Anemia is common in IBD and iron deficiency is the leading cause. Studies show up to 95% of individuals newly diagnosed with IBD are iron deficient. Learn more about iron deficiency and IBD from the ICN Registered Dietitian group, including common symptoms, as well as what to expect with testing, treatment, management and prevention.

Symptoms of iron deficiency

Symptoms of iron deficiency may include fatigue, weakness, headache, poor appetite, trouble sleeping, and dizziness. These symptoms can be impactful and affect quality of life.

Testing for iron deficiency

There are different ways to evaluate someone for iron deficiency. Many of the blood tests used to evaluate for iron deficiency can be affected by inflammation, which can make diagnosis difficult.

Have you or your child had symptoms of iron deficiency or been recently diagnosed with IBD? It is important to ask your provider if they have ordered screening labs for iron deficiency.

Treatment of iron deficiency

If the diagnosis of iron deficiency has been made there are several options for treatment. One way is to take a supplement by mouth. There are different forms of iron, some can be taken once daily and others are taken a few times per day. These are usually over the counter or sometimes prescribed to your local pharmacy. Some may be easier on the stomach than others. Intravenous (IV) forms of iron are also available. IV iron is usually well tolerated, however, it is more expensive.

There are pros and cons to each iron deficiency treatment. It is important to discuss with your provider which treatment is right for you or your child.

Evaluating iron deficiency treatment

It is important to evaluate if the iron deficiency treatment is working. After starting iron treatment you or your child should have iron labs rechecked (usually after 2-4 months of treatment). Once iron deficiency is resolved, the iron supplement can likely be stopped. If the iron deficiency is not resolved, the treatment may need more time or a different treatment may be needed.

Ensuring iron deficiency does not recur

Once an iron deficiency is corrected, it is important to include iron in your or your child's diet and take a multivitamin, which contains iron daily to help to maintain iron levels (DYK: most gummy multivitamins do not contain iron). Iron-rich foods include animal meats, eggs, seafood, beans, iron fortified breads and cereals, and some fruits and vegetables such as leafy greens and raisins.

Ask your provider or dietitian for more information on eating well for preventing a recurrence of iron deficiency.

This post was written by Jen Smith MS RD CSP LD LMT, Clinical Dietitian and Massage Therapist at Nationwide Children's Hospital with input from the Registered Dietitian (RD) group of ImproveCareNow. The RD group submits periodic posts to LOOP, covering nutrition-related topics of interest to the IBD Community. All posts by the RD group will be tagged with #ICNRD so you can find and read them all by visiting: Is there a topic you're interested in reading more about? Please leave a comment below 💚💙
Source list:
Cronin CC, Shanha n F. Anemia in patients with chronic inflammatory bowel disease. Am J Gastroenterol. 2001;96:2296-2298.
Wiskin AE, Fleming BJ, Wootton SA, Beattie RM. Anaemia and iron deficiency in children with inflammatory bowel disease. J Crohns Colitis. 2012;6(6):687-691. 
Goyal A, Zheng Y, Albenberg LG, Stoner NL, Hart L, Alkhouri R, Hampson K, Ali S, Cho-Dorado M, Goyal RK, Grossman A. Anemia in children with inflammatory bowel disease: a position paper by the IBD committee of the North American Society of Pediatric Gastroenterology Hepatology and Nutrition. 71;4:563-582.


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