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Ask Dr. Yogindra Vasavada Your Own Question
Dr. Yogindra Vasavada
Dr. Yogindra Vasavada, Pediatrician
Category: Pediatrics
Satisfied Customers: 3228
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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My child has had low iron from very early on. Even with iron

Customer Question

My child has had low iron from very early on. Even with iron supplementation where her iron increased it still gradually goes down. SHe is now just over three and we had her iron levels tested again. She was within the normal range (on the low side) for everything except her Iron Sat came back at 11%. Her Ferritin level is 17ug/L. My Dr just said to give her a multivitamin with Iron which I do but is that really going to be enough. Is she actually iron deficient or still ok with her Ferritin level being normal. She is also a a carrier of Thalassemia which (for both myself and her) seem to cause small red blood cell size and Low HGB. Will the vitamin be enough to increase or should she be on a therapeutic does of iron and if so how much?
Submitted: 2 years ago.
Category: Pediatrics
Expert:  Dr. Yogindra Vasavada replied 2 years ago.
Sorry about this problem.
With a thalassemia trait, hemoglobin will remain low normal, and she needs more of folic acid and vitamin B12 rather than high dose of iron.
Iron deficiency may co-exist and one should try to find cause, like occult bleeding from stool etc. If oral iron fails to restore blood levels, injectable iron may be given once in a while to top it up. There are formulas available to find out exact dose.
Customer: replied 2 years ago.
I would try oral iron but my Dr wouldn't give me an amount to give and just said a daily vitamin with iron would be enough. I am afraid of giving too much iron without being given a reference amount. Is a daily vitamin with iron enough and is she actually iron deficient if her Ferritin levels are within the normal range but on the lower side of normal?
Expert:  Dr. Yogindra Vasavada replied 2 years ago.
12-150 units are normal level for ferritin.
For maintenance dose, iron is given at 2 mg elemental iron per kilo body weight, and for treatment of anemia, about 6 mg per kg. per day.
After normal hemoglobin is attained, same dose can be continued 2-3 months to replenish store of iron in body.
Customer: replied 2 years ago.
Ok great, so with her ferritin being at 17 ug/L should I be looking at doing all the further investigations or is her iron level actually ok even with a sat level of 11%? That's what I am confused with.
Expert:  Dr. Yogindra Vasavada replied 2 years ago.
Transferrin saturation normally is 20-50% and result is seen along with total iron binding capacity (normal 240-450 mcg %) and iron level, 60-170 mcg %).
Stool occult blood may be tested 3-4 times either daily or alternate day.
Please consider these and go for iron dose which is minimum advisable to avoid overload with iron.