Q. Will iron tablets cause constipation?

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• If she is having chronic anemia then one advice would be to make sure that it is due to iron deficiency anemia indeed and not due to other deficiency or thalassemia minor.

• If hemogram was done, red blood cell distribution width RDW of ≥15% and picture of microcytic or normocytic hypochromic anemia with anisopoikilocytosis (red blood cells of unequal size) will be indicative of iron deficiency and no other test would be needed.

• If not so, serum ferritin and high performance liquid chromatography - HPLC to rule out thalassemia would be recommended.

• For confirmed iron deficiency anemia, preferred medicine of choice should be Orofer XT 100 mg daily.

• If it causes too much constipation then second preferred would be capsule Softeron (Combination of Ferrous fumarate and Folic acid), taken twice daily initially for a month and then daily for three months.

• Measures to prevent constipation will be the same like drink lots of water, keep yourself moving, eat green leafy vegetables and high fiber diet.

• Hemoglobin should return to normal in four to six weeks and treatment for further 8-12 weeks will be required to replenish stores.

• Addition of injection Vitamin B12 500 mcg or 1000 mcg to be taken on the alternate days. Four to six injections may be desired if she is a pure vegetarian.

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