Low Iron and Heart Failure
Many people with heart failure also have iron deficiency – when there is too little iron in the body. In fact, over half of those with heart failure have very low iron levels.
The concern?
- Many people don’t know their iron is too low. That means they aren’t getting treatment to help improve their iron levels, which can help avoid related health problems.
- Studies show that untreated iron deficiency is linked to poorer health for people with heart failure, including:
- Worse heart failure symptoms
- A higher chance of needing hospital care – even dying
- Poorer quality of life (when your general sense of well-being is lower and impacts the things you are able to do, and not do)
- Difficulty exercising or being active
| Among other things, iron helps our bodies make the healthy red blood cells and hemoglobin that then carry oxygen to our organs and tissues so they can work properly. |
For this reason, screening for and treating low iron is now a recommended and important part of managing heart failure for many patients. If you don’t know what your iron level is, ask for a blood test to find out. Read on to learn more.
Signs and Symptoms
- Fatigue, low energy
- Dizziness
- Feeling lightheaded or weak
- Difficulty concentrating
- Shortness of breath
- Headaches
- Fast heartbeat
- Pale skin
- Cold hands and feet
Iron deficiency can also cause one type of anemia (iron deficiency anemia). Anemia occurs when someone has too few red blood cells. But by the time iron deficiency anemia is discovered, someone has likely been walking around with low iron levels for a long time. Low iron by itself – even without anemia – can cause troublesome symptoms and unhealthy changes in the body. That’s why it’s best to find and treat it early on.
Finding Out If Your Iron Is Low
- Blood iron (or serum iron) levels
- Ferritin (a protein for storing iron in our cells – it can give an estimate of how much iron is stored in the body)
- Transferrin saturation or Tsat (iron is carried around the body on a protein in the blood called transferrin; transferrin saturation measures how much iron this protein binds to)
- Blood count (red blood cells and hemoglobin, a protein in red blood cells that carries oxygen)
These are all different measures to assess your iron stores and if your body’s production of red blood cells and hemoglobin might also be affected. There are different definitions and cut-offs for iron deficiency, which can make diagnosing it more complicated. Ask your health care team about your numbers and what they mean.
Are some people with heart failure more likely than others to develop iron deficiency?
Studies suggest that iron deficiency is more common among patients who are:- Female
- At a later, more advanced stage of heart failure
- Found to have higher levels of natriuretic propeptide type B (NT-proBNP) or C-reactive protein, which are markers of cardiovascular disease and inflammation in the body. NT-proBNP can also signal that someone is retaining fluid.
Why Your Iron Might Be Low
- Bleeding or blood loss
- Not getting enough iron in your diet
- Problems with your gastrointestinal (GI) tract or gut being able to absorb or take in iron from foods (this can be due to some health conditions or in rare cases may be genetic)
- Certain medications, for example proton pump inhibitors, can interfere with how the body takes in iron
- Conditions that cause inflammation in the body
- Heart failure itself
Treating Low Iron
While iron supplements taken by mouth can help boost iron levels in patients with other conditions, these supplements have not been shown to benefit patients with iron deficiency related to heart failure.
Generally, for people with heart failure, iron infusions or intravenous (IV) iron therapy that delivers iron directly into a vein works best. IV iron therapy is safe and can help patients feel better and do more. It is given by a health care professional and the exact dosing varies. Some patients need additional treatments over time depending on results from their blood work. Different IV iron forms also have different side effects, so be sure to ask your care team which one is best for you and what to watch for.
- Red meat, pork and poultry (though choose lean cuts of meat)
- Fish and shrimp
- Peas
- Dark green leafy vegetables, such as spinach
- Iron-fortified cereals, breads and pastas
Questions to Ask
- What is my blood iron level?
- How can iron deficiency affect my heart failure?
- Do I need to try to get more iron?
- Would I benefit from treatment to increase my iron?
- What are the pros and cons of taking an iron pill or getting IV iron therapy?
- How long does IV iron therapy take?
- Are there foods I should be eating?
- How do we know what symptoms are from heart failure and which are due to low iron?
- Last Edited 11/19/2024