What medicine is effective for chronic disease anemia?

There is no universal "specific drug" for chronic disease anemia. The core medication logic is to first control the basic chronic disease that causes anemia, and then supplement it with drugs that supplement hematopoietic raw materials and regulate red blood cell production to achieve the best improvement effect.

I was particularly impressed by Aunt Zhang, whom I met during a chronic disease follow-up in the community last month. She has been suffering from rheumatoid arthritis for 12 years. Before, she always felt tired and breathless when climbing stairs. Her hemoglobin was found to be only 92g/L, which is mild anemia. I followed the trend and bought several Internet celebrity blood-enhancing oral liquids. After drinking it for half a year, the indicators did not move at all, and her face was still sallow. Later, we first contacted the doctor in the rheumatology and immunology department to adjust her anti-inflammatory medication to lower the inflammation level, and then took polysaccharide iron complex, which is less irritating to the gastrointestinal tract, and added erythropoietin once a week. After less than two months, we rechecked and found that her hemoglobin had risen to 116g/L. Now I can go to the park with my old sister for two hours without feeling tired.

Many people think that iron supplementation is necessary for anemia. In fact, this matter has been clinically controversial. Nearly half of patients with chronic disease anemia have total iron levels in their bodies that are not low at all. However, due to long-term inflammation of chronic diseases, the iron is "locked" in cells and cannot be used for hematopoiesis. At this time, blindly taking high-dose iron preparations may easily cause iron overload, damage the liver, and affect pancreatic function. There was a patient with stage 3 chronic kidney disease who secretly took imported iron supplements for half a year. Later, his serum ferritin was found to be more than three times the normal value. He stopped for almost a year before slowly returning to a safe range.

This does not mean that iron supplementation is not good. As long as you check the blood first to confirm that the serum ferritin and transferrin saturation are lower than the standard value, the effect of supplementing with mild oral iron supplements is very good. If you are afraid of irritating the stomach and take it with meals, combining it with two tablets of vitamin C can also help improve the absorption rate of iron, which is much faster than taking iron supplements alone.

There are also many patients who come up and ask if they can take erythropoietin. They say that blood rises quickly. In fact, it depends on the score. Erythropoietin is more suitable for anemia caused by chronic kidney disease, tumor radiotherapy and chemotherapy, and before taking it, it is necessary to confirm that the iron reserves in the body are sufficient. Otherwise, it will be like a factory that recruits enough workers but does not keep up with the raw materials, and still cannot produce enough red blood cells. Oral hypoxia-inducible factor stabilizers such as roxadustat, which have been newly released in recent years, can regulate red blood cell production without injection, and are particularly effective in renal anemia. However, the current indications do not cover all types of chronic disease anemia. Whether it can be used needs to be evaluated by a doctor.

As for the commonly asked Chinese patent medicines such as donkey-hide gelatin and Danggui Buxue Pills, there is currently no large-scale clinical evidence to prove that using them alone can quickly correct anemia in chronic diseases. It is fine if used in combination with basic medicines for conditioning, but do not use them as the main force. It will delay the control of basic diseases and the gain will not be worth the loss.

To put it bluntly, there is really no unified "best option" for medication for chronic disease anemia. Don't just follow the trend and buy what others are taking. First, find a doctor to understand the control of your underlying diseases and the lack of hematopoietic raw materials, and then prescribe targeted medicines that have the best effect on you.