Oral Iron Supplement Failure Before Iv Iron Chemo

Iron is one of the most abundant minerals on the Earth, and it is essential to many of the Earth's life forms, including humans. Humans rely on iron to transport oxygen throughout the body and as a key component of several enzymes, including the detoxifying cytochromes. You may become deficient in iron due to poor intake, poor absorption or increased losses. While oral iron supplements are the first line of treatment, some patients ultimately require intravenous iron chemotherapy, or IV iron.

Causes

You may transition from oral supplements to IV iron because you do not tolerate oral iron supplements, because they are ineffective or because they interfere with other medications you require. Oral iron supplements cause side effects, such as stomach pain, upset stomach, nausea, vomiting, diarrhea and constipation. For some patients, these side effects may be so severe that they interfere with the patient's ability to eat or perform activities of daily living. Patients with gastrointestinal diseases or who have undergone surgery to remove part of the gastrointestinal tract may not be able to absorb ingested iron. This may not be clear until blood tests fail to show expected improvements.

Diagnosis

Most people with iron deficiency start to feel better a few days after starting iron supplements. If you do not, or if you experience unacceptable side effects, let your doctor know. Your doctor can suggest other strategies, such as taking a different type of oral iron supplement, taking a lower dose more frequently, taking the medication at a different time or taking the medication with an acidic juice, such as citrus or tomato juice. If these are ineffective, your doctor may diagnose oral iron supplement failure and order IV or IM -- intramuscular -- iron chemotherapy.

Safety

Compared to oral iron supplements, IV iron is more expensive, and it is associated with a higher risk of serious side effects. IV iron injections must be performed at a hospital, clinic or doctor's office. Side effects, including flushing; headache; muscle or joint pain; dizziness; nausea; rashes; pain, redness or swelling at the injection site; fever; chills or drop in blood pressure. Fewer than 1 percent of patients who receive IV iron experience a life-threatening allergic reaction call anaphylaxis. However, your doctor will probably order a small test dose to be administered prior to the full dose, to assess your risk of this complication.

Effectiveness

If oral iron supplements do not work for you, you may notice improvements from IV iron within a few days. The National Anemia Action Council says full effects may not be apparent until 10 to 13 days. You may need to go back for follow-up doses in the interim. Allow about two months for blood tests to show normal hemoglobin, hematocrit, red blood cell count and red blood cell size because that is how long it takes for your body to replace older iron-deficient red cells.

Considerations

William Ershler, a hematologist with the National Institutes of Health, says, "Some patients will not be able to take an oral iron supplement no matter how hard they try." Do not take it personally if you cannot tolerate oral iron supplements. Always let your doctor know about side effects from any form of iron. Also attend all follow-up appointments, including those for lab work. Although your symptoms may resolve quickly, it usually takes six months to one year to replenish iron stores.