Before Iron Treatment,the Right Diagnosis.

Iron deficiency always has a reason. In many people the cause is straightforward: heavy periods, pregnancy, a diet low in iron, frequent blood donation, or endurance training. But iron deficiency can also be the first sign of a condition that needs investigation in its own right, including slow, hidden blood loss from the stomach or bowel (for example from ulcers, inflammation or polyps); bowel cancer or stomach cancer, which can cause gradual blood loss long before any other symptoms appear; coeliac disease and other gut conditions that stop iron being absorbed; inflammatory bowel disease (Crohn's disease or ulcerative colitis); and side effects of long-term medicines, such as anti-inflammatory painkillers or blood thinners. This is why UK clinical guidelines recommend that unexplained iron deficiency anaemia, particularly in men of any age and in women after the menopause, is investigated for a cause in the digestive tract, including bowel cancer (NICE guideline NG12; British Society of Gastroenterology guidelines, 2021). An iron infusion may improve your symptoms and your blood results. If the cause has not been looked for, that improvement can mask a serious condition and delay its diagnosis. Your EGA doctor will ask about your symptoms, diet, menstrual history, bowel habits, medicines and family history, and will advise you if further investigation is recommended, including referral to your GP or a specialist where appropriate.

Fatigue, hair loss and low energy have many causes, and not all of them are iron. Iron that the body does not need cannot easily be removed, and excess iron can build up in organs such as the liver and heart. Your consultation confirms from your blood results that you are genuinely iron deficient before any iron is given, and identifies conditions in which extra iron is harmful, such as haemochromatosis (inherited iron overload).

Not all anaemia is caused by low iron. Low vitamin B12 or folate, chronic inflammation, kidney disease and inherited conditions such as thalassaemia trait can all cause anaemia, and an iron infusion will not correct them. Your doctor will interpret your full blood count and iron studies together to make sure iron is the right treatment.

IV iron is well tolerated by many people, but some factors increase the risk of side effects, including serious allergic reactions. Your doctor will check for previous reactions to IV iron or other medicines, significant allergies, asthma or eczema, active infection, liver problems, and pregnancy or breastfeeding. Iron infusions are not given in the first trimester of pregnancy.

The right dose of iron (500mg, 1000mg or 1500mg) depends on your haemoglobin, ferritin and body weight. Too little may not correct your deficiency; more than you need offers no benefit. Your dose is always decided by your EGA doctor.

We need blood results that include a full blood count (including haemoglobin), ferritin, and iron studies: serum iron, TIBC and transferrin saturation. Your blood test does not need to be done at EGA. Results from your GP, a hospital or another accredited laboratory are accepted, but they must be recent, taken within approximately one month of your consultation. Older results may no longer reflect your current iron status, and a repeat test will be needed. Your doctor may request additional tests where clinically relevant. If you do not have recent results, choose our Iron Consultation + Blood Test package and we will arrange everything at EGA.

Your consultation is where your results are reviewed, the cause of your deficiency is considered, risks are screened and your dose is decided. An iron infusion cannot be booked without it.

Your blood test results (if you are not testing with us); a list of the medicines and supplements you take, including any iron tablets; details of any previous iron treatment and how you responded; any previous allergic reactions to medicines or infusions; any relevant medical history, including gut conditions, surgery or previous investigations such as endoscopy or colonoscopy; and whether you are pregnant, may be pregnant or are breastfeeding.