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Iron Infusions: Helpful or Harmful?

Patients are often recommended iron infusions because they cannot tolerate oral iron due to side effects, extremely low iron levels or in an emergency from acute blood loss.

In my own clinic, I used to utilize iron infusions to help patients with anemia or low ferritin get over the top with their low iron. Iron infusions have worked wonders and likely saved many lives.

Iron infusions were historically needed because standard oral iron amino acid chelates, and salts had such low efficacy and so many side effects.,

Given the high potential for allergic reaction and non-allergic negative reaction to iron, along with the high cost to the clinic and patient I discontinued iron infusions about three years ago.  But I didn’t just stop iron infusions and let my iron-deficient patients flounder in the mess that is standard iron supplementation.

I found a golden ticket to raising iron levels ultra-efficiently with essentially no side effects that came in the form of an oral whole protein iron delivery system. You can read all about it here.

How Much Does An Iron Infusion Cost?

Iron infusions are big business. For those who have received an iron infusion you are already well aware of the steep price tag.  Iron infusions currently vary from $825 to $3,087 per infusion.

Is this not wild? Iron is a necessity for life and yet to get it via intravenous infusion is over the top costly. 

Patients start with iron poor blood and end up financially poor as well.  An iron infusion is rarely a one-time therapy.  Most patients going the iron infusion route will require at a minimum, three iron infusions.

Do Iron Infusions Have Side Effects?

Iron itself is notoriously problematic given the many side effects of standard iron supplements.  The same goes for iron infusions.  Outside of an actual allergy, iron dextran is the least problematic and iron sucrose is the most problematic, of the different types of iron available for infusion.

It is crucial that your vitamin D levels are optimal before receiving intravenous iron, as well as calcium, and phosphate levels.  If not, you are at heightened risk of hypophosphataemia which can manifest as severe anxiety, muscle cramps, palpitations, fatigue, dizziness and nausea to name a few symptoms.

Phosphorus is an essential mineral for energy production of every tissue in your body, so it is vital to keep it balanced and sufficient going into an iron infusion.

One study showed that 51% of people with iron infusion-induced hypophosphataemia experienced symptoms for up to 6 months. Unfortunately, one of the main symptoms of iron-deficient patients is fatigue and yet the bolus iron infusion itself is inducing fatigue by reducing phosphate levels.

Talk to your doctor about supplementing with vitamin D, calcium and phosphorus even if your levels are within the normal range to minimize potential hypophosphataemia episodes related to the iron infusion.

Iron Infusions and Weight Gain

Insulin resistance and weight gain are also related to iron infusions. This is thought to be related to the excess iron in the blood causing oxidative stress when iron is given via iron infusion. Weight gain is often a symptom of iron deficiency and can be very disconcerting to patients who are hoping to turn their body composition around by increasing their iron and unknowingly potentiating insulin resistance through iron infusions.

Annual Iron Infusions and Atherosclerosis

Annual iron infusions are associated with carotid artery intima thickness. This is a consistent marker for atherosclerosis. The greater the thickness, the greater the arterial damage and oxidative stress present within the blood vessels.

When the endothelium (inner lining of blood vessels) is damaged by pro-oxidant molecules like free iron from an infusion, it triggers a cascade of inflammatory events, which if not stopped will cause remodeling and hardening of the arteries.

Vitamin C and Vitamin E Decrease With Iron Infusions

The Journal of Nephrology showed that treatment with intravenous iron but not saline was associated with decreased plasma ascorbate (vitamin C) and α-tocopherol (vitamin E) levels and increased oxidized glutathione/reduced glutathione ratio. They concluded their work by stating, intravenous iron sucrose provokes oxidative damage to peripheral blood lymphocyte DNA in hemodialysis patients.

It should also be mentioned that another study demonstrated that taking high-dose vitamin E with iron infusions could reduce some of the lipid peroxidation induced by the intravenous iron bolus.

Should I Get An Iron Infusion?

The cost of an iron infusion, along with the inflammation and weight gain that usually follow, are enough to detour people away from getting an infusion and seeking an alternative solution. Of course, there are cases of acute blood and iron loss, such as trauma and long-standing menorrhagia where iron infusions may offset any potential negative effects.

However, other than in these circumstances I have not found it necessary to use iron infusions even in the cases of intensive anemia since discovering the whole protein chelated iron system. To get the most out of an iron supplement, I recommend following these dosing guidelines.

References:

Kuo KL, Hung SC, Wei YH, Tarng DC.(2008). Intravenous iron exacerbates oxidative DNA damage in peripheral blood lymphocytes in chronic hemodialysis patients. J Am Soc Nephrology, 19(9):1817-1826. doi:10.1681/ASN.2007101084

Acute Injury with Intravenous Iron and Concerns Regarding Long-Term Safety Kalkidan Bishu and Rajiv Agarwa. Clin J Am Soc Nephrol, 1: S19 –S23, 2006. doi: 10.2215/CJN.01420406

Yokus Osman, Gedik Habip.(2016). Is iron treatment related to weight gain in female patients with iron deficiency anemia? Egyptian Journal of Haematology,Volume 41 (2):42-44.

Have you received an iron infusion before? I’d love to hear about your experience in the comments below.

5 thoughts on “Iron Infusions: Helpful or Harmful?

  1. Pingback: Ferritin: The Blood Test Women Should Get at Every Doctor's Visit - Maryann Jacobsen

  2. Staci G

    I received an iron infusion about five days ago, unaware of the dangerous side effects. Now I am covered in hives and welts that come and ago and are all over my body. Now I am taking steroids to counteract this as the anti-histamines were not effective. I am terrified that I have just given myself long term hives but I am unaware of how to move forward. My side effect is not considered severe and so the journals do not have an indication of why it is happening and at what rate. I am going to buy some vitamin E because of your suggestion. I hope this helps. Thank you

    Reply
  3. Iron deficient

    Horrible experience after iron infusion. I took it for the first time a month ago, my gp didn’t inform me about sides effects other than death from allergic reaction, skin pigmentation and two day lasting headache and feeling unwell. It has been a month and I feel like a wreck. The nausea, headache and most terrible muscle pain last till today a month later. The muscle are literally in spasms and I haven’t had a proper sleep since. My skin at age of 36 is covered in acne which won’t go away. I regret listening to this gp he offered it as a magical cure saying he administrates five of them a day. I’m counting data to feel better:(

    Reply
  4. Jeanette

    I am grateful for iron infusions. Im iron deficient without anemia and no oral treatment plan has helped. I just finished my second round of Venofer in two months and other than a slight headache for the first week during the first round, and some mild edema, I’ve had zero side effects. I don’t want people to be scared to try it for themselves. I highly recommend it! I have never felt so great. Ive had low ferretin for nearly 20 years and I lost so much of my life to fatigue, etc.

    Reply
  5. Brent

    I’ve experienced anemia on and off for about 15 years. I had my first iron infusion yesterday. So far, so good. I have not experienced any problems. I can’t even find the site where they put the IV. I’ve been able to mow the lawn and other yard work. I’ll update if anything changes. So far, it works for me.

    Reply

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