Intravenous Iron Infusions
Update on the intravenous (IV) iron infusion service, by Professor Gerard Conway
London Lauriston Clinic now offers iron infusions.
What are iron infusions?
An iron infusion is a medical procedure where iron in solution is administered directly into the bloodstream through a vein. Common reasons to perform an iron infusion include iron deficiency anaemia, low ferritin not responding to oral treatment or because of side effects to other forms of iron. During an iron infusion, a small needle is inserted into a vein in the arm or hand, and the iron solution is slowly administered over 15-60 minutes.
How is iron status assessed?
There are several ways to test for iron with a blood test.
- Haemoglobin and mean cell volume: Red blood cells require iron and low iron can cause anaemia – low haemoglobin – or small red cells – low MCV.
- Iron: This is the circulating iron level; it is very variable and only a rough guide to body iron.
- Total Iron Binding Capacity (TIBC): An estimate of how much iron can be carried in the blood. With low iron the capacity for more goes up giving a high reading.
- Transferrin: This is the protein made by the liver that carries protein in the blood. If iron is low then transferrin goes up working like a sponge to carry more iron.
- Ferritin: Iron is stored in the body attached to a protein called Ferritin. Ferritin is the most useful item of the iron panel because it is closely related to scalp hair loss. For good hair growth the ferritin level should be over 70 ng/ml. Ferritin is made by the liver and high levels can occur in a many conditions which is where the other readings become useful.
After an infusion, ferritin should be tested at about 1 or 2 monthly intervals to determine how quickly the iron stores are used up and the timing of a follow up infusion if necessary.
When do doctors prescribe iron infusions?
Doctors may prescribe iron infusions when oral iron supplements are ineffective or poorly tolerated. Iron in the body is a balance between that that can be absorbed from diet or supplements and iron losses particularly for women with heavy periods. The body can be very inefficient at absorbing iron such as for people with inflammatory bowel disease or coeliac disease. Symptoms of iron deficiency include fatigue, weakness and hair loss.
What happens during an iron infusion?
There are several forms of intravenous iron. A typical dose of iron is 1000 mg which can be given as a single infusion or in multiple small infusions. The most widely available brand in the UK is given as multiple doses of 200 mg and the full dose is administered in short visits over 5 or more days. This allows for flexibility on the total dose. Iron infusions are typically performed in a hospital or clinic by a doctor or a registered nurse. London Lauriston Clinic provides iron infusions which are supervised by one of our doctors.
What are the benefits and risks of iron infusions?
Iron infusions are generally safe and effective, but there are some potential side effects.
Benefits of iron infusions:
- Rapid Improvement: Iron infusions can quickly increase iron levels in the body, leading to faster symptom relief compared to oral supplements.
- Effective for Severe Iron Deficiency: They are particularly helpful for people with severe iron deficiency or conditions that prevent iron absorption from oral supplements.
- Improved Quality of Life: By addressing iron deficiency, infusions can improve energy levels, reduce fatigue, and enhance overall well-being.
Risks of iron infusions:
- Side Effects: Common side effects include headache, nausea, muscle aches, and a metallic taste in the mouth. More serious side effects, such as allergic reactions, are rare but possible.
- Hypotension: Iron infusions can sometimes cause a sudden drop in blood pressure, which may lead to dizziness or fainting.
- Infection: There is a small risk of infection at the injection site.
It is important to discuss any potential risks and benefits with a healthcare professional before undergoing an iron infusion.
For the safety of our patients, all infusions are delivered with an urgent care doctor present at the clinic, ready to provide a support in case of any allergic reactions.
Do I need a referral for an iron infusion?
Your GP or specialist can provide a referral, including a copy of your test result, and a prescription. Usually, you will need to see one of our specialists to re-assess the requirement for an infusion and have an up-to-date blood test to allow for a calculation of the correct dose or iron. If you think that an iron infusion may be indicated for you, then a doctor at the London Lauriston Clinic can perform an assessment without a referral.
The cost of an iron infusion only — from £795.
For any enquiries re appointment or further information please contact us by calling during normal working hours on 020 4511 0444 or by sending an email to info@llclinics.co.uk.
Dr Gerard Conway is a senior consultant endocrinologist who is also the Medical Director of the London Lauriston Clinic.
28/01/2025
