Treatment of Iron Deficiency After Gastric Bypass

To the Editor In a JAMA Diagnostic Test Interpretation article, Dr Murali described a patient with combined vitamin B12 and iron deficiency after bariatric surgery. The patient had a low mean corpuscular volume because the iron deficiency was primary. I am concerned about the recommendation to prescribe 60 mg of oral iron twice daily. In the section on the treatment of adults with iron deficiency on the UpToDate website, oral iron is specifically proscribed. Ingested iron must be conjugated to vitamin C, amino acids, and sugars in the presence of gastric acid in the stomach to protect the iron from the alkaline secretions in the proximal duodenum. Absent that event, ingested iron is converted to unabsorbable ferric hydroxide.
Source: JAMA - Category: General Medicine Source Type: research