Anemia - Iron-Deficiency Follow Up

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 and then every 3 months for 1 year. 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, 1 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.