Energy crash! Time to go to the hospital and get strapped up to an IV for an iron infusion! Wait!!! What!?!?

My OBGYN knows I am normally quite high energy, so when I told her about my severe exhaustion, she knew something was up. We had my iron levels tested. Despite a healthy diet, full of iron rich foods, and taking prenatal vitamins, the levels were too low. She prescribed an iron infusion in the delivery suite so we could monitor my baby boy the whole time. It sounded pretty invasive and full on, so I didn't want to do it at first.

My OBGYN gave me clearance to try another option first. I tried taking an oral iron supplement in addition to my prenatal vitamins. Unfortunately a couple weeks later I felt like I had walked off a cliff into the low energy zone. The best thing for me to compare it to is the exhaustion I used to feel after a long 20+ mile run during marathon training - not wanting to move a muscle because everything felt fatigued. 

Most days I could go about my business until mid afternoon, before heading into the twilight zone. But unfortunately, a little over a week ago that feeling started coming on earlier an earlier. I could hardly keep my eyes open - was losing concentration - became short of breath - noticed my heart rate was going up - and even felt dizzy a few times. It became apparent that I ought to go ahead and get the iron infusion.

I hated the idea because I am so conscious about eating a balanced diet. Although I don't eat red meat, I make sure to meet the recommended daily value of iron (heaps of green veggies, beans iron fortified cereals, etc), and religiously take my prenatal vitamins. I began to feel like I had been doing something wrong.  But my OBGYN reassured me. She said it's quite common for pregnant women to be iron deficient, even when they are eating healthy diets. The growing baby just sucks a lot of goodness from us unfortunately! Having done quite a bit of research on this as of late, I have now learned that a way for all of us, pregnant or not, to make sure we actually absorb the iron we are eating, is to pair it with vitamin C. This is something I was not taking into account.

Going to the delivery suite at the hospital for the iron infusion turned out to be a great idea. The process was not painful (aside from the stick when the needle for the IV goes in) and it lasted less than an hour. I was told the main side effects are quite minor - possible headache or nausea. But the other big risk is daunting. If the needle goes in wrong, there is a very slight chance the iron will stain your arm, permanently. Eeeek! I did not want to end up with a brown, iron tattoo for sure!

Fortunately all went smoothly. I am told it typically takes a little over a week to notice a real difference in energy levels, but I already feel like it was a fabulous decision to get the iron infusion. Just going to the delivery suite in the hospital was also comforting in a way. I got a mini tour, and now feel more prepared for my labor and delivery. Makes total sense! Now I know where all the magic will happen next month - when we welcome our baby boy into the world!

In this post you will find two videos. One is from the delivery suite at the hospital showing what an iron infusion looks like. The second video is a walk and talk with a friend of mine who is a family physician, Dr. Jill Gamberg. We chat about iron deficiency during pregnancy, how to make sure we absorb the iron we are ingesting, and how an iron infusion works.

ANNA: What is an iron infusion?

Dr. Gamberg: An iron infusion is a procedure in which iron is delivered to your body intravenously or into a vein through a needle.  

ANNA: Are iron infusions common?

Dr. Gamberg: In Australia the prevalence of iron deficiency varies depending on which part of the population you are considering. 

It affects approximately 10% of non-pregnant young women.

In developing countries this is higher – about ¼ of the population is iron deficient

I wouldn’t say iron infusions are common but they are certainly being used more frequently in the community due to the types of infusions that are now available.  These have lower incidence of severe side effects, and therefore do not necessarily need to be done in the hospital. 

ANNA: Who should get iron infusions?

Dr. Gamberg: People who can’t take iron by mouth

People who can’t absorb iron adequately through the gut

People who can’t absorb enough iron due to blood loss

People who have decreased iron or iron stores

People who become anaemic due to low iron

ANNA: Are they safe for mom and baby?

Dr. Gamberg: Infusions are often preferred over oral iron supplements because taking it by mouth can cause gastrointestinal side effects – like nausea and constipation. However, iron infusions are usually reserved for the second or third trimester of pregnancy. The iron infusions can have side effects too, so it is really important to have a thorough discussion with your doctor beforehand. It’s not yet known if it is safe to administer iron infusions during the first trimester.

