Brief Answer:
Check for bleed; use iron supplements

Detailed Answer:
Hello ma'am and welcome.

Thank you for writing in.

I would be more than glad to help you with this kind deed. Let us start by addressing each question in the sequence as asked by you.

Treatment of iron deficiency anemia depends on the level of deficiency, but the options are as follows:
-Iron supplements to be taken on an empty stomach
-Vitamin C supplements, as these promote the absorption of the iron supplements
-Investigate to look for any source of bleeding. Like blood in vomit, urine, stool, etc. These should be suspected when, despite supplementation, the iron levels do not rise or normalize

As the patient is 45 years old, if she is still menstruating, then we need to add oral contraceptives to reduce flow of her period (i.e. reduce loss of blood). Gastric bleeding is one common cause (eg. peptic ulcers), introduction of antibiotics to the treatment regimen would be required. Cyst or growth in various parts of the body can at times lead to bleeding from the blood vessels supplying blood to them.

For maintenance, if there is no source of bleed, once the hemoglobin level is normalized, then you can maintain the same with just her diet. But, if there is a bleed, simply by correcting the source of bleed, the anemia will not recur.

So just treatment does not suffice, a deficiency needs to be investigated as the most common causes are bleeding and malnutrition. I hope this information helps you, please feel free to write back to me for any further information. I would be more than happy to help.

Best wishes.

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Brief Answer:
You are most welcome

Detailed Answer:
Hello once again.

You are most welcome. I am always available to help guide you through management of your friend/patient.

Please do not hesitate to contact me for any clarifications.

Best wishes.

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