Iron Deficiency Anemia Guidelines

Updated: Sep 30, 2020
  • Author: James L Harper, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Guidelines

Guidelines Summary

Guidelines from the American Gastroenterological Association on the evaluation of iron deficiency anemia include the following recommendations [36] :

  • In patients with anemia, a cutoff of 45 ng/mL is recommended over 15 ng/mL when using ferritin to diagnose iron deficiency.
  • In asymptomatic postmenopausal women and men with iron deficiency anemia, bidirectional endoscopy is recommended over no endoscopy.
  • In asymptomatic premenopausal women with iron deficiency anemia, bidirectional endoscopy is suggested over iron replacement therapy only.
  • In patients with iron deficiency anemia without other identifiable etiology after bidirectional endoscopy, noninvasive testing for  Helicobacter pylori, followed by treatment if positive, is suggested over no testing.
  • In patients with iron deficiency anemia, suggest against routine gastric biopsies to diagnose atrophic gastritis.
  • In asymptomatic adults with iron deficiency anemia and plausible celiac disease, initial serologic testing, followed by small bowel biopsy only if positive, is suggested over routine small bowel biopsies.
  • In asymptomatic patients with uncomplicated iron deficiency anemia and negative results on bidirectional endoscopy, a trial of initial iron supplementation is suggested over the routine use of video capsule endoscopy.