Patients struggling with iron malabsorption? Here is everything you need to know about iron therapy.

Intravenous (IV) nutrition therapy has found numerous applications in the healthcare sector. It consists of a fast and optimized nutrient delivery method that can be given as a single dose shot or as a bolus: continuous injection into the bloodstream over time (minutes to hours). When it comes to the type of nutrients injected, a wide array of vitamins, minerals, amino acids, and other necessary fluids can be administered, depending on the health-associated needs to be met. Iron perfusion, for instance, has been the most popular type of IV nutrition therapy for the past decades.


Iron is a trace element, meaning that it is found in trace amounts in the body and is mainly absorbed in the small intestine. A men's body weighing 70 kg ( or 154 lbs) contains about 4 g of iron, while a woman's body weighing 60 kg (132 lbs) has about 2.5 g of iron. The body needs iron to make hemoglobin, a protein in red blood cells that allows them to carry oxygen throughout the body. Iron is also substantial for the production of adenosine triphosphate (ATP), the body's primary energy source. It further mediates several vital physiological processes, such as the regulation of cell growth and differentiation and neurocognitive functions.



Iron deficiency, the body lacking iron, is a common nutritional deficiency among patients of all ages. It is usually associated with a low hemoglobin level in the blood, a condition known as anemia. However, non-anemia-related iron deficiency can also cause symptoms such as fatigue and lack of energy and would be differentiated during patient examination. The latter is often treated with oral iron supplementation, such as iron tablets. However, taking iron supplements (especially sulfate-iron complexes) can cause abdominal pain and gastrointestinal irritation without covering all types of iron deficiencies and proven efficacy. In addition, newer iron preparations, including intravenous iron administration, are more stable and have lower risks of side effects, with more significant therapeutic benefits, over a shorter period. 1


Common factors that promote the decrease of iron level:

The most obvious reason can be the lack of dietary iron intake. It can be from animal products: red meat, liver, poultry, and seafood (heme-iron), or from plant-based sources such as spinach, lentils, and other leafy greens and legumes (non-heme iron). Blood loss, for instance, can be a detrimental factor to the decrease of the iron level in the body: for women precisely, this consists of a monthly period during which iron supplementation is necessary. Moreover, blood loss can occur during medical interventions such as surgeries, accidents, ulcers, and certain types of cancer. Another essential factor to keep in mind is how well the iron is absorbed after administration. It has been shown that iron malabsorption can occur when taking certain medications that interfere with that or consuming certain foods and drinks; tea, coffee, and rosemary extracts have been found to inhibit iron absorption. Therefore, it is advised to look up the patient's prescription medicines beforehand. 2


When is an Iron IV therapy suitable for patients?

When the following symptoms are described and reported, it is important to start getting iron IV therapy. Among the common iron deficiency symptoms: muscular weakness, general fatigue, dizziness, looking pale and lacking stamina, concentration and poor memory, headaches, mood swings, hair loss, and lack of appetite.


Before beginning the treatment, iron measurement is required:

There is no universally accepted limit value for the normal level of iron in the blood. Ferritin, a protein, however, is a good benchmark, as it indicates the level of iron stored in the body. If the ferritin level is below 15 nanograms per ml of blood (ng/ml), the reserves are considered exhausted. It is advisable to ask your patient to run a blood test and discuss the results before the treatment.


Who is Iron IV therapy for?

According to recent findings in clinical studies, IV iron therapy can significantly improve the quality of life of patients in the following situations:

Iron IV therapy has been moved to the frontline treatment options. It has been proven efficient for patients suffering from heart failure, intestine-related diseases, and inflammatory bowel diseases. 3 Also, patients undergoing kidney dialysis treatments are more subject to losing significant amounts of blood, and therefore can benefit from an IV therapy.

Furthermore, normal adults can benefit from this type of therapy if they are non-anemic and suffer from general fatigue, which hinders them from accomplishing daily tasks, according to a study. 4 These findings can be extended to people who find difficulties in exercises and endurance sports. 5


Conclusion

Iron deficiency can be a quite common condition, stemming from various issues that range from cardiac disease to an iron-poor diet. Therefore, recommending novel iron supplementation methods such as IV therapy for your patients can improve their condition and their quality of life.


References:

1: https://pubmed.ncbi.nlm.nih.gov/30970354/

2: https://academic.oup.com/ajcn/article/73/3/607/4737430

3: https://pubmed.ncbi.nlm.nih.gov/32220343/

4: https://pubmed.ncbi.nlm.nih.gov/32043476/

5: https://pubmed.ncbi.nlm.nih.gov/28836730/