Anemia of chronic disease - no improvement

Patient

Q: My 10-year-old son has a hx of Crohn's colitis dx three years ago. He is also post-CVA (caused by hypercoagualable state of IBD). He has had ongoing anemia which was thought due to his very poorly controlled IBD and the constant blood loss. He is (finally) in relative remission but his anemia is not improving. He was switched to liquid iron 6 mls t.i.d., three months ago, but the only change is that all his iron levels are STILL getting lower. I understand that his iron stores will take some time to improve but why would the rest of his iron levels continue to decrease even while he's on a supplement and not losing blood?

Doctor

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