- Iron supplement (oral/parenteral)
- Erythropoiesis-stimulating agents (Erythropoietin,Epoetin alfa ,Epoetin beta ,Darbepoetin alfa,Methoxy polyethylene glycol-epoetin beta)
Check for symptoms
- Most commonly, people with anemia report feelings of weakness, or fatigue, general malaise(uneasiness), and sometimes poor concentration. They may also report dyspnea (shortness of breath) on exertion.
- In very severe anemia, the body may compensate for the lack of oxygen-carrying capability of the blood by increasing cardiac output. The patient may have symptoms related to this, such as palpitations, angina (if pre-existing heart disease is present), intermittent claudication(muscle pain) of the legs, and symptoms of heart failure.
- In severe anemia, there may be signs of a hyperdynamic circulation: tachycardia (a fast heart rate), bounding pulse, flow murmurs, and cardiac ventricular hypertrophy (enlargement). There may be signs of heart failure.
- The consumption of non-food items such as ice, but also paper, wax, or grass, and even hair or dirt, may be a symptom of iron deficiency, although it occurs often in those who have normal levels of hemoglobin.
- Chronic anemia may result in behavioral disturbances in children as a direct result of impaired neurological development in infants, and reduced scholastic performance in children of school age. Restless legs syndrome is more common in those with iron-deficiency anemia.
Anemia is typically diagnosed on a complete blood count.
Normal Haemoglobin according to W.H.O
Age or gender group
Hb threshold (g/dl)
Hb threshold (mmol/l)
Children (0.5–5.0 yrs)
Children (5–12 yrs)
Teens (12–15 yrs)
Women, non-pregnant (>15yrs)
Classification of Anemia by Cause:
Excessive hemolysis (RBC destruction)
- impaired red blood cell (RBC) production,
- increased RBC destruction (hemolytic anemias),
- blood loss and fluid overload (hypervolemia).
- Several of these may interplay to cause anemia eventually. Indeed, the most common cause of anemia is blood loss, but this usually does not cause any lasting symptoms unless a relatively impaired RBC production develops, in turn most commonly by iron deficiency.
Counselling on side effects:
- When taking iron supplements, stomach upset and/or darkening of the feces are commonly experienced. The stomach upset can be relieved by taking the iron with food; however, this decreases the amount of iron absorbed. Vitamin C aids in the body’s ability to absorb iron, so taking oral iron supplements with orange juice is of benefit.
- Milk products and Calcium supplements decrease the absorption of iron so more time gap to be maintained between iron supplements and calcium supplements.
The amount of iron ingested may give a clue to potential toxicity. The therapeutic dose for iron deficiency anemia is 3–6 mg/kg/day. Toxic effects begin to occur at doses above 10–20 mg/kg of elemental iron. Ingestions of more than 50 mg/kg of elemental iron are associated with severe toxicity.
A 325-mg tablet of ferrous sulfate has 65 mg (20%) of elemental iron
A 325-mg tablet of ferrous gluconate has 39 mg (12%) of elemental iron
A 325-mg tablet of ferrous fumarate has 107.25 mg (33%) of elemental iron