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Anemia question

Discussion in 'Medical Students - MD' started by closertofine, Nov 23, 2005.

  1. closertofine

    closertofine Emerging from hibernation
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    Quick question: how is it possible for a person to have iron-deficiency anemia while taking a multivitamin with 100% of the RDA for iron? Could blood donation be a cause?

    Would it be treated by adding an iron supplement on top of the multivitamin?

    OK, so that was more than one question...just wondering if anyone has an idea...
     
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  3. velo

    velo bottom of the food chain
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    Could have an intestinal malabsorption problem. Iron is absorbed almost exclusively in the duodenom, so processes that affect the duodenum like celiac sprue (caused by an allergy to glutton containing products i.e. wheat) could conceivably cause "iron deficiency" anemia.

    You'd also want to confirm that this is "iron deficiency" anemia and not hypochromatic microcytic anemia that has been incorrectly labeled iron deficiency. The differential there would be a little broader and include things like thalassemia, lead poisoning, or even the so-called "anemia of chronic disease."

    A more complete history and more details about the lab values would be required to really give a good answer.
     
  4. velo

    velo bottom of the food chain
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    oh and no it couldn't be blood donation. If you actually got anemic from that it would be normocytic and wouldn't be confused with iron-deficiency.
     
  5. If you mean this in a short term context your are correct but in the long term that is incorrect -- blood donation with inadequate iron replacement for whatever reason is no different than menstruation or occult GI bleeds without adequate iron replacement. It is possible to get iron deficient.
     
  6. velo

    velo bottom of the food chain
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    True but I was going off of the OP in which he claimed to be taking an iron containing multivitamin
     
  7. mustangsally65

    mustangsally65 Sally 2.0
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    Is the vitamin just for one gender, or is it not specified? If it's not specific, then you have to think that menopausal women don't need as much iron as pre-menopausal women, while men don't need as much as women (I think!).
     
  8. fielight

    fielight Senior Member
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    iron deficiency anemia is, most of the time, due to chronic blood loss (menorrhagia, colon cancer, tapeworms), but can occur in the elderly (insufficient intake from diet), babies (no iron in breast milk), pregnant women (increased need), and children/teenagers (due to growth spurt). to properly diagnose though, things like serum iron, ferritin, TIBC, blood smears would be needed. an IM doctor told me once that you'd never just give the patient iron for iron deficiency anemia, because there's probably something else going on... and (i believe), in the case of blood loss, giving iron may improve the anemia somewhat, but the patient will only get worse over time.
     
  9. closertofine

    closertofine Emerging from hibernation
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    thanks, you all...I'm a little embarrassed to admit it, but now I'm not exactly sure if this was correctly classified as iron deficiency anemia. The lab test that I saw showed low ferritin, and a nurse there referred to it as an anemia for which iron supplements should be prescribed...so I guess I drew my own (logical?) conclusion that it would be considered iron deficiency anemia. If not, then I guess I'm way off track...thanks again for the info!
     
  10. closertofine

    closertofine Emerging from hibernation
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    I'm guessing it wasn't specific...I hadn't thought of that...thanks!
     
  11. closertofine

    closertofine Emerging from hibernation
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    hmm, thought of something else...the multivitamin contained 100% of the RDA for iron, which I think is 18 mg, while the iron supplement added has 325 mg. I'm not sure why that high of a level is prescribed, unless it's to "build back" iron stores that are deficient?
     
  12. cytoskelement

    cytoskelement Dr. D.R.E.
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    very little iron is absorbed through the GI track. its to assure that you absorb the 18 you need.
     
  13. ruler

    ruler Member
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    hi,the problem is most commenly one of malabsorption problems like chrons‘disease or tropical sprue but it may be sideroplastic anaemia(arefractory type)znd in this case if you give iron supplement it may leads to iron over load you depend on the peripheral blood picture and examination of the bone marrow to deffrentiate. :luck: :luck:
     
  14. boilerbeast

    boilerbeast suPURDUEper
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    There's two kinds of dietary iron, heme (from animal products) and non-heme (in veggies/supplements/whole grains, etc. Heme-iron is absorbed really well, whereas only a small percentage of the non-heme iron is absorbed. The amount on the label is the amount ingested, not the amount absorbed. Ascorbic acid increases absorption of non-heme iron.

    Take home-point: Take the iron supplement with orange juice and eat some meat.

    I was a dietitian in my former life. :) Just my $.02.
     
  15. closertofine

    closertofine Emerging from hibernation
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    thanks...I should have mentioned this before, but I'm a vegetarian...guess that could be a big part of the problem...but there's no way I could bring myself to go back to eating meat. I'll definitely try the orange juice, though. Thanks! :)
     

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