ANNA: I don’t think I have any friends who have had an iron infusion. Are they used more in Australia than elsewhere?

They are not more common in Australia.  The newer infusions that are available are easier to give and have less side effects.  So they are probably being offered more readily in the community.  

ANNA: Is it common for pregnant women to become iron deficient? If so, which trimester?

Dr. Gamberg: A pregnant woman’s need for iron increases as her baby develops. As the baby absorbs iron from her body, the mother’s iron levels may drop, resulting in iron deficiency or anemia.  

Pregnant women are advised to take oral iron in the first trimester and continue throughout the pregnancy if their iron levels are low.  If they cannot tolerate oral iron or the levels drop too low, pregnant women may be offered an iron infusion.  It is not recommended to have an infusion in the first trimester but they can certainly be offered in the 2nd and 3rd trimesters. 

ANNA: Along with exhaustion, what are the symptoms?

Dr. Gamberg: 

Tiredness

Shortness of breath

Paleness

Headaches and dizziness

Dry damaged hair and skin

Soreness of the tongue and mouth

Heart palpitations

Restless legs

Brittle fingernails

Strange cravings

Cold hands and feet

Feeling anxious

More frequent illnesses

ANNA: How low is too low?

Dr. Gamberg: If you feel any of the symptoms we mentioned, you should speak to your doctor and have your iron and haemoglobin levels checked.  The numbers are important of course, but they aren’t the full picture.  If you’re numbers are very low, of course you should be treated as soon as possible.  If you’re numbers a little low, and you have symptoms, then treatment will definitely make you feel better. How a person feels is very important in a doctor’s decision to treat.

ANNA: Is there a danger to the baby if mom is iron deficient?

Dr. Gamberg:The baby will take all the nutrients it needs to develop properly.  The pregnant mother is the one who will become very unwell, have symptoms, and become iron deficient or anaemic.  Of course, if the mother is severely malnourished then it can and will affect the baby’s development.  This does not happen very often in Australia or the USA.

ANNA: Who should take iron supplements in addition to prenatal vitamins?

Dr. Gamberg: All women are advised to take pregnancy vitamins that contain the amount of iron that is safe and necessary for the baby’s growth and to keep the mother at an iron level that she will feel well.

People who are vegan or vegetarian, or have iron absorption problems, or who are iron deficient prior to pregnancy should take iron supplements in addition.  But they should always speak to their doctor first.

ANNA: I don’t eat red meat, but get more than 100% daily value of iron from dark green veggies, beans, chickpeas, iron fortified cereal, etc. I also take a pregnancy vitamin recommended by my GP or OBGYN. Could there be another reason my iron is low and I’ve been feeling more exhausted than most?

Dr. Gamberg: There are plenty of medical reasons why a pregnant mother could have low iron and feel exhausted.  It is important to speak to your doctor if you have any medical conditions or issues prior to pregnancy.

A couple of simple tricks can help most people absorb iron better.  If you take your iron supplement or eat your iron rich foods with vitamin C, it helps iron absorb more efficiently.  In the same respect, if you avoid dairy products or antacid treatments in the hour surrounding taking the iron supplement or eating iron rich foods, this can help too! 

Dr Jill Gamberg BIO:

Dr. Gamberg graduated with Honours from the University of New South Wales with a Bachelor of Medicine and Surgery in 2007, after which she completed her General Practitioner training in the Hunter Valley region. Jill is a fellow of The Royal Australian College of General Practitioners, and practices as a GP in Sydney in addition to her role at Healthshare.

Jill has early professional experience as a qualified Sports Therapist, and has brought her knowledge of musculoskeletal conditions and sports injuries to her practising as a GP. Jill’s style is preventive, holistic and integrative, and she has a strong interest in the areas of paediatrics, antenatal care, nutritional deficiencies, and travel medicine.

With a passion for nutrition, the outdoors and keeping active in her spare time, Jill enjoys travelling, nature, exercise, good food and spending time with her family.