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May 27, 1992

Testing Ironclad Practices-Reply

Author Affiliations

Virginia Commonwealth University Richmond

JAMA. 1992;267(20):2738-2739. doi:10.1001/jama.1992.03480200046014

In Reply.  —Dr Crosby lucidly illustrates the misuse of iron in the treatment of anemia unrelated to iron deficiency. Patients also misuse over-the-counter iron preparations. Self-treatment can result in significant iron overload or delayed diagnoses since iron deficiency anemia, a major clue for diagnosing chronic blood loss, may not develop. Crosby emphasizes that when treating anemia, "iron is the proper treatment for iron deficiency anemia and that anemia alone." This is an excellent and general rule that is too often ignored.My Editorial was not intended to detract from, or to encourage testing of, this particular medical principle. The major point was that some common practices or even standards of care seem contrary to medical principles and that such disagreements must be resolved. Zauber et al1 could have tried to reason with individual physicians about iron supplementation or submitted an editorial with their viewpoint. I suspect, however, that such