Q: What does Iron do in the body?

A: Iron is an essential nutrient that provides oxygen and energy to the body.

Iron is also an important part of haemoglobin (Hb). Haemoglobin is the substance in red blood cells that carries oxygen around the body

Iron is also a key component of enzymes that manufacture energy in the muscles.

Q: How is Iron Deficiency Diagnosed?

A: Your blood results will tell us the amount of iron you have in your blood is low. Iron Deficiency is measured by two markers: Ferritin and Transferrin saturation.

Ferritin is a protein that stores iron in your cells, particularly the liver. Measurement of Ferritin reflects the body’s iron stores. A low Ferritin means a low store of iron.

Transferrin carries iron from the body’s stores to the bone marrow where iron is used to make new blood cells. In iron deficiency the transferrin becomes empty so you develop low ‘T stats’.

Q: How does Iron Deficiency cause Anaemia?

A: You need iron so your body can make new haemoglobin and red blood cells to carry the oxygen your body requires. Iron is the ‘building block’ of red blood cells. Therefore, a lack of iron leads to reduced production of haemoglobin and also reduced production of red blood cells. When production falls the amount of red cells in the blood circulation falls leading to anaemia. The definition of anaemia is when there is a haemoglobin concentration of <12g/L in women and <13g/L in men.

In iron deficiency anaemia, the red blood cells produced are also poor quality, being smaller than normal (microcytic seen by a low MCV on your blood test). Therefore, it is very important to have enough iron in your blood.

Q: What’s the normal amount of iron in the body?

A: Iron is predominantly held in the red blood cells and muscles of your body. At any one time you should have about 3000mg of iron in your body. Normally, your iron stores are well maintained by the spleen, where iron is recycled. Only a small amount of iron is needed to ‘top up’ your iron stores to keep them at a healthy level. This can usually be gained by absorbing iron from your diet at about 2-5mg per day. However, if you are iron deficient you will need to absorb larger amounts of iron to maintain healthy levels.

Q: If I’m iron deficient, how low on iron am I?

A: On average, if you are iron deficient you are probably functioning on 30–50% of your iron stores, so you will be deficient by about 1000mg or more depending on your weight.

To put this in perspective: A normal menstrual cycle results in the loss of 80mg of iron, so a woman must recycles much of her body’s iron stores every year. Indeed 10–12% of women are iron deficient and anaemic at any one point in time and a third of all women will develop iron deficiency anaemia in their lifetime.

Q: What are the options to treat iron deficiency anaemia?

A: Iron deficiency anaemia can be treated using iron tablets. However, this method usually has a poor absorption rate, where the average dosage is 200mg, but only about 4-16mg of iron is actually absorbed into the body. This means it can take many weeks to stabilise iron deficiency and can take a month or more to improve the body’s iron stores. Most people need 1–2 months to see their anaemia improve and would need to be on iron supplements for 3–9 months, to fully replenish normal iron stores.

Q: What is the benefit to an Iron Infusion?

A: In the last five years two new preparations of iron have been developed. These new formulations enable an individual to receive a ‘total dose’ infusion safely in 15 to 30 minutes. This means we can safely and effectively give you enough iron to replenish your normal iron stores in a single treatment. An iron infusion is a considerably faster and more effective method to correct anaemia than iron tablets, which can take months to fully replenish iron stores.

Typically, your doctor will prescribe 1000mg to 1600mg of iron to be given. This is a ‘total dose’ infusion which will correct all your body’s iron stores rapidly. Also, because the iron is delivered straight to the muscles and bone marrow, where it is needed most, most people will experience an improvement within the first few days.

In fact, following an iron infusion you are likely to notice that you are less tired, have more energy, better concentration and become less breathless when taking exercise.

Following the infusion, provided you maintain a healthy diet which includes iron, you will not need any further treatment with iron tablets.

Q: Are there any risks?

A: Overall this is a safe procedure. There are some side effects that about 3–4 people in every 100 notice: The most common is a metallic taste in your mouth, mild flushing or feeling queasy.

Approximately 3 in 100 people who receive intravenous iron do feel some side effects, the vast majority of which are mild and self-limiting. While very rare, more significant side effects may occur in less than 10 in one million people. In a recent detailed review (JAMA 2016) it was suggested that the overall risk was similar to receiving penicillin.