General Information
Iron is an important component of red blood cells in our blood. When iron stores are low, red blood cell production is reduced resulting in a lowered capacity to transport oxygen and nutrients around the body. This condition is known as iron deficiency anaemia (IDA) and is diagnosed via a blood test.
Although in the early stages of IDA, the patient may have few signs and symptoms, as the deficiency worsens, symptoms may start to be noticeable. Symptoms of IDA include weakness and fatigue, chest pain, a rapid heart rate, shortness of breath (especially on exertion), dizziness, headache and light headedness to name a few.
People with underlying medical conditions that affect the body’s ability to absorb iron (such as Crohn’s Disease or Coeliac Disease) or conditions where blood may be lost at a greater rate than it can be produced (such as Inflammatory Bowel Disease and Endometriosis) are at greater risk of iron deficiency anaemia. Some diets, which are low in iron, also place a patient at greater risk of IDA.
Many patients are referred to the Centre for Digestive Diseases for investigation of the cause of the IDA and management of the condition.
Indications
Oral iron supplements taken regularly can increase the iron stores in the body but it is a very slow process. The body is only able to absorb a very small amount of iron every day with the remainder excreted out in the stool. This means in most cases it would take considerable time for anaemia to be reversed through this method. Traditional oral iron supplements may have unpleasant side effects including constipation, dark stools and abdominal discomfort and are contraindicated for patients with certain medical conditions such as Inflammatory Bowel Disease (IBD).
Iron infusions administered via injection are an effective, rapid method of replenishing the iron stores1. Iron Infusions are done as an inpatient procedure at CDD but only require the patient to be at the CDD for approximately 1 – 2 hours.
Special Considerations
Before the procedure, please ensure a member of your treating team is aware if you have ever experienced an allergic reaction to a previously administered iron infusion or to hydrocortisone.
Sedation
Iron Infusion does not require sedation or anaesthetic.
Post Procedure Care
Please note the following important points after you have your procedures:
- To maximize your iron stores following your iron infusion you doctor may prescribe an oral iron supplement to continue on with. If your Doctor has prescribed an oral iron supplement, please start this the day after your procedure.
- To ensure that your iron stores have improved following the iron infusion please complete your blood tests 6 and 12 weeks after treatment.
Complications
Iron Infusions are considered safe procedures2 but a small number of patients may experience side effects which may include: flushing, sweating, urticaria (rash) and / or joint and muscle pain. Iron can cause skin discolouration if the cannula through which the infusion is running becomes dislodged and the infusion is administered (not into the vein) but into the surrounding tissues. Discolouration is semi-permanent and will fade over time.
Although rare, it is possible to have an allergic reaction to the iron infusion. For the duration of your infusion you are monitored by trained nursing staff and hydrocortisone is administered to reduce risk, but reaction at the time of infusion or a delayed onset reaction is still possible. Signs of an allergic reaction may include hives, rash, difficulty breathing, bronchospasm (shortness of breath), palpitations, hypotension (low blood pressure) and angioneurotic oedema. Delayed side effects including fever, joint and muscle pain, back pain, enlarged lymph glands have also been reported.
Serious reactions are rare (<1%) but if they occur, hospitalisation may be necessary. If you observe any of these complications following procedure please seek medical advice immediately.
If you wish to discuss the potential risks or any issues regarding your procedure(s) in more detail, please speak with your gastroenterologist.
Contact Details
Please see the following link for CDD contact details during office hours Monday, Tuesday, Thursday and Friday (7am – 5pm ) and Wednesday (8.30am – 1.30pm): https://centrefordigestivediseases.com/contact-us/. As the Centre is a Day Stay Unit only, if complications following procedure arise outside of business hours you should seek medical attention from either your GP or nearest hospital emergency department.
Further Reading and References
1Litton, E., Xiao, J. & Ho, K.M. (2013). Safety and efficacy of intravenous iron therapy in reducing requirement for allogeneic blood transfusion: systematic review and meta-analysis of randomised clinical trials. BMJ, 347: f4822. Doi: 10.1136/bmj.f4822
Link to Publication: https://www.bmj.com/content/347/bmj.f4822
2Auerbach, M. & Macdougall, I.C. (2014). Safety of intravenous iron formulations: facts and folklore. Blood Transfusion, 12(3): 296-300. Doi: 10.2450/2014.0094-14
Link to Publication: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4111808/pdf/blt-12-296.pdf
