Iron deficiency anemia induced by magnesium overuse: a case report

Hiroshi Sugimoto,Ui Yamada

doi:10.1186/s13030-019-0159-y

Hiroshi Sugimoto, Ui Yamada

Open Access

https://doi.org/10.1186/s13030-019-0159-y

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Journal: BioPsychoSocial medicine	Publication Date: Jul 30, 2019
Citations: 7	License type: open-access

Affiliation: St. Luke's International Hospital

Abstract

BackgroundAlthough in vitro studies show that iron absorption can be inhibited by magnesium laxatives such as magnesium oxide, taking oral iron supplements with magnesium laxatives is not considered a clinical problem.Case presentationA 28-year-old woman diagnosed with anorexia nervosa who overused magnesium laxatives was admitted to our hospital to evaluate her refractory iron deficiency anemia (IDA), despite having taken oral iron replacement therapy for nine months. She had had amenorrhea for years and her fecal occult blood tests were negative. Furthermore, upper gastrointestinal endoscopy showed no suspected gastroduodenal bleeding or gastroenteritis. We considered her IDA to be induced by malabsorption of iron due to magnesium laxative overuse. Psychoeducational intervention stopped the overuse and oral iron replacement therapy was switched to the intravenous route. During outpatient follow-up, her anemia gradually improved; however, when her magnesium laxative overuse began again, her hemoglobin levels suddenly decreased.ConclusionsClinicians should be attentive to the interactions between iron and magnesium laxatives.

Highlights

In vitro studies show that iron absorption can be inhibited by magnesium laxatives such as magnesium oxide, taking oral iron supplements with magnesium laxatives is not considered a clinical problem.Case presentation: A 28-year-old woman diagnosed with anorexia nervosa who overused magnesium laxatives was admitted to our hospital to evaluate her refractory iron deficiency anemia (IDA), despite having taken oral iron replacement therapy for nine months
Clinicians should be attentive to the interactions between iron and magnesium laxatives
Oral iron replacement therapy is considered the first-line therapy for IDA; in vitro studies show that iron absorption can be inhibited by magnesium laxatives, such as magnesium oxide [1]

Summary

Introduction

In vitro studies show that iron absorption can be inhibited by magnesium laxatives such as magnesium oxide, taking oral iron supplements with magnesium laxatives is not considered a clinical problem.Case presentation: A 28-year-old woman diagnosed with anorexia nervosa who overused magnesium laxatives was admitted to our hospital to evaluate her refractory iron deficiency anemia (IDA), despite having taken oral iron replacement therapy for nine months. Conclusions: Clinicians should be attentive to the interactions between iron and magnesium laxatives. Oral iron replacement therapy is considered the first-line therapy for IDA; in vitro studies show that iron absorption can be inhibited by magnesium laxatives, such as magnesium oxide [1].

Results

Conclusion