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Suggest Treatment For Malabsorption, Iron Deficiency And Low Ferritin Level

Posted on Wed, 4 Nov 2015

Question: Hello,
My daughter was born 10 weeks premature. She is now 1 year old and still struggling with iron deficiency. She has had malabsorption issues and has struggled with weight gain. On the last blood test (2 months after the previous) her HB increased from 83 to 99. However her transf. Saturation is only 10% and her Ferritin went from 3 down to 2. She did have a bad month with gastro, illness and teething so spent the first month unwell and the last month she is back to eating and feeding well.
Is this a good sign that her Hb is going up or is it very dangerous that her Ferritin and trans.. saturation are so low. Am I on the right track or what else can I do?
Thanks for your help in advance.

Answered by Dr. Shailja Puri (26 minutes later)

Brief Answer:
Malabsorption is the underlying cause of iron def, needs to be managed.

Detailed Answer:
Hello,
Thanks for posting your query on HealthcareMagic.

Your daughter is suffering from iron deficiency.
The iron stores are also quite low.
The underlying cause of iron deficiency is malabsorption because all the iron that is taken in diet is not being absorbed in the gastrointestinal tract.
Its a good sign that hemoglobin level is going up but the ferritin level is still low.
So, the management to correct the malabsorption is required to correct the iron and other deficiencies.
I believe that you are already in consultation with your paediatrician for find the cause and management of malabsorption.
If you have more queries, I will be glad to answer.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Shailja Puri (14 minutes later)

What can happen to her if her ferritin level drops down to zero?
is diet sufficient to rectify this anaemia (what we are currently doing)?

Answered by Dr. Shailja Puri (48 minutes later)

Brief Answer:
Ferritin will not go down to zero,dietary iron will take care of iron needs

Detailed Answer:
Hello and welcome again,
The ferritin level will not drop down to zero if iron is given in diet.
ferritin is the storage form of iron and it is consumed when the usable form of iron is depleted.
Iron in diet will prevent the body from using the stored iron.
So, the dietary iron will take care of ferritin but it wont be able to increase the ferritin level.

Thanks and take care
Dr Shailja Puri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Shailja Puri (15 hours later)

Ok good to know, thank you.
What is the best way to then increase her ferritin level if she doesn't tolerate iron supplements? They put her off her food even with the smallest dose (she can't afford to lose any weight being 6kg at 1 year old), they make her tongue white all over, foul breathe, cries all day and becomes disengaged. I wish she could tolerate this.

Answered by Dr. Shailja Puri (5 hours later)

Brief Answer:
Iron needs to be given,diet alone will not help to increase ferritin.

Detailed Answer:
Hello and welcome to HCM,
Iron supplements will be required to increase the ferritin level.
Intake of iron supplements is associated with side effects but they decrease with passage of time.
Iron supplements can also be given in injectable form but it may be difficult to start injectable regime in an infant.
Thus, oral regime will have to be followed.
Diet alone will not be able to increase ferritin stores.

Thanks and take care
Dr Shailja Puri

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Above answer was peer-reviewed by : Dr. Prasad