This Clinical Practice Update provides evidence-informed, pragmatic guidance on the optimal management of iron deficiency anemia across diverse clinical scenarios commonly encountered in practice. Drawing on a comprehensive review of published literature and expert consensus, the recommendations emphasize individualized therapy based on tolerance, absorption capacity, and underlying etiology. Oral iron remains first-line therapy, with no formulation demonstrating superiority, and lower-frequency dosing strategies favored to enhance tolerability without compromising absorption.

Vitamin C coadministration is advised to optimize bioavailability. Intravenous iron is recommended when oral therapy fails, is poorly tolerated, or absorption is impaired, with preference for formulations that achieve repletion in one or two infusions. The update addresses complex populations, including patients with inflammatory bowel disease, post-bariatric surgery, portal hypertensive gastropathy, celiac disease, and small-bowel angioectasias, underscoring the importance of treating underlying pathology alongside iron replacement. Collectively, this guidance supports safe, efficient, and etiology-driven correction of iron deficiency anemia for improved patient outcomes.