Iron-deficiency anaemia – treatment in the primary care physician’s clinic

Iron-deficiency anaemia is the most common diagnosed anaemia. A daily, properly balanced diet protects against iron deficiency. An important role in controlling iron store is played by hepcidin and chelating proteins, the levels of which are used in diagnostics. Iron homeostasis does not include mechanisms of removing iron overload. The appearance of iron deficiency in an adult male or in postmenopausal female means blood loss until proven otherwise. Iron deficiency anaemia may be the first symptom of gastrointestinal cancer. For the majority of cases oral iron therapy is adequate. This treatment, however, should not be provided hastily, without conducting iron store measurements.

The free iron concentration is of low diagnostic value. The highest specificity for iron deficiency is reduced concentration of ferritin and reduced iron saturation of transferrin. The serum ferritin level is the most convenient laboratory test to estimate iron stores.

The goal of therapy in patients with iron-deficiency anaemia is not only to repair the anaemia, but also to provide the stores.