Iron deficiency anaemia (IDA) remains prevalent in Australia and worldwide, especially among high-risk groups. IDA may be effectively diagnosed in most cases by full blood examination and serum
ferritin level. Serum
iron levels should not be used to diagnose
iron deficiency. Although
iron deficiency may be due to physiological demands in growing children, adolescents and pregnant women, the underlying cause(s) should be sought. Patients without a clear physiological explanation for
iron deficiency (especially men and postmenopausal women) should be evaluated by gastroscopy/colonoscopy to exclude a source of gastrointestinal
bleeding, particularly a malignant lesion. Patients with IDA should be assessed for coeliac disease. Oral
iron therapy, in appropriate doses and for a sufficient duration, is an effective first-line strategy for most patients. In selected patients for whom intravenous (IV)
iron therapy is indicated, current formulations can be safely administered in outpatient treatment centres and are relatively inexpensive. Red cell transfusion is inappropriate
therapy for IDA unless an immediate increase in
oxygen delivery is required, such as when the patient is experiencing end-organ compromise (eg,
angina pectoris or
cardiac failure), or IDA is complicated by serious, acute ongoing
bleeding. Consensus methods for administration of available IV
iron products are needed to improve the utilisation of these formulations in Australia and reduce inappropriate transfusion. New-generation IV products, supported by high-quality evidence of safety and efficacy, may facilitate rapid administration of higher doses of
iron, and may make it easier to integrate IV
iron replacement into routine care.