Ms. Xu, 35, a middle school teacher, and Mr. Zhang, 69, a retired worker, both experienced dizziness, weakness, panic attacks and other uncomfortable feelings in recent months, and people around them noticed that they “looked bad” and urged them to come to the hospital. In addition to “pallor”, there were no other positive findings. So I gave them each a routine blood test. Twenty minutes later, the results came back, and both blood tests indicated “moderate microcytic hypochromic anemia”, “probably iron deficiency anemia again”, I thought. I gave Zhang three fecal occult blood tests and instructed him to visit the gastroenterology department for a careful examination of the digestive tract, except for gastrointestinal lesions. Ms. Xu was advised to visit the gynecology department to exclude gynecological disorders. A few days later, the two patients came to me again with the lab report and the opinions of other departments, and the “iron triple” lab results further confirmed the diagnosis of “iron deficiency anemia”, and Ms. Xu was diagnosed with “uterine fibroids” by the gynecology department. Ms. Xu was diagnosed with “uterine fibroid” by the gynecology department and had to undergo an elective surgery, and Mr. Zhang was diagnosed with “colon cancer” and was scheduled for surgery by the surgery department. These scenarios are frequent in hematology clinics because iron deficiency anemia is the most common of all anemia types, accounting for about 50% to 80% of anemia, and is prevalent throughout the world, occurring in all ages, especially in women and children of childbearing age. The main causes of iron deficiency anemia are: 1. Insufficient intake and increased need are mainly seen in children during growth and development and in pregnant and lactating women. 2. Excessive loss: Chronic blood loss due to various causes is the most common reason, mainly seen in excessive menstruation, recurrent nasal bleeding, gastrointestinal bleeding, hemorrhoid bleeding, etc. 3, malabsorption: gastric and duodenal resection, chronic gastroenteritis, chronic atrophic gastritis, addiction to strong tea, etc. In addition, a large amount of chronic intravascular hemolysis, such as paroxysmal sleep hemoglobinuria (PNH), where iron is excreted from urine with iron-containing hemoglobin or hemoglobin, can also cause iron deficiency anemia. Iron deficiency anemia is not difficult to diagnose and the treatment is relatively simple, but whether it can be cured depends crucially on whether the cause can be removed. For women of childbearing age like Ms. Xu, if there is a problem of excessive menstruation, they should ask for gynecological help to solve it, otherwise once they stop taking iron supplements, iron deficiency anemia will soon recur. As for male patients like Mr. Zhang and postmenopausal women, who do not have menstrual blood loss problems, once diagnosed with iron deficiency anemia, it is important to exclude gastrointestinal blood loss diseases, especially gastrointestinal tumors, otherwise not only is iron supplementation ineffective, but also the best time for treatment may be missed as a result. While removing the cause of the disease, iron supplementation therapy can be started, commonly used as Sulforaphane
0.1g, 3 times/d. After taking iron orally, reticulocytes start to rise in 5-10 days, reaching a peak in 7-12 days, and then start to decline, and hemoglobin starts to rise after 2 weeks, recovering in 2 months on average. In conclusion, the key to the treatment of iron deficiency anemia is etiological treatment.