Are iron injections the best option over iron supplements to restore iron levels?

Question

Hello doctor,

I have had low iron for quite a while. I also have polycythemia from testosterone supplementation, and at one point, my hematocrit got high enough that I was told to make biweekly blood donations. While the hematocrit has been controlled, my iron never rebounded, and I have struggled with low energy, depression, and exercise capacity.

I have tried taking iron supplements, but they irritate my stomach. Would it make sense to get an iron injection or infusion to get levels back to normal?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your report (attachments removed to protect the patient's identity) suggests polycythemia means high red blood cell count, hematocrit, and hemoglobin. Your ferritin level is a little low. If you take iron supplements, it is possible to raise hemoglobin to a higher level. So I would not suggest it.

The ferritin level decrease in your case is due to phlebotomy. Polycythemia is also one of the causes of weakness. However, you can also check other causes of weakness, like low vitamin D levels and serum TSH (thyroid-stimulating hormone) estimation, to rule out hypothyroidism, low calcium, etc.

You can consult your doctor for a detailed physical evaluation.

I hope this helps.

Thank you.