I need me some iron!

November 28, 2008 1:37 PM

Anyone have experience with intravenous iron treatments for anemia?

I was diagnosed with anemia at the beginning of this year and took iron pills for several months until my doctor told me I was no longer anemic. However, she said I should continue to take the iron pills only when I get my period once a month.

When I initially started taking the pills, there was an adjustment period of about a month while my body dealt with some uncomfortable side effects. My stomach pretty much went nuts. After a bit, I got used to it and taking them daily wasn't so terrible.

Cutting down to just one week a month though, seemed to confuse my body and the discomfort lead me to become lax on taking them during my period.

I was feeling fine for the past few months, but have recently noticed anemia symptoms again. I know I need iron, but I really don't want to go back to the pills. I heard that there are alternative treatments such as getting the iron administered intravenously every 3 months or so.

Has anyone had any experience with this kind of treatment? If so, do you prefer it to the iron pills? Thanks!

posted by missjamielynn to health & fitness (14 comments total)

I personally do not have experience with this, but my mother does. She has a slightly different issue, something called "watermelon stomach", wherein she gets these lesions (I guess that's the best word for them) on the lining of her stomach and then she starts leaking blood into her stomach at a very slow rate. She has to get them sealed up every couple of years (outpatient procedure at a clinic with an argon laser).

A side effect of all of this was that she also started taking iron pills so that her body could regenerate the lost blood quicker, but her doctor wasn't satisfied with the results of the iron pills and instead started giving her intramuscular iron injections every couple of months. Apparently she tells me they hurt like a bitch, and the injection site is sore and bruised looking for a week or more as the iron migrates out of the muscle, so her preference would be to have stayed on the pills if they did the job properly, but for her they don't.
posted by barc0001 at 1:53 PM on November 28, 2008

(I've been a practicing internist for 14 years.) Intravenous or intramusclar iron is seldom used; its primary recipients are people on dialysis or with anemias from other severe chronic medical conditions. There is a small risk of serious complications, including death, from IV iron. Oral therapy has no such risk so it is preferred if at all effective.

Iron is hard on the gut, however. This is exacerbated by its very poor absorption, requiring relatively large amounts to be taken. It is better absorbed in an acid environment, so taking a vitamin C (ascorbic acid) tablet along with the iron is commonly done.

I recommend you take a low dose (65 mg as opposed to prescription-strength of 325mg) iron pill plus a vitamin C tablet once daily, every day of the month. If even this low dose constipates you, you may need to use a stool softener or increase your fiber and fluid intake.
posted by neuron at 2:03 PM on November 28, 2008

I too was diagnosed last year as being anemic, and I've been taking a single 45mg Carbonyl Iron caplet daily, and I haven't had any stomach upset. Carbonyl iron is said to be easier on the stomach than Ferrous Sulfate.
posted by seymour.skinner at 2:24 PM on November 28, 2008

My doctor recommends Slow FE, which is an extended-release iron pill. According to her, the slow release can avoid some of the more severe stomach-related side effects of iron supplements.

I never got a chance to try them, because my bloodwork came back showing I wasn't anemic at all (I just have really heavy periods), but friends of mine that have tried it say it's better than regular iron supplements.
posted by bedhead at 2:47 PM on November 28, 2008

Heme iron is easier to absorb. The best-absorbed iron is found in egg yolks, beef is a close second. Those foods are high in fat and cholesterol, however; neurons' advice is probably healthier.
posted by ikkyu2 at 3:40 PM on November 28, 2008

I agree with trying to do it orally if at all possible. I have had gastric bypass and cannot absorb iron orally. This summer, I had to have 5 intravenous iron treatments. It isn't fun. I didn't have any reaction but it takes a long time and made me feel kind of hung over for a day or so. It can cause quite a serious reaction so just get in the habit of taking your pill. I had a prescription pill called Proferrin Forte that was very easy on the stomach. Ask your Dr for that one. Good luck,
posted by pearlybob at 5:11 PM on November 28, 2008

I have used the Slow FE, and didn't have too much trouble with it. It was much kinder to the digestive tract than other Iron supplements. I've had good luck with a nice steak and a giant side dish of spinach, also.
posted by The Light Fantastic at 6:42 PM on November 28, 2008

I was on intravenous iron earlier this year for 12 weeks...I had already been sick and in the hospital so my veins did not take kindly...

I had to get a PICC line. The PICC was great because they could just plug me in, and, they could do blood-draws to check my levels out of it too...so I was spared from any needles for a few months. The bad part about the PICC was I am allergic to all the types of adhesives they used and I had to get them rotated out and changed every few days, so I was left with a very sore, very raw arm for those 12 weeks. It also really stunk to get the PICC installed, took 4 times, a few hours and lots of boohooing on my part.

