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

Such as a patient who cannot tolerate oral iron and has had a anaphylaxis to intravenous iron
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How do you approach iron supplementation in an iron deficient patient who cannot tolerate oral iron and who has had a severe infusion reaction to IV iron?

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4 Answers
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Mednet MemberInvited Expert
Hematology · Georgetown University School of Medicine
Answered on

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...

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Mednet Member
Medical Oncology · Midwestern Reg Medcl Center
Answered on

Use a different iron IV given with premedications.

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Medical Oncology · SSM Health Medical Group
Answered on

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.

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Mednet Member
Hematology · Mount Sinai
Answered on

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

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