full blood test may be done two weeks after treatment has started, in order to assess treatment response. The haemoglobin level should rise by about 0.1g to 0.2g per decilitre per day (about 2g per decilitre every three weeks). Iron replacement will normally be continued for three months once the haemoglobin has returned to normal, in order to replenish iron stores in the body.
Failure to respond to treatment usually means that tablets are not being taken properly. However, it can be due to continuing excessive blood loss, failure to absorb the iron, an inflammatory disease, or another cause of anaemia.
If iron taken by mouth cannot be tolerated, or if more iron is being lost than can be absorbed by mouth, then providing iron by injection or through a vein may be considered.
The treatment of pernicious anaemia is also highly effective. A form of vitamin B12 known as hydroxocobalamin is given twice in the first week and then weekly until the blood is normal. In very severe cases a blood transfusion may be needed. Once normal a dose of vitamin B12 needs to be taken every three months for life.
Haemolytic anaemia may be treated by removing the spleen where most of the red cell destruction occurs. This is usually very effective.
Aplastic anaemia may be more difficult to treat. Because all the cells produced in the bone marrow are affected, no immune system cells are produced, putting the individual at considerable risk of contracting infections. Bleeding may be a problem because of the absence of bone marrow products called platelets that are needed for blood clotting. Without treatment the condition can lead to death.
In the presence of a matched donor and young people with severe or very severe aplastic anaemia, a bone marrow transplant is usually the treatment of choice. People without a donor are usually given immunosuppressive therapy (IS) as first line treatment, and require regular blood transfusions.During (and before) pregnancy.
If possible, it is recommended that women take folic acid supplements for three months before they become pregnant. In cases of unplanned pregnancy it is recommended that women start taking folic acid as soon as they know they are pregnant for at least the first 12 weeks of pregnancy. The recommended dose is 400 micrograms daily a day. Folic acid can be found in green leafy vegetables, root vegetables, mushrooms, fruit, nuts and pulses.
Iron tablets are recommended for pregnant women who may not be getting enough iron from their diet. The normal recommended daily dose for a pregnant woman is 30mg. Around the 20th week is when the most iron will be needed, as this is when the most extra blood production happens. Iron can be found in leafy green vegetables (e.g. broccoli, spinach, kale), lean red meat (e.g. pork, lamb or beef),strawberries and fibre-rich or wholemeal foods. Vitamin C helps the body absorb iron, this can be found in orange or cranberry juice or taken as a supplements. Tea and coffee affect the body’s absorption of iron and should be reduced or eliminated from the diet.
