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Malabsorption - iron

Last edited: 4/15/2026

Overview

Iron malabsorption refers to impaired absorption of iron from the gastrointestinal tract, leading to iron deficiency despite adequate intake, often observed in conditions like celiac disease, inflammatory bowel disease, and chronic diarrhea 1.

Diagnosis

  • Key Diagnostic Criteria: Low serum ferritin, low transferrin saturation, elevated total iron-binding capacity (TIBC) 1.
  • Recommended Tests: Serum ferritin, serum iron, total iron-binding capacity (TIBC), transferrin saturation 1.
  • Grading: Typically assessed through biochemical markers; no specific grading system mentioned 1.
  • Management

  • First-Line Treatments: Oral iron supplementation (e.g., ferrous sulfate, ferrous gluconate) 1.
  • Adjunctive Treatments: Address underlying cause (e.g., dietary modifications, treatment of inflammatory conditions) 1.
  • Specific Considerations: In pediatric populations, ensure adequate micronutrient intake through specialized enteral formulas 1.
  • Special Populations

  • Pediatrics: Ensure enteral formulas provide sufficient micronutrients; observed that despite lower energy intake, many children achieved reference nutrient intake levels 1.
  • Comorbidities: Management should focus on treating underlying conditions contributing to malabsorption (e.g., inflammatory bowel disease) 1.
  • Key Recommendations

  • Monitor micronutrient levels regularly in patients with malabsorption syndromes to prevent deficiencies 1 (Evidence: Moderate).
  • Use specialized enteral formulas in pediatric patients to meet micronutrient requirements, even with reduced energy intake 1 (Evidence: Moderate).
  • Address and treat the underlying cause of malabsorption to improve iron absorption 1 (Evidence: Moderate).
  • References

    1 Johnson TE, Janes SJ, MacDonald A, Elia M, Booth IW. An observational study to evaluate micronutrient status during enteral feeding. Archives of disease in childhood 2002. link

    Original source

    1. [1]
      An observational study to evaluate micronutrient status during enteral feeding.Johnson TE, Janes SJ, MacDonald A, Elia M, Booth IW Archives of disease in childhood (2002)

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