Iron Deficiency and Replacement
| Objective: Monitor for and manage iron deficiency |
| Patient population: Adult patients (>18 years) with known diagnosis of IBD |
IBD Provider:
1. Review CBC (hemoglobin, MCV), Fe, Ferritin, FeSAT, TIBC.
2. Confirm iron deficiency (Ferritin <20 g/L or iron saturations <15%) or if active disease, Ferritin <100g/L, Iron saturations <15%.
3. Review hemoglobin (Hb)
- If Hb <70 g/L: consider urgent PRBC transfusion if symptomatic; or urgent iron infusion (if asymptomatic) and repeat Hb in 2 weeks.
- If Hb = 70-100 g/L: iron infusion and repeat Hb in 8 weeks.
- If Hb >100 g/L: oral iron supplements, if intolerant organize iron infusion, repeat Hb Ferritin, Fe, Iron studies, CRP in 12 weeks.
4. See Table 1 for Iron replacement options.
5. Arrange for IB iron replacement using the Iron patient care orders
6. Inform family physician of plan for iron replacement
Table 1 Options for Iron replacement
Resources:
Patient Education: anemia caused by low iron in Adults https://www.uptodate.com/contents/anemia-caused-by-low-iron-in-adults-beyond-the-basics (freely accessible)
American Society of Hematology (Patient Education) - Iron-Deficiency Anemia https://www.hematology.org/education/patients/anemia/iron-deficiency
