Iron is one of the minerals that the body must have in order to produce red blood cells and transport oxygen. In some cases, iron infusion may be required to treat an iron deficiency in people who don’t absorb iron well through their gastrointestinal tract, people with chronic blood loss, people who are receiving supplemental erythropoietin (which stimulates blood production), or people who can’t tolerate oral iron supplement. In cases when you need an iron infusion through an IV, your doctor may give you a reference for a hematologist who will supervise this IV iron infusion.
What Is Iron Infusion?
Intravenous or IV iron supplementation is one of several ways of adding iron to the body. It involves delivering the iron infusion via a needle that enters a vein. This medication will only be given with direct supervision from a doctor.
There are several preparations of IV iron infusion, including ferric gluconate, iron sucrose, and iron dextran. You can administer large doses of the iron in a single infusion with iron dextran, but the other two options will need more frequent doses over the course of several weeks. It is possible that an iron infusion will cause an allergic reaction, so sometimes you will receive a test dose before the first full treatment. It is more common to experience an allergic reaction with iron dextran, and this may require your doctor to switch the preparation used.
Who Should Have an Iron Infusion?
An iron infusion may be recommended if you have anemia. There is an increased risk of iron deficiency among the following groups of people:
- Children who have over 16 to 24 oz. cow’s milk each day
- People who restrict their diets and take few iron-rich foods, like vegans and vegetarians
- People with bariatric procedures and peptic ulcer disease
- People with certain gastrointestinal conditions such as Crohn’s disease, ulcerative colitis, celiac disease
- People with a major physical trauma or surgery
- Women with heavy menstrual periods and women who are breastfeeding or pregnant
It is also possible to develop anemia from blood loss from your gastrointestinal tract, bladder, or kidneys, or blood loss due to chronic nosebleeds. It can also be caused by intravascular hemolysis which causes red blood cells to break down within the blood stream so iron is lost in urine.
Do I Have Iron Deficiency?
Anemia will typically be diagnosed via a blood test including a CBC (complete blood count). You can also identify anemia via its symptoms:
- Pale complexion
- Heart palpitations
- Shortness of breath
- Lethargy and tiredness
Although less common, other symptoms of iron deficiency that may indicate the need for an iron infusion include:
- Spoon-shaped nails
- Painful ulcers on the mouth’s corners
- Difficulty swallowing
- Pica (the desire to eat items which aren’t food, like clay or paper)
- Hair loss
- Abnormally smooth or sore tongue
- Feeling itchy
- Altered taste buds
- Tinnitus (hearing sounds that come from within the body instead of from outside)
- Headache
Does Iron Infusion Have Side Effects?
As with any treatment, there are potential side effects associated with iron infusion. Possible side effects include swelling of the legs or arms, dizziness, joint pain, back pain, cough, headache, constipation, diarrhea, an odd taste in your mouth, vomiting, nausea or muscle cramps. It is also possible to notice redness, swelling or pain by the injection site. While these side effects are normal, if they continue or become worse, you should talk to your doctor. It is also possible to notice fainting or severe dizziness during the actual IV iron infusion, which can be improved by lowering the dose or the rate of the infusion.
Precautions for Iron Infusion
It is important for your doctor to check your condition regularly when you receive iron infusion. Here are the things your doctor may pay attention to.
1. Interactions
Unless it cannot be avoided, you should not have an iron infusion when taking certain medications or foods as they may increase the risk of specific side effects. These include zinc, mycophenolic acid, minocycline, eltrombopag, and foods with phytic acid (such as grains, nuts, seeds, and beans). If you need to continue your medication while having the infusion, your doctor may adjust the dosage or frequency of your medication or provide special instructions about consuming alcohol, tobacco or certain foods.
2. Medical Problems
Certain medical conditions can also affect having an iron infusion. Therefore you should always inform your doctor of other medical issues you have. This is especially important with low blood pressure (hypotension) and iron overload. You should not use IV iron with iron overload and must use caution with hypotension as it can worsen the condition.
3. Blood Pressure
Your doctor may regularly check your blood pressure or ask you to do so at home to ensure there aren’t any unwanted side effects. Anytime you notice abnormal blood pressure levels, you should immediately contact your doctor.
4. Allergic Reactions
It is possible for an iron infusion to lead to an allergic reaction, including anaphylaxis which may be life-threatening and must have immediate medical care. You should contact your doctor immediately if you notice chest pain, trouble breathing, itching, rash or swelling of your throat, tongue and face.
5. Other Symptoms
You may notice fainting, lightheadedness or dizziness as well, particularly when you suddenly get up after sitting or lying down. It is more likely to notice these symptoms when you first start IV iron infusion or when your dosage is increased.
Other Ways to Treat Anemia
1. Diet
You can also treat anemia by adding the following iron-rich foods to your diet:
Meat: Lamb, pork, or beef, particularly liver and other organ meats
Poultry: Duck, turkey, and chicken, particularly liver or dark meat
Fish: Particularly anchovies, sardines, or shellfish
Leafy greens in the cabbage family: Collard greens, turnip greens, kale, broccoli
Legumes: Black-eyed peas, pinto beans, peas, and lima beans
Cereals, rice, grains, or pastas
2. Iron Pills
It is also possible to treat anemia with oral iron supplements. Sometimes, you may need ESAs (erythropoietin-stimulating agents) which your doctor will give you in the form of a shot. The majority of people with an iron deficiency get 150 to 200 mg of elemental iron each day, so talk to your doctor about your recommended amount. Some doctors will also suggest taking 250 mg vitamin C with your iron tablets as vitamin C improves iron absorption.