How Iron Deficiency Anemia Is Treated

Medically reviewed by Jane Kim, MD

Iron deficiency anemia (IDA) occurs because your body lacks adequate iron to produce enough hemoglobin. The goals of treatment for IDA are to treat underlying causes and to restore levels of red blood cells (RBCs), iron, and hemoglobin.

Treatment might include home remedies and lifestyle changes, over-the-counter (OTC) therapies, prescriptions, blood transfusions, and intravenous (IV) iron therapy. Options depend on the severity of IDA and what has caused it.

IDA cannot be corrected overnight. With some time and diligence, iron levels can be restored back to normal levels. Keep reading to learn about IDA and your various treatment options available for improving iron levels and reducing IDA's effects.

Home Remedies and Lifestyle

There are home remedies and lifestyle changes related to diet that can help you to improve iron levels.

Increase Your Dietary Iron Intake

Aim to eat a healthy, balanced diet that includes good sources of iron to avoid deficiency. The best source of iron is heme iron, which includes animal-based foods such as red meat, poultry, and seafood.

Iron-rich non-heme sources, including tofu, legumes, and spinach, also contain iron, but the iron from those foods is not as easily absorbed.

Some foods high in iron, such as red meat, may also be high in saturated fat and should only be eaten in healthy amounts.

Related: Which Foods to Eat When You Have Anemia

Increase Your Vitamin C Intake

According to a 2020 report in the medical journal JAMA Network Open, vitamin C is the only dietary ingredient other than animal products that might help promote the absorption of iron.

Foods that are rich in vitamin C include vegetables, such as broccoli, cabbage, and tomatoes; fruits, including strawberries and citrus; and juices, including tomato and orange juice. To increase iron absorption, include vitamin C–rich foods in the same meal as iron-rich foods.

Be Mindful of Caffeine

Try to avoid drinking caffeinated beverages, including coffee and tea, while consuming iron-rich foods and iron supplements. Several studies have found that coffee and other caffeinated beverages can inhibit iron absorption.

A 2020 review of studies reported in the Journal of Nutrition and Metabolism noted a study that found one cup of black tea reduced iron absorption by up to 64% and one cup of coffee reduced iron absorption by up to 39%. Another study in the review found that the absorption reduction from black tea ranged from 79% to 94%.

The effects of caffeine on iron last only a short time, according to a study reported in 2017 in The American Journal of Clinical Nutrition. This means that if you have a cup of coffee, wait an hour or more, and then eat a meal of iron-rich foods or take an iron supplement, the coffee likely won’t have any effect on the iron.

Other common substances in food or medications that inhibit iron uptake include antacids, calcium supplements, phytic acid/phytates in bran, and proteins in soybeans, milk, and eggs.

Over-the-Counter (OTC) Therapies

The amount of iron found in food is often small compared with what you need to treat IDA. That means that diet alone is not enough to improve your iron levels. According to the American Society of Hematologists, when a person has been diagnosed with iron deficiency, they will likely need to take iron orally or intravenously.

See a Doctor Before Taking an Iron Supplement

You should see a doctor if you or your child develops symptoms of IDA. You should never self-diagnose or self-treat IDA. Do not start taking iron supplements without first talking to a doctor because it is possible to overload on iron. Excess iron can damage the liver and lead to other serious complications.

You don’t need a prescription for iron supplements, but you should work with your doctor to find the right supplement and dose. For most adults with IDA, 100 to 200 milligrams (mg) is the recommended amount per day.

Lots of different iron formulations are available over the counter (OTC), and they are generally equally effective, with similar side effects. However, note that enteric-coated iron is not recommended, as the iron is not well-absorbed.

Most supplements need to be taken two or more times a day. Extended-release iron products can be taken once daily.

Iron supplements can cause side effects, including abdominal pain, nausea, diarrhea, constipation, and dark stools. Taking iron supplements with a meal can offset some of these effects.

Prescriptions

Prescription treatment for IDA falls into two categories—treating the IDA and treating the underlying causes of the IDA.

Prescription Drug Therapies

Prescription drug therapies used to treat IDA might include ferrous sulfate, erythropoietin (EPO) injections, and iron infusion therapy.

Ferrous Sulfate

Prescription ferrous sulfate is used to treat or prevent low iron. It is available under several brand names and can also be found over-the-counter.

