Day 2- Anemia
Iron Deficiency Anemia (CMAJ)
Most people with iron deficiency will need 150-200mg per day of elemental iron (2-5mg of iron per kg body weight per day)
Use ferrous fumarate, sulfate or gluconate once-daily or every-other-day dosing
Iron salts require an aciditc environment for absorption and should be taken on an empty stomach (with orange juice or vitamin C)
IV iron is indicated when: (Blood and Clots)
oral iron poorly tolerated or failure of oral trial
poor oral absorption (ie. gastritis)
rate of bleeding is too brisk for oral iron
severe anemia (Hb<90 g/L) especially if ongoing bleeding
time-sensitive pressures (ie. OR)
See transfusion blog post for indications for pRBC !
B12 Deficiency (CMAJ)
Vitamin B12 deficiency occurs frequently (>20%) among elderly people, but is often unrecognized
Causes include: food-cobalamin malabsorption syndrome (>60% of all cases), pernicious anemia, insufficiency dietary intake and malabsorption
250-500 ug of vitamin B12 daily, consider IM injection if very low
NEJM Manifestations of Vitamin B12 Deficiency