How to Treat Iron Deficiency Anemia
Iron deficiency anemia, or what used to sometimes be called iron-poor blood, occurs when there are not enough healthy red blood cells to carry oxygen to all the cells and tissues of your body.  Iron is needed by the body to make hemoglobin, which is the large, complex protein that transports oxygen into cells and transports carbon dioxide to the lungs. Anemia can be chronic or acute, and it can range from mild to severe.  If you have iron deficiency anemia, you can learn how to treat it.
1. **Choose a ferrous iron supplement.** Iron can exist in two ionic forms: ferrous and ferric. Ferrous supplements are better absorbed than ferric. These include ferrous sulfate, ferrous gluconate, ferrous fumarate, and ferrous citrate. Ferronyl is another form of iron that is better absorbed and commonly used in treatment of iron deficiency anemia. It can be found in supplements as well.

Look at the elemental iron content in supplements if listed. You want about 30% elemental iron. The greater the percentage or milligrams listed, the more iron is likely to be absorbed.

The dosage is usually 15 to 65 mg of elemental iron per day. This is usually best in divided doses.

Make sure your supplement is tested by an independent lab and has a “Seal of Approval” from either Consumer Labs, the Natural Products Association (NPA), LabDoor, or the United States Pharmacopeia (USP).
Ferrous is the standard treatment over ferric because it is absorbed better and it has less negative side effects.
2. **Take iron on an empty stomach.** Most of the adverse effects of an iron supplement can be avoided by taking the iron on an empty stomach, aside from orange juice. Vitamin C helps the body absorb iron.

You can drink orange juice along with the iron supplement or take a vitamin C supplement.
Do not take iron with milk, calcium supplements, or antacids. This will reduce the absorption of the iron.
Do not take the iron with high fiber foods, coffee, or tea.
3. **Be aware of the risks and side effects of iron supplements.** You should know that just because something is natural or required by the body does not mean you can’t overdo it. Iron is a good example. Iron supplements can be dangerous if you take too much. Follow the manufacturer’s instructions and keep them away from children.

A condition called acquired hemochromatosis can occur because of taking too much iron as a supplement. It can cause joint and abdominal pain, weakness, lowered sex drive, and fatigue.

Iron taken as supplements can cause an upset stomach, constipation, or black stools.

Talk to your doctor if you are also taking tetracycline, penicillin, ciprofloxacin, or drugs used for Parkinson disease and seizure disorders. Iron can interfere with these medications.
If you have peptic ulcer disease, enteritis, or ulcerative colitis, your should not take iron supplements.
4. **Incorporate enough iron into your diet.** You can get your recommended daily amount of iron from food sources. Many believe this is a safer and more effective way of increasing your iron. The amount of iron you need per day depends on your sex and your age. Use the following guide to determine how much iron you need:

Infants: Newborns – 6 months: 0.27 mg/day; 7 – 12 months: 11 mg/day.
Children: 1 – 3 years: 7 mg/day; 4–8 years: 10 mg/day.
Men over 9 years old: 8 mg/day.
Women: 9 – 13 years: 8 mg/day; 14 – 18 years: 15 mg/day; 19 – 50 years: 18 mg/day; 51 years and older: 8 mg/day.
Pregnant women should have 27 mg/day. Women who are nursing should get the following: 14 – 18 years old: 10 mg/day; over 18 years old: 9 mg/day.
5. **Eat iron-rich foods.** A good way to treat iron deficiency anemia is to incorporate more iron into your diet. There are many foods that provide good sources of iron. Iron can be found in almost every food group, and there are plenty of non-meat sources of iron for vegetarians and vegans. Iron rich foods include:

Lean red meat, liver, pork, poultry, and fish
Leafy greens like spinach, mustard greens, collard greens, Swiss chard, kale, and beet greens, along with broccoli and all different kinds of lettuce
Soy products, such as tofu, soybeans, and soy milk
Legumes, such as peas, white beans, red beans, and chickpeas
Dried fruits, such as raisins, apricots, and prunes
Prune juice
Whole grain cereals and breads that have been iron-fortified
6. **Limit iron-decreasing foods.** Certain foods can decrease your body’s iron absorption. If you have iron deficiency anemia, do not drink tea, coffee, or cocoa with your meals because they lower the amount of iron you absorb. You should also not take an iron supplement with your meals.
Don’t drink milk or eat other dairy products for at least an hour after taking iron. The calcium in dairy products may decrease iron absorption.
7. **See your doctor.** To receive the proper treatment, a medical diagnosis has to be determined. There are many forms of anemia, and there can be serious consequences if anemia is left untreated or treated incorrectly. Before you can treat the anemia, you have to understand the cause of it. Make sure you see your physician if you are experiencing any of the symptoms of anemia so that they can determine the underlying cause and proper diagnosis.

