Intravenous iron therapy in non-anemic iron-deficient menstruating adolescent females with fatigue

Am J Hematol. 2016 Oct;91(10):973-7. doi: 10.1002/ajh.24461. Epub 2016 Jul 20.

Abstract

Menstruating women, with or without underlying bleeding disorders, are at increased risk for developing iron deficiency-related fatigue, even in the absence of anemia. Oral iron therapy has limitations which include poor absorption and non-adherence due to gastrointestinal side effects. We performed a prospective clinical trial of post-menarchal adolescent females with iron-deficiency with or without mild anemia and fatigue who received a standardized regimen of intravenous iron sucrose. The baseline mean (SD) hemoglobin was 11.96 g dl(-1) (1.05) in 20 girls (ages 14-21 years); with a range of 10.3-14.1 g dl(-1) . In this cohort, intravenous iron was well tolerated and patients demonstrated a sustained increase in ferritin levels with means (SD) of 13.4 ng ml(-1) (13.1) at baseline to 141.5 ng ml(-1) (104.5) at 6 weeks and 85.2 ng ml(-1) (128.4) at 6 months after the infusions. We used a standardized (Peds QL(TM) Multidimensional) fatigue scale to objectively measure fatigue and proxy scores by parents with mean screening scores (SD) of 35.2 (16.8) and 31.9 (19.6), respectively. We demonstrated a clinically significant improvement both in patient as well as parent fatigue scores (in 19 out of 20 subjects) at 6 weeks (Mean (SD) 58.3 (21.3) [P < 0.0001] and 57 (24.4) [P < 0.0001], respectively); as well as 3 and 6 months after the iron infusions. In nonanemic patients, iron administration did not significantly influence hemoglobin concentration. Therefore, the fatigue-reducing effects of iron therapy reflect the nonhematological functions of iron. Am. J. Hematol. 91:973-977, 2016. © 2016 Wiley Periodicals, Inc.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Intravenous
  • Adolescent
  • Anemia, Iron-Deficiency
  • Fatigue / diagnosis
  • Fatigue / drug therapy*
  • Female
  • Ferritins / blood
  • Hemoglobins / analysis
  • Humans
  • Iron / administration & dosage*
  • Iron Deficiencies
  • Menstruation / blood
  • Young Adult

Substances

  • Hemoglobins
  • Ferritins
  • Iron