Yes it should be given to all womens especially in asians countery. It should be started one week before surgery and continue for atleast a month or so
Firstly, there is a tendency to ‘inappropriately’ prescribe iron tablets when haemoglobin (hb) is low prior to surgery. (personal observation) In the event a person is experiencing a clinical situation whereby surgery is required it is more likely that the anaemia is due to anaemia of chronic disease (AOCD). I am aware that there may be situation whereby iron deficiency anaemia (IDA) may occur together. We should give due respect to our body adaptation to adverse situation. AOCD primarily aim to reduce circulating iron and hoards iron into intracellular ferritin reserve. This leads to functional iron deficiency state. Why? Circulating iron is sought after by entities that is detrimental to our well being. As part of the same mechanism elevated serum hepcidin reduces iron transfer from the gut into the blood. Hence why are we purposely introducing measures (giving iron supplements) to violate this very measure that our body is toiling to preserve. Besides how much of the swallowed iron will be absorbed. Even in normal situation when hepcidin level is favourable, the non-heme iron absorption is below 10%.
Secondly, patient’s undergoing surgery is at risk of stress ulcer. There has been situation whereby the caregiver is being alerted of a possibility of upper gastrointestinal (UGIT) bleeding because the stool has turned dark. This is more so in an era when anticoagulation is more widely used for post surgical DVT chemoprophylaxis. In several situations, I noticed this confusion came about because the patients has been prescribed hematinics. I am sure there are those who will argue that our hem-occult test could easily differential non-heme (supplement iron) from heme iron (UGIT bleed). My argument is, why create additional stress for ourselves if the iron supplements are not a necessity in the first place.
Leaving in a multiethnic community, I notice there is ethic variation in the risk of UGIT bleed, higher among the Chinese and lowest among the Indians. Hence, I assume, that those living in the Indian Subcontinent may not be concern with this issue. I am not sure of other regions.
Thirdly, we should be aware that there is a large buffer between what we accept as normal value based on 95th-centile population variation and level that interferes with bodily function. We all accept that the normal platelet level is 150,000 – 140,000/microliter but spontaneous bleeding is not expected until below 10,000/microliter. A marginally low haemoglobin should not lead to alarm unless if the patient has other co-morbidity of concern.
Based on the above reasons and perhaps also defined by my personal philosophy of minimal intervention, I will not provide iron supplements unless there is clear indication of iron defiency anaemia.
The reason to supplement would be because much research indicates that those with high-normal iron stores HEAL surgical wounds much faster than those with low-normal levels of iron stores--it had little to do with anemia. Also, one needs to have vitamin C in the food or supplement with the iron to have better absorption, less gastroentintestinal side effects, and proper cross-linking of collagen. I exclude those with definite contraindications, such as hemochromatosis or active life-threatening infection/cancer. Then, I offer/recommend it to others to get/keep hemoglobin 14-16, ferritin 100-200 (maybe even higher if there's a lot of false prior elevation due to inflammation), and zinc protoporphyrin (ZPP) 20-35 before and after surgery.
Dr. Ismet is correct. When the diet is hi-raw or all-raw and basically vegetarian, with occasional ocean vegetables such as (especially) dulse and hiziki---which are supremely high in natural iron and completely assimilable---the body will be well-prepared for surgery in most cases. Any iron excesses will be spilled as necessary, and there will be plenty of reserves. This is optimum. No iron supplements will be necessary. Moreover, iron supplements often Rx'd for Pts by MDs involve inorganic iron, which binds minerals in the bowel, causing constipation. Therefore, it's best to simply go the natural route as described above. This has been my experience.
Thank you very much Mr. Leonard Mehlmauer, I think, regularly fruit consumption (like apricot) may companse some minerals (like Na, K, Se) and some iz elements (like Fe, Mn, Mg, P, Zn) and you can also see my new article "Effects of Sun Dried Organic Apricot on Some Serum Mineral Levels in Rats".