How would you manage symptomatic iron deficiency in patients with PV on frequent phlebotomies?   

While iron deficiency by itself is not harmful, if someone has symptomatic iron deficiency, you could consider them intolerant to phlebotomies, and start a cytoreductive agent. Then, over time they can replete their iron stores. In some patients who are very symptomatic from their iron deficiency, I...

Symptomatic iron deficiency such as cheilosis, glossitis, and esophagitis is uncommon in my experience with PV patients (I don't count restless legs) but when it occurs, iron replacement in low doses brings symptomatic relief, though esophagitis may require therapy for candida. Phlebotomy intoleranc...