Iron therapy is a medical treatment designed to increase low iron levels in the body, used under the guidance of a healthcare provider. When the body lacks enough iron, it cannot produce an adequate amount of hemoglobin, a protein in red blood cells that carries oxygen. The goal of therapy is to supply enough iron to restore normal bodily functions and replenish the body’s iron reserves.
Conditions Treated with Iron Therapy
Iron therapy primarily treats iron-deficiency anemia, a condition where a lack of iron reduces the number of healthy red blood cells. This can cause symptoms like persistent fatigue, weakness, pale skin, shortness of breath, and noticeable heartbeats.
Several situations can lead to iron deficiency. Inadequate dietary intake is a frequent cause, particularly for individuals on diets low in iron-rich foods. Another major factor is chronic blood loss, such as from heavy menstrual periods or gastrointestinal bleeding from ulcers or other conditions.
The body’s demand for iron also increases during certain life stages, making deficiency more likely. Pregnancy is a prime example, as iron is needed for fetal development. Additionally, some medical conditions like celiac disease and inflammatory bowel disease (IBD) can damage the intestinal lining, hindering proper iron absorption.
Oral Iron Supplementation
Oral iron supplementation is the most common initial treatment for iron deficiency. These supplements are available over-the-counter but should be taken based on a healthcare provider’s recommendation. Common forms include ferrous sulfate, ferrous gluconate, and ferrous fumarate, which differ in the amount of elemental iron they contain for absorption.
To enhance absorption, it is recommended to take the supplement on an empty stomach. Pairing the iron supplement with a source of vitamin C, like orange juice, can also increase absorption. It is also advised to avoid taking iron with tea, coffee, or calcium-containing products, as they can inhibit its uptake.
Oral iron supplements are known for causing gastrointestinal side effects. Constipation, nausea, abdominal pain, and dark-colored stools are frequently reported. To manage constipation, increasing dietary fiber and water intake or using a stool softener can be helpful. Taking the supplement with a small amount of food can lessen nausea, though this may slightly reduce iron absorption. Research also suggests that lower or alternate-day dosing can be as effective while minimizing side effects.
Intravenous Iron Infusions
When oral supplements are not viable, providers may recommend intravenous (IV) iron infusions. This method delivers iron directly into the bloodstream, bypassing the digestive system. IV iron is used for patients who cannot tolerate oral iron’s side effects or have a condition preventing adequate gut absorption.
This therapy is also used for severe iron-deficiency anemia when levels must be restored quickly. Patients with chronic kidney disease or those who have undergone certain gastric surgeries may also be candidates. The procedure occurs in a clinical setting and can last from 15 minutes to a few hours, depending on the prescribed formulation and dosage.
While IV iron avoids the gastrointestinal issues of oral pills, it has its own potential side effects, like headache, dizziness, or a metallic taste. Discomfort can occur at the injection site, and though rare, serious allergic reactions can occur, so patients are monitored closely.
Monitoring Treatment and Effectiveness
Iron therapy requires careful monitoring for effectiveness and safety. A provider uses follow-up blood tests to track hemoglobin, which indicates oxygen-carrying capacity, and ferritin, which reflects the body’s iron stores. An adequate response is an increase in hemoglobin of about 1 g/dL after one month of treatment.
Patients often feel an improvement in symptoms, like reduced fatigue, within a few weeks. However, fully normalizing hemoglobin and replenishing iron stores can take several months. Oral therapy is continued for at least three months after hemoglobin levels normalize to ensure iron reserves are rebuilt.
Following the prescribed dosage and duration is important. Stopping treatment prematurely can cause a relapse, while taking too much iron can be toxic. A condition called iron overload, or hemochromatosis, can occur if the body accumulates excess iron, which can damage organs. Regular monitoring helps prevent this and ensures the underlying cause of the deficiency is addressed.