Your physician will perform a physical exam, listen to your heart and your breathing, and check for physical signs of anemia, such as pale skin and pale mucous tissues.
They will also likely draw a small amount of blood to obtain a Complete Blood Count. This is a test that counts the number of red blood cells and other cells in the blood. The test will also test for the amount of hemoglobin in the red blood cells. If the underlying cause of the anemia is not clear, other tests may be ordered.
8. **Treat any underlying causes of anemia.** To treat iron deficiency anemia, you may need to treat the underlying condition that led to the anemia. The treatment depends on your specific condition.

For iron deficiency anemia due to blood loss during menstruation, hormone treatments may be considered to lighten the flow.
For anemia due to bleeding in the digestive tract, antibiotics and antacids or acid-reducing medications may be prescribed.
In the case of lead poisoning, chelation therapy is used. In chelation therapy, certain drugs are used to bind to and filter out the lead.

Rarely, blood transfusions may be necessary in severe cases of iron deficiency anemia.
If the anemia is due to internal bleeding, surgery may be required to stop the bleeding.
Other possible reasons for iron deficiency include decreased iron absorption, Celiac disease, certain foods and medications, poor response to erythropoietin, or gastric bypass surgery.
9. **Identify the symptoms of iron deficiency anemia.** There are many different type of anemia, and anemia sometimes has generic symptoms that might be due to other conditions. This is why a doctor’s diagnosis is important. The symptoms of iron deficiency anemia include:

Constant fatigue not relieved by rest or sleep
Pale skin
Dizziness
A rapid or an irregular heartbeat
Cold hands and feet
Shortness of breath or difficulty breathing
Chest pain
Cognitive problems, such as confusion or memory loss
Headache
10. **Learn the causes of iron deficiency anemia.** Red blood cells contain a protein known as hemoglobin. Hemoglobin in the red blood cells picks up oxygen in the lungs and dumps out the carbon dioxide at the same time. Hemoglobin contains iron, and without the iron, hemoglobin can’t function properly. Also without sufficient iron, your bone marrow cannot make enough red blood cells, and the result is anemia. You can get iron deficiency anemia if you:

Don’t consume enough iron in your foods. This can be due to poor nutrition and pregnancy.
Can’t absorb the iron from your foods.  This can happen with certain disorders, such as celiac disease, or if part of your intestines have been removed by surgery.
Lose too much iron by some form of internal bleeding, such as bleeding in the intestine, heavy menstrual bleeding, or because of the use of certain medications like aspirin or NSAIDs that can cause internal bleeding.
Have lead poisoning. The lead replaces the iron in hemoglobin, and the hemoglobin cannot carry oxygen properly.
Take aspirin regularly, which can cause ulcers and lead to bleeding.
11. **Determine if you are at risk.** There are a  number of risk factors for iron deficiency anemia. Knowing if you are at risk can help you monitor for any symptoms or increase the amount of iron-rich foods in your diet. The most common risk factors include:

Gender.  Women who menstruate are at greater risk because they lose iron during their periods. Those with heavy periods are at a higher risk.
Age. Children and infants need more iron for proper growth and development.
Intestinal conditions that prevent the absorption of nutrients. Examples of these types of intestinal disorders are celiac disease, Irritable Bowel Syndrome (IBS)  and Irritable Bowel Diseases (IBD), and Leaky Gut Syndrome.
Pregnancy. Being pregnant can deplete a woman’s store of iron because it is being used to help produce blood in the fetus.
Nutrition. Many people don’t eat well and do not get enough iron in their foods. Vegetarians and vegans can be at risk for iron-deficiency as well, but only if they don’t include iron-rich foods in their diets.
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