Treatment Options

Treatment options for iron deficiency in chronic heart failure

If you have chronic heart failure, then having iron deficiency as well can have serious consequences, reducing your quality of life1 as well as increasing your risk of death.2 Therefore it is important that your iron deficiency is treated. Effective treatment can improve your quality of life as well as reduce your risk of being hospitalised with worsening heart problems.3

Treating iron deficiency can improve quality of life3 and reduce risk of hospitalisation3

There are several ways in which iron deficiency can be treated, depending on why you are iron deficient and how low your iron levels are. Your doctor will assess all the options, and any medication you are already on, before choosing which is best for you.

One option is to increase the amount of iron in your diet by including iron-rich food such as red meat, liver, enriched cereals and leafy vegetables.4 However, a change in diet may not be enough to correct your iron levels, or be a fast enough change. Other options are:

• Oral iron supplements available over-the-counter or on prescription4
• Intravenous iron where iron is given via an injection directly into your blood stream5

Oral iron tablets are widely used but are associated with side-effects such as constipation, nausea and heartburn in up to 60% of patients.5

These side-effects mean you might not feel like taking your tablet regularly, so you won’t get the iron you need.5 If you have chronic heart failure there are several reasons why getting your iron via an injection could be the better option for you, including:

• Functional changes in your gut mean you may not be absorbing iron properly5
• You could be on several tablets already, so adding another tablet, typically 3 times a day, could be difficult5

Treatment with intravenous iron can quickly restore your iron levels,5 improve your quality of life and reduce symptoms of fatigue.3 Intravenous iron does not need to be given every week; in a study of patients with chronic heart disease 75% of patients only needed 2 injections at the most over a year.3

Talk to your doctor about your treatment options and your symptoms so you can decide together on the best way to get your iron levels back on track.

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• 1. Comín-Colet J, Enjuanes C, González G, et al. Iron deficiency is a key determinant of health-related quality of life in patients with chronic heart failure regardless of anaemia status. Eur J Heart Fail. 2013;15(10):1164-72. doi:10.1093/eurjhf/hft083.
• 2. Jankowska E a, Rozentryt P, Witkowska A, et al. Iron deficiency: an ominous sign in patients with systolic chronic heart failure. Eur Heart J. 2010;31(15):1872-80. doi:10.1093/eurheartj/ehq158.
• 3. a. b. c. d. e.
  Ponikowski P, van Veldhuisen DJ, Comin-Colet J, et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency. Eur Heart J. 2014:657-668. doi:10.1093/eurheartj/ehu385.
• 4. a. b. Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med. 2008;121(11):943-8. doi:10.1016/j.amjmed.2008.07.012.
• 5. a. b. c. d. e. f. Mcdonagh T, Macdougall IC. Iron therapy for the treatment of iron deficiency in chronic heart failure : intravenous or oral ? Iron deficiency : a common co-morbidity in heart failure. Eur J Heart Fail. 2015.