Iron Infusions: How to minimize side effects

How do you make the most of your iron infusion and minimize the side effects? We know that iron infusions carry a much higher risk than oral iron, yet they are recommended often by medical professionals right out of the gate for low iron levels. Many patients have side effects from oral iron intake, but this is often because of inferior iron formulas or inferior delivery systems. This isn’t a good reason to jump straight to iron infusions. 

Side Effects of Iron Infusions

Why not support the digestive process and utilize clinically validated oral iron interventions that work in tandem with the body’s innate mechanisms for maintaining optimal iron balance? For the patient there is both the higher cost of iron infusions compared to efficient oral iron supplementation along with the following side effects:

  • Racing heart
  • Aching arms
  • Phosphorus depletion
  • Increased fatigue
  • Weight gain

These are not just momentary 24 hour symptoms, often these symptoms continue for months. For many, iron deficiency is already a long journey back to optimal health, let’s not add any more suffering to that journey. 

If you are reading this, you are likely someone who has dealt with iron deficiency, and potentially used iron infusions and received some unexpected results. Iron infusions seem like a logical solution. You are low in iron so you receive an infusion that is 100x the normal physiologic dose and you expect your iron levels to go up and to go back to feeling like your old, energized self. Unfortunately, I am bombarded with messages where this is not the case. 


Iron infusion support

First, we can use more efficient oral iron formulations and second, we can be more attentive to supporting the patient to minimize the risk of iron infusions and maximize the potential reward.  

Since iron infusions will continue, I wanted to give an overview of how to make them most effective and how to minimize side effects for patients.

  • Lactoferrin binds to free iron and can reduce oxidative damage. Iron knows it is not allowed to flow freely without a carrier in the blood, so it is always in search of a support protein to shuttle it around. If transferrin is already loaded, then it will grab albumin or citrate. But in the case of iron infusions, all systems will be overloaded. Using lactoferrin could help in scavenging free iron to decrease excess oxidation from the bolus iron infusion.
  • Add extra antioxidant support.  Since we are putting a highly oxidative substance directly into the blood at a physiologic level, it is important to support and counteract with antioxidants. I will often use the mother of all antioxidants, Glutathione in supplemental form for this task.
  • Iron infusions can cause severe renal wasting of phosphate resulting in hypophosphatemia. This can be severe, highly symptomatic and remain for months. Low calcium, phosphorus, Vitamin D or high parathyroid gland can all increase the risk of hypophosphatemia with iron infusions. Get your levels checked and make sure they are optimal before getting an infusion.
  • Some people will have normal levels of calcium, vitamin D, phosphorus and still end up with hypophosphatemia, so instead of doing 1000mg out of the gate of IV iron, consider doing 250mg or 500mg, if you are set on going the infusion route.  You may also want to consider supplementing with calcium, phosphorus and vitamin D leading up to and following your IV for a couple weeks to minimize phosphorus depletion.
  • Utilize CoQ10 to offset the oxidative stress caused by the acute iron overload. Studies in hemochromatosis demonstrate benefit with CoQ10 supplementation in helping decrease the damage caused by excess, unusable iron.

Understand that when receiving an iron infusion, you could be getting 1000mg of iron in a single infusion. This amount of iron is 100x greater than the body would obtain from food in a single day.  And given the fact that the body doesn’t have an efficient way of clearing this highly oxidative substance, greatly increases the risk for potential side effects.

For more on the side effects of iron infusions and how I have used an iron supplement called Blood Vitality with my patients, check out this post.

Let me know your experience with iron infusions and any tips or tricks you have used to help yourself through this intervention.

2 thoughts on “Iron Infusions: How to minimize side effects

  1. Jennifer adams

    I am so thankful for your post. I stumbled upon your article desperately trying to figure out how I gained 7 pounds from my iron infusion & how to get rid of it. I’ve tried everything and can’t lose the weight. I take glutathione daily along with my other supps. Am very active CrossFitter, macro, keep up on my metabolic rate, and thyroid. Nothing is counteracting the weight so any feedback is appreciated. I’ve canceled all subsequent iron infusions!

  2. Simply Eden

    Hi there,

    My first experience with iron infusion was in 2021 due to microcytic anemia. I had no apparent side effects except I gained 50 pounds! It happened within weeks of starting the first dose of infusions and I can’t get rid of it. 😔
    Now my 2nd round of infusions (due to iron deficiency anemia) I had to stop after 3 IVs. The pain I’ve experienced is unreal. Burning, aching, stabbing, cutting, throbbing, intense joint and muscle pain such that I felt I had no other choice but to cease the treatment. I’m trying oral ferrous glucinate at home with vitamin C, D3, B12, and a calcium/magnesium combination.

    I knew intuitively when the pain started (within 2 days of first IV) that there was some sort of overload or toxicity. I called my Dr and said this is too much, I can’t do it, but he wanted me to keep trying, so we spaced them out to 2 wks apart. It didn’t make a difference. It seemed that the iron settled in muscle/joint areas then moved onto the next area (shoulders, neck, hips and sacrum, thighs and knees, ankles and shins, ribcage and sternum, L-spine). It’s seems like it’s just been moving around my body, but I’m not sure what it’s looking for. It feels like tiny burning hot shards of glass are tearing apart the bones, muscles and other connective or soft tissue in whichever area it settles in.

    I can barely move and need my cane around the house (I’m 57). I’ve had increased migraines, symptoms of POTS, and increased fatigue. I do have comorbidities of previously dxd Fibromyalgia, gastroparesis, hypoglycemia, IBS, DDD, several bulging/herniated discs, cysts and mild stenosis, osteoarthritis, osteoporosis and osteopenia – early for my age, venous insufficiency, and a few other problems; so I admit I’m already quite complex, but the infusions have made everything worse. I can’t drive or be left home alone. I can’t work in my garden or even walk to the mailbox without one of my kids (all adults) assisting me. It’s been 18 days since the last IV. I’m so grateful I didn’t gain weight again, but now I literally feel like the life is being sucked out of me. As if I’m truly dying, several times during the day. My blood pressure, pulse and blood glucose tank several times a day.

    It was supposedly the milder form of iron that’s meant for people with sensitivity to the infusions. Gadfrey, I can’t imagine if it was a different one. I don’t know if this is ever going away, or what I can do about it, and my Dr doesn’t seem to know what to do either. He says I’m one of those 0.0000387% of people who have these types of reactions. Now what? Please help!?


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