IV Therapy for Iron Deficiency
Iron is a mineral that helps make hemoglobin. Iron is necessary for the red blood cells to bind to oxygen and deliver oxygen to all the tissues in our body.
Per the CDC, iron deficiency is the most common nutrient deficiency and more than a quarter of the world's population is anemic (PMID: 17693180)
Who needs IV iron:
Those who have iron deficiency anemia or iron deficiency would benefit from iron infusions. There are several studies that show benefit from iron replacement in those who have serum ferritin <50mg/mL to improve symptoms of fatigue (PMID: 21705493; PMID: 27351586)
Additional conditions that would benefit from IV iron:
Risk factors for iron deficiency and iron deficiency anemia:
Athletes
Menstruating females
Pregnancy
Low iron diet: vegans and vegetarians
Gastric bypass
Inflammatory bowel disease: Crohn's, Ulcerative colitis
Malabsorption: Celiacs
Cancer
Why choose IV iron over oral iron supplementation:
IVs are recommended over oral supplementation if: you need to get your iron levels up quickly i.e. severe anemia, if you're unable to absorb iron orally, experiencing negative side effects from oral iron, or if you want to improve iron deficiency symptoms quickly.
Oral iron supplements do work, they are affordable and for many well tolerated. However, supplementing with oral iron typically take 3-4 months to improve iron levels and up to 70% of patients experience gastrointestinal side effects such as constipation and bloating (PMID: 25700159).
IV iron on the other hand bypasses the digestive system, so you do not have any gastrointestinal side effects and absorb 100% of the iron. IVs can deliver a high dose of elemental iron that cannot be absorbed via your gastrointestinal tract and is a great way to replete your iron levels quickly. The downside is that it is more expensive than oral iron and unless you are severely anemic (and depending on your insurance plan) it is not covered by insurance.
What to expect when getting an iron IV:
At Island Functional Medicine we use iron sucrose for our IVs. This is because it is known to be the safest form of iron when used for IVs. Iron sucrose has a very low risk of anaphylactic reaction and is generally very well tolerated. Over the 7 years of providing iron infusions, I have not once had a patient have a negative reaction from iron sucrose.
The maximum dose of iron we infuse per treatment is 300mg. This is based on safety data (PMID: 11684551) and IVs are infused over 30-45 min.
Side effects, while not common, include: drop in blood pressure, joint pain, flushing and anaphylaxis (severe allergic reaction). Anaphylaxis is very rare with iron IV, especially with iron sucrose and in those who do not have medication allergies. Iron IVs are also very concentrated, so I recommend hydrating well the day of the infusion to prevent dehydration.
IV iron can improve iron deficiency symptoms immediately after infusion, but most patients experience symptom improvement the next day.
MEDICAL DISCLAIMER: the information in this blog post is for informational and educational purposes only. The information and education provided is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis
