Nutrition Support Blog: Iron Supplementation Answers

Posted by SF8N at May 22, 2014 11:12 AM |

May 22, 2014

Nutrition Support Blog:  Iron Supplementation Answers

by Joe Krenitsky, MS, RD

For a number of years we hosted a “Nutrition Support Forum” 1 to 2 times per year.  This was an idea we borrowed from a colleague, where we would invite dietitians and other nutrition support professionals from surrounding hospitals for a ½ day to share case studies, ideas and review an article or two.  The moderator would open the forum with an icebreaker, with each participant giving their name, workplace and some bit of trivia such as their favorite movie, or 3 foods they could not live without.  The day our icebreaker included each participant’s “nutritional pet peeve” we very nearly did not have time to discuss cases or the article because everyone was so enthusiastic about having a safe and sympathetic forum to vent a bit.

One of my nutritional pet peeves is the un-physiologic and non-evidence-based way that iron supplements are usually prescribed.  Traditionally, iron is prescribed in very large doses 3 times/day. If you were attempting to design a way to dose iron that would encourage GI symptoms, noncompliance and interfere with the absorption of other trace minerals, you would be hard pressed to do better than 60 mg of elemental iron 3X/day. However, there has been limited research and few articles to help educate your staff about dosing iron and treating nutritional anemia’s,..until now.  A great new article in JPEN reviews nutritional anemia and outlines the research and history of iron dosing, as well as other micronutrients involved in nutritional anemia.

http://pen.sagepub.com/content/early/2014/05/18/0148607114533726.abstract

The article is a wonderful review and a great resource.  I suspect that a lot of work (and coffee) went into putting it together, and I am grateful for the author’s efforts.  I recommend you add this one to your spring reading list.

I also recommend you think about hosting a nutrition or nutrition support forum.  It is a great way to get to know your local peers, foster communication and share ideas.  I would consider steering clear of bringing up clinical nutrition pet peeves, so you have time for other discussions.  If you do bring up nutritional bugbears, feel free to mention my plan to ban Full Liquid diets from hospitals – or at least require RD permission before anyone tries to order that high lactose, high fat, high FODMAP liquid diet for bedbound folks recovering GI function, or from pancreatitis :)

 

“But it's all wrong,.. that is I think I disagree….”

                     -John Lennon, Strawberry Fields Forever, 1967

“Learn the rules so you know how to break them properly”

                                 - Dali Lama

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