Effectiveness of Intravenous Iron Therapy in the Management of Severe Iron Deficiency Anemia: A Retrospective Study

Abstract Anemia is a global health problem, and the most common cause is iron deficiency anemia (IDA). Although blood transfusion is considered for patients with hemoglobin (Hb) values below 7 g/dl, the optimal transfusion threshold for slowly developing anemia in ambulatory patients has not been clearly defined. IDA can progress slowly, allowing the hemodynamic system to compensate and prevent symptoms, even at very low hemoglobin levels, particularly in young, healthy individuals. Transfusion decisions should be individualized to the severity of symptoms rather than simply hemoglobin levels. The aim of this study is to retrospectively evaluate outpatients with iron deficiency anemia who refused blood transfusion and were treated with intravenous iron supplementation. This study is a retrospective study based on medical records. The patients with Hb level below 7 were found from medical records. The patients who did not undergo blood transfusion and were treated with IV iron were identified. The response to parenteral iron replacement therapy in severe IDA was evaluated in terms of improvement in hemoglobin, hematocrit, and ferritin levels and whether any complications developed. The study included 84 patients, with 89.3% being women and 10.7% men, and an average age of 35.1 years. The most common symptoms reported were fatigue, dizziness, and pallor. Hemoglobin levels significantly increased from 6.4 to 11.1 g/dl ( p < 0.001) after IV iron treatment, as did ferritin levels, while total iron-binding capacity decreased. No complications, mortality, or morbidity were reported. Anemia such as IDA may develop without serious symptoms, even if Hb levels are below 7. It is important to manage these individuals with personalized care rather than relying solely on Hb levels for blood transfusion decisions. IV iron therapy can effectively raise Hb levels and reduce associated risks by reducing unnecessary blood transfusions. These findings highlight the need for individualized IV iron therapy as a first-line treatment in young healthy patients to improve outcomes and optimize healthcare resources.