Iron is a vital mineral that is crucial to oxygen delivery, energy metabolism, and the proper functioning of the immune system. When levels fall too low, it causes iron deficiency anemia — a syndrome that results in fatigue, weakness, shortness of breath, and other health issues. Oral iron supplements are usually the initial treatment of choice, but they do not always respond for everyone. In these situations, Intravenous (IV) iron treatment is a good and quick-acting option.
Here we discuss the benefits and complications of intravenous iron therapy and what to expect to assist you in making decisions regarding your treatment.
What Is Intravenous Iron Therapy?
Intravenous iron treatment entails injecting iron straight into your system via a vein, generally an IV drip. This method gives your body access to more iron more quickly than taking oral iron tablets. IV iron therapy is typically utilized in the following situations:
- Oral iron produces side effects or is not well tolerated.
- You need rapid repletion of iron.
- There is continued blood loss or chronic illness (e.g., chronic kidney disease, congestive heart failure).
- Patients have inflammatory bowel disease, including Crohn’s disease or ulcerative colitis.
- Pregnancy-associated anemia is not treated with oral iron.
Intravenous Iron Preparations
There are a number of intravenous iron preparations that exist, including:
- Iron sucrose (Venofer®)
- Ferric carboxymaltose (Injectafer®)
- Iron dextran (INFeD® or Dexferrum®)
- Ferric gluconate (Ferrlecit®)
- Ferumoxytol (Feraheme®)
Each formulation has varying dosing regimens and infusion durations. Your physician will decide the most suitable formulation depending on your medical condition, iron deficiency, and any previous intolerance to iron therapy.
Advantages of Intravenous Iron Therapy
1. Intradeficiency Correction Rapid
Compared to oral supplements, intravenous iron therapy may replenish iron levels far quicker. Most patients improve their energy levels within a week or a few days following the treatment, particularly those who have been experiencing anemia-caused severe fatigue.
2. Improved Absorption
Some people are unable to adequately absorb iron from the digestive system, either because of gastrointestinal disease or history (like gastric bypass). IV therapy circumvents the gut, providing maximum absorption.
3. Less Gastrointestinal Side Effects
Nausea, constipation, bloating, or black stools often result from oral iron. IV iron treatment avoids these gastrointestinal side effects, making it perfect for individuals who are not tolerant to pills.
4. Convenience for Some Patients
While it might seem contradictory, most patients prefer IV iron over chronic oral therapy because less is required to restore iron reserves. Several IV preparations permit a single infusion to provide the body with all the iron that it needs.
5. Effective for Chronic Conditions
Individuals with chronic disorders like CKD, cancer, or inflammatory bowel disease frequently need iron repletion. IV iron is especially effective in these groups and is commonly combined with other therapies such as erythropoietin-stimulating agents.
What to Expect During the Procedure
1. Before the Infusion
Your doctor will probably order blood work to test your iron, hemoglobin, and ferritin levels. Depending on the results, your doctor will decide on the dose and number of infusions required.
You may be questioned beforehand about
- Previous allergic reactions
- Kidney or liver function
- Present medication
A test dose is administered to some patients if the doctor is worried about potential allergic reactions potentially occurring, particularly from older versions such as iron dextran.
2. During the Infusion
- A little IV will be placed into a vein, usually in your arm, while you sit peacefully in a chair.
- The infusion may take 15 minutes to several hours, depending on the formulation.
- During the entire procedure, you can be monitored for signs of a reaction.
- During the treatment, you can usually read, relax or use your phone.
3. After the Infusion
Most patients can resume normal activities after their infusion. Your doctor will suggest follow-up blood draws in a few weeks to evaluate your response to treatment.
Side Effects of IV Iron Therapy
Intravenous iron therapy is usually safe but may at times result in mild to moderate side effects, such as:
- Headache
- Dizziness
- Nausea or vomiting
- Low blood pressure during infusion
- Flushing or metallic mouth taste
- Muscle or joint pain
- Mild skin irritation at the site of injection
These reactions are usually temporary and clear up without additional treatment.
Rare but Serious Reactions
Extreme allergic reactions are very rare, particularly when using more current intramuscular forms of iron. But they can be:
- Anaphylaxis (severe allergic reaction)
- Chest pain
- Trouble breathing
- Swelling of face or throat
For this reason, IV iron must always be given with medical supervision, particularly on your initial infusion. The facility is prepared to deal with any allergic reaction as soon as it occurs.
Who Should Not Get IV Iron Therapy?
IV iron is not ideal for people who:
- Have an established allergy to a certain iron formulation
- Have conditions of iron overload like hemochromatosis
- Have present infections
- are expecting and in the first trimester (until it’s really needed)
Always talk with your medical practitioner to see if IV iron therapy is safe and a good option for you.
Conclusion
Intravenous iron therapy is an effective and efficient way to correct iron deficiency anemia, particularly when oral supplements don’t work. With rapid onset of action, less gastrointestinal side effects, and customized dosing options, it’s become the go-to treatment for most patients with moderate to severe anemia or chronic illness.
Though generally safe, IV iron should always be administered in a medical setting due to the potential for rare but serious reactions. If you’re struggling with symptoms of anemia and haven’t found relief with oral iron, speak to your healthcare provider about whether intravenous iron therapy is right for you.