How do you approach the management of a patient with symptomatic iron deficiency anemia who is intolerant of iron?

Oral iron will not work. I would bet my last dollar there was no anaphylaxis but rather an imprudently treated minor infusion reaction which is the cause of ostensible “anaphylaxis” over 99% of the time. You can’t verify that it was real because I can assure you:

1. It was not.
2. They did not do a trypt...

Use a different iron IV given with premedications.

Lucky Iron Fish has worked very well for my patients, including patients with inflammatory bowel disease. No GI intolerance issues and it has reduced the amount of IV iron I have given.

I have had empiric success in placing the iron in a larger volume and infusing at a slower rate, particularly in pregnant patients.