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Anaemia - iron deficiency - Management
When should I refer or seek specialist advice?

  • For people of any age with dyspepsia who present with iron deficiency anaemia — refer urgently (within 2 weeks) for endoscopy, or to a specialist with expertise in upper gastrointestinal cancer.
    • For people with iron deficiency anaemia without dyspepsia — recognize the possibility of upper gastrointestinal cancer and consider urgent referral for further investigations.
  • For men of any age with unexplained iron deficiency anaemia and a haemoglobin level of 11 g/dL or below — refer urgently (within 2 weeks) to a gastroenterologist.
  • For women who are not menstruating, with unexplained iron deficiency anaemia and a haemoglobin level of 10 g/dL or below — refer urgently (within 2 weeks) to a gastroenterologist.
  • People with unexplained iron deficiency anaemia who do not fulfil these criteria for urgent referral will still require referral for further investigation. The urgency of this will require clinical judgement based on the haemoglobin level and clinical findings.
  • Other situations in which specialist expertise is required include:
    • If the person has profound anaemia with signs of heart failure — admit to hospital.
    • If a woman with menorrhagia has iron deficiency anaemia that has failed to respond to treatment — refer to a gynaecologist (urgency of referral should reflect clinical judgement).
    • If a person is unable to tolerate, or is not responding to, oral iron treatment — seek specialist advice.
    • If a person who has initially responded to iron treatment develops anaemia again without an obvious underlying cause — seek specialist advice regarding further assessment and investigation.

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