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.