How to quickly raise iron levels outside of being hospitalized.
November 15, 2011 5:40 PM   Subscribe

In the U.S., what options exist for a nearly immediate increase in hemoglobin levels (or iron) outside of a blood transfusion in a hospital?

For instance, can doctors give a blood transfusion in their office? Also, I've heard that some type of iron injection is available in the UK but I don't know what is called or whether it is an option available in the US.
posted by who squared to Health & Fitness (15 answers total)
I think it would be easier to answer your question well with an understanding of what the information is for.
posted by Blasdelb at 5:46 PM on November 15, 2011

I, too, do not know what it's called other than "an iron shot," but I had them performed in my doctor's office two or three years ago after large oral iron supplements didn't improve my anemia. So that is available in the U.S.
posted by Occula at 5:46 PM on November 15, 2011 [1 favorite]

This is anecdata, but my mother ate blood sausage every day for a week to bring her iron levels up when she was pregnant with my brother. After that week, her iron levels were indeed higher, though I don't know that the sausage was definitely the cause.
posted by KathrynT at 5:53 PM on November 15, 2011

Iron and hemoglobin are not the same thing; hemoglobin requires iron (it's a metallic protein), but it is to raw iron what a Audi A8 is to a pile of aluminum ingots. So an iron shot (iron dextran) would raise iron levels and might eventually allow your body to create more hemoglobin, but I don't see how it would immediately result in more available hemoglobin or red blood cells.

In other words, you can't "blood dope" by taking iron injections before a race or something, in the way you can via a whole-blood transfusion or infusion of packed red blood cells. At least not that I've ever heard of, anyway. Unless you're anemic, your body should just excrete the extra iron rather than overproducing hemoglobin and RBCs.

And I suspect that a doctor could do a blood transfusion in their office (it's not that complex; it can be done in the back of an ambulance) but I doubt many doctors offices keep either whole blood or PRBC around, since it's both extremely perishable and expensive.
posted by Kadin2048 at 6:02 PM on November 15, 2011 [5 favorites]

Don't even consider the "amateur transfusion" comment. In my opinion that is irresponsible to suggest as well as potentially deadly :(

When I had chemo my hemo levels dropped nearly 50% they were able to give me shots of procrit which will raise your hemo level considerably. It's not without risk so consult with your doctor.
posted by Poet_Lariat at 6:05 PM on November 15, 2011

AFAIK, the injections people with refractory anemia often get are B-12 injections. There are outpatient infusion centers, but they're usually for chemotherapy/post-chemo treatment, autoimmune disorders or people with immunosuppression, and less common hematology disorders.
posted by cobaltnine at 6:10 PM on November 15, 2011

There are outpatient infusions centers where people can get transfusions without being "in the hospital." In many cases they're attached to a hospital, though not always. Either way, the person doesn't get admitted to a hospital bed, they simply hang out in a chair while they get the blood transfusion, and then go home.

Like Kadin2048 said, getting extra iron is not the same thing as getting more hemoglobin. Iron is just one of the building blocks of hemoglobin, and having more of it does not mean you'll necessarily build more hemoglobin. Even if it does improve your hemoglobin levels (like if iron deficiency was the main reason you were low to begin with), it will not be "instant." It takes time to build red blood cells. A transfusion is really the only "instant" fix.

Procrit or Epogen are trade names for a drug called epoetin, which mimics your body's natural hormone that signals the marrow to create more red blood cells. It's an injection that can be given outside of a hospital that will raise your hemoglobin, but again, not instantly. As with iron, it takes time to build more red blood cells. These drugs also have serious risks and are used with caution even in people who have remarkably low hemoglobin, for instance after receiving chemo.

To fake a higher hemoglobin, a person could in theory drink very little fluid until they were dehydrated. This would cause their hematocrit (one measure of red blood cells) to appear artificially high, because it's measured as a percentage of blood volume. Less fluid in the blood makes it look like there's more hemoglobin, but it's only relative to the fluid in the body. Certainly this is not a healthy approach to anything, and I can't think of any good reason to do it, but sometimes we do see it. Not because people are trying to have a higher hematocrit, just because they're dehydrated for some reason.
posted by vytae at 6:16 PM on November 15, 2011

Response by poster: Wow, definitely not blood doping. It's just finding options for someone who is anemic and will probably need a blood transfusion but doesn't want to be admitted--fear of hospitals.

I will go research Procrit and Epogen. Thank you.
posted by who squared at 6:56 PM on November 15, 2011

Response by poster: If anyone care share their experience with "iron shots," that would be very welcome. Memail is cool. Thanks.
posted by who squared at 6:58 PM on November 15, 2011

Transfusions are routinely done in infusion centers affiliated with hospitals - it's an in and out thing, but you do need to get it done under the proper monitoring in case you have a reaction. So I think that would be the best option for your friend, it doesn't require admission. It's not routine to give people EPO as a substitute for transfusion, it's typically used for people who either have anemia secondary to chronic kidney disease or cancer.
posted by treehorn+bunny at 7:11 PM on November 15, 2011

The options for your friend will depend on why he/she is anemic. If the problem is low iron, Epogen/procrit won't help him or her, because red cell synthesis depends on having adequate iron stores. If the problem is something like end stage renal disease where the iron levels are fine but the bone marrow is not appropriately making red cells, they could help. Neither of those will help much if the underlying problem is blood loss or B12 deficiency.

Outpatient transfusions are pretty routine in infusion centers but not in the average doctor's office, mostly because they take a long time and require monitoring as well as very elaborate protocols around the storage, handling, and administration of the blood. People do also get IV iron (also usually delivered at infusion centers because it can cause allergic reactions) if they have iron deficiency anemia and are not able to absorb oral iron.
posted by The Elusive Architeuthis at 7:24 PM on November 15, 2011

Some of these options are only appropriate for certain conditions: if I recall correctly, epoetin requires the patient to have iron in their system; it's not for iron-deficiency anemia, but for when the kidneys or bone marrow just aren't producing enough red blood cells. B-12 injections are for another type of anemia, and so on.
posted by cobaltnine at 7:25 PM on November 15, 2011

Response by poster: Ok, looks like the best option is a transfusion center for either blood transfusion or IV iron. The problem is iron-deficiency anemia due to blood loss.

I appreciate the clarification on the epogen/procrit usage. You guys are stellar.
posted by who squared at 7:48 PM on November 15, 2011

Really these are options that don't have any business being weighed on Ask Metafilter as anything more than potential things a licensed physician might bring up.

Your friend needs to be seen by a physician with access to diagnostic tests, their full medical history and most importantly them in person. A primary care physician that has a history with your friend, or an ability to start developing one, would be best (Particularly considering the long term nature and complexity of many of the root causes of what your friend might have) but a physician at an urgent care facility will work fine.

Barring, particularly complex or life threatening, unlikely things that your friend could have (That would really need a hospital in ways that fear has no business in the decision making), we can tell you that there shouldn't be a reason to go near a hospital, especially so close to Chicago.
posted by Blasdelb at 8:09 PM on November 15, 2011

Mod note: a couple of comments removed; the commenter was misunderstanding the question, and asked that his/her answers be removed
posted by taz (staff) at 6:39 AM on November 16, 2011

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