I am anemic even after taking iron supplements. Why?

Question

Hi doctor,

I have a history of anemia. I have been taking iron supplements prescribed by my doctor for the past few months. After a while, I had an appointment, and my doctor said that I am still very anemic. A few years ago, I had an eating problem. I was overeating, but I did not gain weight. Is there something wrong with me?

Answer 1

Hi,

Welcome to icliniq.com. If you are taking supplements regularly, it's important to consider whether you truly have iron deficiency anemia or if there might be ongoing blood loss, such as through menstruation or in your stools. The first step should be to undergo a peripheral smear test and serum iron studies to determine the presence of iron deficiency. If these tests show no evidence of iron deficiency, then it's advisable to check serum vitamin B12 and folic acid levels, as these can also contribute to anemia. If the diagnosis is indeed iron deficiency anemia, it's recommended to pause iron supplements for three to four days and undergo stool testing for occult blood to identify the underlying cause. If the occult blood test is positive, further investigations may be necessary. Following diagnosis, you should discuss appropriate treatment and potentially higher-dose iron supplements with your healthcare provider. It's crucial to have a thorough discussion with your doctor regarding these issues.