Your doctor will prescribe the dosage based on the recommended daily allowance for your age and health status. For adults with IDA, the dosage for prescription ferrous sulfate is 100 to 200 mg per day.

For maximum absorption, ferrous sulfate should be taken on an empty stomach. But taking supplements with meals can help reduce gastrointestinal (GI) side effects. You may also discuss taking iron supplements every other day to reduce the GI side effects.

Do not stop taking prescribed iron supplements without first talking to your doctor. If you are experiencing severe side effects, such as metallic taste or stomach troubles, reach out to your doctor. They can recommend other treatment options that might be easier for you to take.

Erythropoietin (EPO) Injections

The kidneys produce erythropoietin, which can stimulate the bone marrow so the marrow produces more red blood cells. Your doctor might prescribe EPO injections if you have IDA that has been caused by kidney disease or cancer.

Iron Infusion Therapy 

An iron infusion involves delivering iron into the body intravenously—into a vein through a line. Iron infusions are prescribed by doctors to treat IDA in people who can’t take iron by mouth or who can’t absorb iron adequately.

It is also prescribed in cases where iron levels need to be improved quickly, such as to avoid a blood transfusion or medical complications.

Treating Underlying Causes

Iron supplementation doesn’t do much good if the underlying cause of IDA isn’t addressed. For example, heavy menstrual bleeding and gastrointestinal bleeding are causes of IDA that can be addressed and treated.

Doctors can prescribe birth control pills to people who have heavy periods to reduce the amount of menstrual bleeding they experience monthly. Internal GI bleeding, from causes such as stomach ulcers and colon polyps, can also lead to IDA. These can be treated with antibiotics and other medications, or with surgery.

Surgeries and Specialist-Driven Procedures

While rare, you might need a procedure to treat IDA. Surgeries and specialist-driven procedures include a blood transfusion or surgical repair of a bleeding ulcer or stomach tear.

Blood Transfusion

In the most severe cases, a blood transfusion is the quickest way to replace red blood cells. A blood transfusion is a procedure where donated blood is given through a line placed into a vein, usually in your arm.

This can be a lifesaving procedure to replace blood due to a medical condition, surgery, or injury. Blood transfusions usually occur without complications, and when complications occur, they are usually mild.

Surgical Repair of a Bleeding Ulcer

A bleeding ulcer or stomach tear may need to be repaired. A surgical procedure can stop blood loss and reduce any further damage from the tear or ulcer.

The bleeding from a bleeding ulcer can be stopped using a laser during an endoscopy—a procedure that involves using a thin flexible tube (the endoscope), with a light, camera, and tiny instruments. The endoscope is placed down the mouth into the stomach while you are sedated.

If the laser cannot stop the bleeding, your doctor might perform a partial gastrectomy to remove the part of the stomach that is affected by the ulcer. Fortunately, surgery to manage a bleeding ulcer is rarely necessary, and only about 5% to 10% of people with bleeding ulcers need surgery.

Complementary and Alternative Medicine (CAM)

Complementary and alternative medicine (CAM) is the medical term for therapies that are not part of standard medicine. There are no CAM therapies that are considered safe or effective for treating IDA.

If you have IDA, your doctor is the best source of advice on CAM therapies. It is never a good idea to start a CAM therapy for IDA without first speaking with your doctor.

Summary

Iron deficiency anemia is treated by restoring iron levels and addressing underlying causes. Rather than self-diagnosing and using supplements, it is important to see a doctor to determine the correct treatment.

Iron supplements and diet modifications may be suggested. Sometimes a blood transfusion or iron infusion is needed to get faster restoration. Surgery may be needed to address problems that lead to IDA.

A Word From Verywell

Iron deficiency anemia has many causes, and treatment is generally tailored around what has caused your IDA and the effect it might have on your health. The outlook for IDA is good provided you receive appropriate treatment.

Left untreated, IDA can lead to serious complications, such as frequent infections, growth and behavior problems in children, and complications of pregnancy, including premature birth, having a low-birth-weight baby, and postpartum depression.

Talk to your doctor if you think you are experiencing signs of IDA, such as chronic fatigue, shortness of breath, heart palpitations, headaches, and pale skin. Your doctor can administer blood work and determine the source of your symptoms.

Read the original article on Verywell Health.