Monitoring
Correction of iron-deficiency anemia usually occurs within 2-4 months of appropriate therapy. There are no standard recommendations for follow-up after starting iron therapy. It is advised to have CBC monthly for 3 months, every 3 months for 1 year, then every 6 months for 2-3 years. Response to iron therapy is expected after 2-3 weeks of treatment and may be seen as reticulocytosis in 4 days and hemoglobin >10 g/L in 4 weeks. If there is no favorable response, it may mean non-compliance, continued blood loss with inadequate iron replacement, malabsorption, wrong diagnosis or other complicating factors (eg H pylori infection, celiac disease), thus further investigation and reassessment of treatment is advised. If the hemoglobin and RBC indices remain normal, one additional CBC should be obtained 12 months later. Further follow-ups are not necessary if the patient is asymptomatic and the hematocrit level is normal.