Iron Deficiency & Iron Infusion

-What is an iron infusion?

An iron infusion is a procedure in which iron is delivered to your body intravenously or into a vein through a needle. 

-Are iron infusions common?

In Australia the prevalence of iron deficiency varies depending on which part of the population you are considering.

It affects approximately 10% of non-pregnant young women.

In developing countries this is higher – about ¼ of the population is iron deficient

I wouldn’t say iron infusions are common but they are certainly being used more frequently in the community due to the types of infusions that are now available.  These have lower incidence of severe side effects, and therefore do not necessarily need to be done in the hospital.

-Who should get iron infusions?

People who can’t take iron by mouth

People who can’t absorb iron adequately through the gut

People who can’t absorb enough iron due to blood loss

People who have decreased iron or iron stores

People who become anaemic due to low iron

-Are they safe for mom and baby?

Infusions are often preferred over oral iron supplements because taking it by mouth can cause gastrointestinal side effects – like nausea and constipation. However, iron infusions are usually reserved for the second or third trimester of pregnancy. The iron infusions can have side effects too, so it is really important to have a thorough discussion with your doctor beforehand. It’s not yet known if it is safe to administer iron infusions during the first trimester.

-I don’t think I have any friends who have had an iron infusion. Are they used more in Australia than elsewhere?

They are not more common in Australia.  The newer infusions that are available are easier to give and have less side effects.  So they are probably being offered more readily in the community. 

-Is it common for pregnant women to become iron deficient? If so, which trimester?

A pregnant woman’s need for iron increases as her baby develops. As the baby absorbs iron from her body, the mother’s iron levels may drop, resulting in iron deficiency or anemia. 

Pregnant women are advised to take oral iron in the first trimester and continue throughout the pregnancy if their iron levels are low.  If they cannot tolerate oral iron or the levels drop too low, pregnant women may be offered an iron infusion.  It is not recommended to have an infusion in the first trimester but they can certainly be offered in the 2nd and 3rd trimesters.

-Along with exhaustion, what are the symptoms?

- Tiredness
- Shortness of breath
- Paleness
- Headaches and dizziness
- Dry damaged hair and skin
- Soreness of the tongue and mouth
- Heart palpitations
- Restless legs
- Brittle fingernails
- Strange cravings
- Cold hands and feet
- Feeling anxious
- More frequent illnesses

-How low is too low?

If you feel any of the symptoms we mentioned, you should speak to your doctor and have your iron and haemoglobin levels checked.  The numbers are important of course, but they aren’t the full picture.  If you’re numbers are very low, of course you should be treated as soon as possible.  If you’re numbers a little low, and you have symptoms, then treatment will definitely make you feel better. How a person feels is very important in a doctor’s decision to treat.

-Is there a danger to the baby if mom is iron deficient?

The baby will take all the nutrients it needs to develop properly.  The pregnant mother is the one who will become very unwell, have symptoms, and become iron deficient or anaemic.  Of course, if the mother is severely malnourished then it can and will affect the baby’s development.  This does not happen very often in Australia or the USA.

-Who should take iron supplements in addition to prenatal vitamins?

All women are advised to take pregnancy vitamins that contain the amount of iron that is safe and necessary for the baby’s growth and to keep the mother at an iron level that she will feel well.

People who are vegan or vegetarian, or have iron absorption problems, or who are iron deficient prior to pregnancy should take iron supplements in addition.  But they should always speak to their doctor first.

-I don’t eat red meat, but get more than 100% daily value of iron from dark green veggies, beans, chickpeas, iron fortified cereal, etc. I also take a pregnancy vitamin recommended by my GP or OBGYN. Could there be another reason my iron is low and I’ve been feeling more exhausted than most?

There are plenty of medical reasons why a pregnant mother could have low iron and feel exhausted.  It is important to speak to your doctor if you have any medical conditions or issues prior to pregnancy.

A couple of simple tricks can help most people absorb iron better.  If you take your iron supplement or eat your iron rich foods with vitamin C, it helps iron absorb more efficiently.  In the same respect, if you avoid dairy products or antacid treatments in the hour surrounding taking the iron supplement or eating iron rich foods, this can help too!

Samantha Andison