Sitting in the chair 3 hours a week for 12 weeks put a major cramp in my work attendance, but my boss was really good about it. I also got severe migraines after each session, which were helped by taking migraine medication an hour or two before each appointment.
posted by Jenny is Crafty at 6:43 PM on November 28, 2008

Get your B12 levels checked. My mom was suffering from severe anemia and iron injections for over a year before her PCP decided to check her B12 levels which turned out to be extremely low. Once they regulated her B12 levels by giving her B12 shots her anemia finally stabilized. She feels so much better. I just wish it didn't take so long for her doctor to figure it out.
posted by wherever, whatever at 7:00 PM on November 28, 2008

My doc suggests Vitron C, which is ferrous fumarate plus vitamin C for absorption. I find that it doesn't screw up my digestive tract like the ferrous sulfate does. I know others who take the carbonyl iron previously mentioned and do well on it.
posted by cabingirl at 9:04 PM on November 28, 2008

I know a few women who have had great success treating anemia with blackstrap molasses, which you should be able to find at your local Whole Foods type store.
posted by hindmost at 10:15 PM on November 28, 2008

IV/IM iron IS dangerous, very invasive, EXPENSIVE, and reserved for those who are severely anemic (dialysis, etc) as mentioned earlier. There is almost no way you will get this type of treatment. But there are lots of prescription vitamin/iron formulations, including Proferrin Forte mentioned above and several different formulations of one called Chromagen. A lot of these contain substances that make digestion/absorption of the iron easier. They are also very expensive, though, and many are not covered by insurance since vitamins and minerals are technically available over the counter.

A simple, cheap pharmaceutical solution is to take your regular iron tablets with a few precautions. The SlowFE can be a good choice as long as you take enough. And absorption isn't as great on a full stomach, but eating something with your iron really helps with stomach upset. And you can prevent the unpleasant, er, "lower GI side effects" by taking a stool softener: docusate sodium, 100mg twice daily (a typical US brand name is Colace). You don't need a stimulant laxative, just a softener... these won't cause any unwanted urges/running to the potty, just make it easier on you. Start taking them the day you start taking the iron and stop when you're done. That all really helped me when I was taking iron therapy.
posted by keribear at 11:29 PM on November 28, 2008

Yeah, I've had an IV iron infusion. In my case I was told to expect the infusion to last a year or so. Your anemia sounds similarly mild.

Side effects: my arthritis went nuts for a couple of weeks and then I felt great. The IV treatment was not painful, just boring, and every time I tried to flip a page in my book, I dislodged the damn thing and set off the alarm. Probably drove the nurses crazy; the rest of the patients getting infusions were weak, mostly cancer patients who nodded off sedately during treatment and napped (most likely because of the benadryl added to to the treatment to lessen the chance of reaction). If I recall correctly it took an entire afternoon, about four hours.

I've been anemic my entire life, and didn't have an infusion until I was around twenty-nine. Quite frankly, the lower dose iron pills didn't affect me at all (even when taken with vitamin C), and the higher dose would stop me up for days with constipation and SEVERE stomach pains. Colace (as someone suggested above) when taken with iron would give me bouts of constipation followed by uncontrollable leakage, until the colace was uh, gone. SlowFE was hideous to me. I also tried carbonyl iron, with similar effects. And prescription iron pills. (Don't get me started on the wankers who appear in all these threads and spout "Vitamin C!, spinach, etc." ugh.) I eat a ridiculous amount of fiber, but I tried fiber pills, and stayed hydrated. Nothing worked, not for twenty-nine years. Quite frankly I would have been better off trying infusions sooner. No, it's not fun, but for me it's not a huge hassle, and it's WAY more fun than shitting watermelons and watching your ass and gut get ripped apart, thus losing hey, more iron!

But they're right. Massive doses of iron are not a good idea if you can avoid it. Do some research at your local medical library if you want to know why, and what side effects are possible. My hematologist pooh-poohed all my concerns about the infusions and refused to discuss it with me, but fortunately I have room on my docket for one jerk doctor and I know what I need from him; I can take it on very rare occasions and leave the rest. Fortunately in my case he was right about one thing; the infusion was the right idea.

It sounds like you haven't done due diligence yet. You've only been recently diagnosed. Try other forms of iron, (and hey, stool softeners do work for some people, or so I hear), talk to your doctor(s), and if you don't think they're being candid or exploring all the options, find a good doctor. If you do explore alternative treatments keep in mind that injections and infusions are two different things.

Good luck!
posted by tejolote at 12:15 AM on November 29, 2008

I can't answer your question, but there is lots of similiar anecdotal info in this related thread.
posted by OlivesAndTurkishCoffee at 4:45 PM on November 29, 2008