Iron infusion for iron deficiency Definition With iron deficiency, a distinction is made between iron deficiency without anemia (= anemia) and iron deficiency with anemia. This can be differentiated laboratory-chemically as follows: Iron deficiency without anemia: normal hemoglobin, low ferritin (= storage iron). Iron-dependent metabolic processes may be impaired. Iron deficiency anemia: low hemoglobin, ferritin and MCV are reduced. Hypochromic, microcytic anemia Symptoms Reduced physical performance, fatigue, irritability, dizziness, cognitive disorders (poor concentration, impaired learning ability, memory impairment), headaches, increased heart rate, impaired thermoregulation, hair loss, brittle nails, mouth ulcers, tachycardia, shortness of breath during exertion, pale skin and mucous membranes, sleep disorders, shoulder and neck pain, appetite for clay and earth, among others. Individual symptoms are also possible with iron deficiency without anemia. Treatment: There are no generally accepted ferritin thresholds for diagnosing iron deficiency without anemia. Ferritin levels are elevated in inflammatory diseases. Indication Iron substitution For all patients with iron deficiency anemia If ferritin <15 ng/ml iron infusion For ferritin 15-30 ng/ml oral iron (Fe2 : Tardyferon®, Ferro Sanol®, Fe3: Maltofer® (slightly better tolerated, but slightly poorer absorption). If oral iron is not tolerated or is insufficiently effective, iron infusion. If ferritin 30-50 ng/ml Floradix, colostrum with iron or possibly iron tablets. Follow-up checks For iron deficiency without anemia Patients receiving oral iron: at the earliest 6-8 weeks after discontinuation of iron. Hb, CRP, ferritin. Patients who have received an iron infusion: Ferritin determination at the earliest 12 weeks after the last iron infusion (earlier measurement gives falsely high values!). Early check-up if symptoms do not improve or disappear within a few weeks. For iron deficiency anemia Hb after 4 weeks (should have increased by 2g/dl). Further Hb checks every 4 weeks until Hb normalizes. Ferritin determination 6-8 weeks after the last iron intake to monitor iron stores. If iron infusion is used, ferritin should not be checked until at least 12 weeks afterward.