Iron supplementation in iron deficiency anaemia

Patient

Q: I recently was diagnosed with iron deficiency anemia. My RBC is 3.51, Hemoglobin 10.9, and Hematocrit 32.4. Iron and Total Iron Binding Capacity-Iron, total 66, Iron Binding Capacity 396, % Saturation 17. Ferritin is 30 and Vitamin B12 is 383. My Dr. prescribed Ferrous Sulfate 325 MG Tablet, 1 tablet twice a day and Vitamin C to help in absorption. Is this too much iron? Also, I have acid reflux disease and the iron supplements are causing me to have more indigestion. I want to take only 1 tablet of iron a day with the Vitamin C to see if this will cut down on the heartburn symptoms. However, I am concerned if taking only 1 tablet will help my iron deficiency. I will be calling my Dr. on Monday, but would like to know what you advise also?

Doctor

A:   The initial adult dosage of regular-release ferrous sulphate is 325mg orally once per day for iron deficiency anaemia. However for maintenance, this regular-release preparation 325mg may be taken up to 3 times per day. I would advise administration of this preparation once daily, in addition to vitamin C, if you have minimal side-effects with a once daily dosage regimen. Twice daily dosing may raise iron stores more rapidly however if associated with more unpleasant side-effects, compliance with this medication may be difficult. For this reason once daily dosing may be sufficient, in addition to a diet of iron-rich foods.

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