Iron Deficiency Anemia
What is iron deficiency anemia?
Iron deficiency anemia is a common type of anemia (low hemoglobin level). It happens when there is not enough iron in the blood. The body needs iron to make hemoglobin. Hemoglobin carries oxygen throughout the body. When you don’t have enough iron in your blood, your body can’t get the oxygen that it needs. Iron is also needed for your muscles to work.
What causes iron deficiency anemia?
You may be at risk for getting iron deficiency anemia if:
- You are a woman who has heavy periods.
- You are a woman who is pregnant, just gave birth or is breastfeeding.
- You recently had a major surgery or injury.
- You have a history of celiac disease, ulcerative colitis or Crohn’s disease.
- You have had gastric bypass or other weight loss surgery.
- You are a vegetarian or vegan with a diet that lacks iron rich foods.
- You have bleeding in your gastrointestinal (GI) tract as a result of inflammation of the stomach or esophagus, ulcers in your stomach or bowel, hemorrhoids, diverticulitis or cancers in your GI tract.
- You have history of frequent nose bleeds with major blood loss.
- You donate blood often.
What are the symptoms of iron deficiency anemia?
- Feeling tired and low energy.
- Feeling short of breath or having chest pain.
- Feeling weak.
- Having a rapid heartbeat.
- Wanting to chew on ice, clay or other things that have no nutritional value.
- Your nails may be brittle or weak and your hair may fall out.
How is iron deficiency anemia diagnosed?
If you are having symptoms, your provider will order tests. These may include:
- Blood tests to check a complete blood count (CBC), and tests to measure your hemoglobin, hematocrit, ferritin, and serum iron.
Your provider will want to find the cause for the iron deficiency anemia, which is often bleeding. Tests to check for bleeding can include:
- Endoscopy or colonoscopy.
- Testing the stool and urine for blood.
If it is caused by heavy periods, your provider may have you see a gynecologist.
How is iron deficiency anemia treated?
There are many ways to treat iron deficiency anemia. These include:
- Adding more iron to your diet through the foods you eat.
- It’s important to include iron rich foods into your diet. Foods that are high in iron include: shellfish like clams, mussels and oysters, spinach, liver and other meat made from animal organs like kidneys, brain or heart, beans, peas, chickpeas, soybeans and lentils (legumes), red meat, quinoa, broccoli and tofu. You may want to ask to speak with a dietician about your diet.
- Taking iron supplements by mouth (oral FESO4).
- Intravenous iron replacement therapy.
Intravenous Iron Replacements
Iron sucrose (Venofer®), Ferric carboxymaltose injection (Injectafer®) and ferumoxytol injection (Feraheme®) are medications used for the treatment of iron deficiency anemia. They are given by intravenous (into a vein) infusion.
These is a risk of reactions to these medications. You will be monitored during, and for 30 minutes after you get your infusion. Symptoms of a reaction include low blood pressure, fainting, and unresponsiveness. Tell your provider right away if you have any symptoms during or after the infusion.
It is not known if these medications could harm unborn babies. Talk with your healthcare provider before getting pregnant or breastfeeding if you take any of these medications.
Ferumoxytol Injection (Feraheme®) can interfere with MRI studies for up to three months after you have been given the medication. MRI studies should be done before a ferumoxytol injection (Feraheme®) is given or three months after.
Other side effects that you may have include:
Iron sucrose (Venofer®)
- Can cause low blood pressure (hypotension). Patients should have their blood pressure checked regularly during therapy. Any hypotension should be treated. Symptoms include feeling tired, lightheadedness, dizziness, nausea and clammy skin. Tell your care team about any symptoms you are having.
- Can also cause iron overload. Your healthcare provider will check your blood levels during and after your treatment. Other side effects may include nausea, muscle cramps and headache.
Ferric carboxymaltose injection (Injectafer®):
- Can cause high blood pressure (hypertension). Patients should have their blood pressure checked regularly during therapy. Any hypertension should be treated. If hypertension cannot be controlled, the medication may be stopped. Report any headaches, vision changes or dizziness to your care team as these can be signs of high blood pressure.
- Can also cause nausea, flushing, dizziness and low levels of phosphorus in the blood. Your healthcare provider will check your blood levels during and after your treatment.
Ferymoxytol injection (Feraheme®)
- Can cause low blood pressure (hypotension). Patients should have their blood pressure checked regularly during therapy. Any hypotension should be treated. Symptoms include feeling tired, lightheadedness, dizziness, nausea and clammy skin. Report any symptoms to your care team.
- Can also cause iron overload. Your healthcare provider will check your blood levels during and after your treatment. Other side effects can include headache, nausea, dizziness, fatigue and diarrhea.
What happens after treatment for iron deficiency anemia?
Your provider will continue to check your blood tests. You may continue to take oral iron supplements after receiving IV iron therapy. You may also need to receive IV iron again in the future. Make sure to report any symptoms to your healthcare provider.