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Can iron infusions make you sick or tired?

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If you’re struggling with tiredness due to low iron levels, your doctor may recommend an iron infusion. 

But could the iron infusion itself make you tired? Is that a real thing? And if it is, could a glass of Coke be the answer?

Managing your phosphate levels

Phosphate is a charged particle containing a mineral called phosphorus. Your body needs this for many functions involving your nerves, muscles and bones.

Your body begins to struggle if your phosphate levels are too low (hypophosphataemia). Many people’s levels are a little bit on the low side but they don’t necessarily experience symptoms. 

However, severe hypophosphataemia can affect many aspects of your health, including your blood, central nervous system, heart and lungs, mineral metabolism and musculoskeletal system. That can cause serious symptoms including: 

  • Pain
  • Weakness
  • Numbness
  • Confusion and irritability
  • Breathing difficulties
  • Heart failure. 

Hypophosphataemia may occur due to:

  • Malnutrition due to eating disorders or conditions that reduce your ability to absorb nutrients
  • Hormonal imbalances due to Cushing’s syndrome or hyperparathyroidism
  • Low levels of magnesium potassium or Vitamin D
  • Certain medications. 

Now, here’s the interesting bit…one potential cause of hypophosphataemia is an iron infusion. 

How does an iron infusion lower your phosphate levels? 

While anyone receiving an iron infusion can develop hypophosphatemia, certain groups are more at risk. According to recent studies, about 40-70% of patients experience a drop in phosphate levels after an iron infusion. 

If your phosphate levels are low before your infusion, there’s a greater risk of them dropping even lower afterwards. That can include patients with: 

  • Eating disorders
  • Low body weight
  • Chronic kidney disease
  • Inflammatory bowel disease
  • Abnormal uterine bleeding (a common reason for seeking an iron infusion)

Then there’s the type of iron infusion you receive. There are a number of different formulations that your doctor may prescribe and they all have different risks and benefits. Some, such as ferric carboxymaltose (FCM), are more likely to cause a drop in phosphate levels. 

Managing the risk of low phosphate in iron infusion patients

At Moonee Valley Specialist Centre, we do everything we can to help you avoid feeling sick or tired after an iron infusion. 

Surprisingly, many clinics do not routinely explain the risk of hypophosphatemia to patients, nor do they offer treatment or advice on how to prevent or manage it. As a result, many people experience post-infusion symptoms without understanding why.

Those conversations are important to us though. If we know more about your medical history, we can take steps to reduce the risk of low phosphate levels after your infusion. And you’ll know what to look out for, just in case it does happen.

If we think you’re at increased risk of hypophosphataemia or if you’re concerned about the possibility, we may: 

  • Recommend you take phosphate tablets, which contain about 500 mg of phosphate
  • Avoid using FCM and choose a different iron type of iron infusion.

If you’re reluctant to take tablets, you could always have a glass of Coca-Cola, which contains about 54 mg of phosphate. That’s far less than the tablets but easier for some patients to manage. Make sure it’s regular Coke, though, not the diet version. 

Being alert to the risk of hypophosphataemia after an iron infusion

If you’re having an iron infusion, you’re probably already experiencing symptoms such as fatigue, shortness of breath and general weakness. 

Against that backdrop, it can be hard to tell if you’re experiencing ongoing symptoms of low iron or if your symptoms relate to hypophosphataemia after your iron infusion. After all, symptoms of iron-infusion-induced hypophosphataemia also include fatigue, shortness of breath and general weakness.

So, what should you do? 

Firstly, take the precautions outlined above if you know you’re likely to be at risk (phosphate tablets and avoiding FCM). 

Secondly, contact us or see your GP or pharmacist if you’re concerned. You may need a follow-up blood test.  

Within 6-8 weeks after an iron infusion, your iron levels should be returning to normal, meaning symptoms such as fatigue and shortness of breath should ease. 

If that’s not the case, please tell your doctors. Iron-induced hypophosphataemia can last for 6 months to 2 years (not 2-3 weeks as originally thought) so the duration of your symptoms provides a clue. 

Iron infusions at Moonee Valley Specialist Centre

We’re keen to ensure you have a smooth iron infusion experience at Moonee Valley Specialist Centre. 

That’s why we provide a high-quality service where you’re assured of our close attention. We assess you carefully before your infusion, including discussing the risk of hypophosphataemia. We then monitor closely throughout your infusion to reduce the risk of any potential complications.  Please book an appointment today. 

Disclaimer 

All information is general and is not intended to be a substitute for professional medical advice. Moonee Valley Specialist Centre can consult with you to confirm if a particular treatment or procedure is right for you. Any surgical or invasive procedure carries risks. A second opinion may help you decide if a particular treatment is right for you.

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