Iron deficiency anaemia and iron infusion
Low iron is the most common nutritional deficiency in India, and the most commonly left half treated. Tablets are the right place to start, but a good number of people cannot tolerate them, cannot absorb them, or are losing iron faster than a tablet can replace it. For those people an intravenous infusion refills the stores in one or two visits instead of six months.
₹1,800 all inclusive for a 1000 mg sitting. Consultation and blood tests charged separately.
How iron deficiency is confirmed
Haemoglobin tells us whether you are anaemic. It does not tell us whether iron is the reason, and people are commonly iron deficient long before their haemoglobin falls. The test that settles it is ferritin, usually read alongside transferrin saturation.
- A ferritin below 100 mcg/L is treated as iron deficiency.
- A ferritin between 100 and 299 mcg/L counts as well when the transferrin saturation is under 20 per cent, because inflammation and infection push ferritin up and can hide a real deficiency.
Both are part of our metabolic profile at ₹1,795, or they can be done on their own. Finding out why you are losing iron matters as much as replacing it, so the consultation looks for the cause: heavy periods, gut blood loss, coeliac disease, previous bariatric surgery, long-term acid suppressing medicines and poor intake are the usual ones.
Work out your dose and your cost
The dose of intravenous iron is not the same for everybody. It is worked out from your body weight and your haemoglobin, using the manufacturer's own table. Enter both below to see how much iron you would need, how many visits that takes, and what it would cost.
The dose table we follow
This is the manufacturer's table, reproduced as it is printed. It is the same table your doctor uses.
| Haemoglobin | 35 kg to under 70 kg | 70 kg and over |
|---|---|---|
| below 10 g/dl | 1500 mg | 2000 mg |
| 10 to under 14 g/dl | 1000 mg | 1500 mg |
- Under 35 kg the total is 500 mg, whatever the haemoglobin.
- With a haemoglobin of 14 to 15 g/dl the total is 500 mg, whatever the weight.
- Not more than 1000 mg is given in any one week.
What it costs
One figure, and it is the figure at the desk. Each sitting includes the injection, the intravenous cannula, the giving set and fixative, the saline, the syringes, the nursing time and the observation period afterwards.
| Total iron needed | Visits | Total cost |
|---|---|---|
| 500 mg | 1 visit | ₹1,550 |
| 1000 mg | 1 visit | ₹1,800 |
| 1500 mg | 2 visits, a week apart | ₹3,350 |
| 2000 mg | 2 visits, a week apart | ₹3,600 |
Not included: the doctor's consultation at ₹400, and your blood tests. If you are admitted for another reason and the infusion is given during that admission, it is billed with the rest of your inpatient care instead.
What the visit is like
- You see the doctor first. Bring your blood reports. The cause of the deficiency is looked into, the dose is worked out, and the infusion is prescribed at that visit.
- You sit in day care. A cannula goes into a vein in your arm. The iron is diluted in a small bag of saline and runs in over about 30 minutes. You can sit, read or work through it, and you do not need to fast.
- You are watched for half an hour afterwards. This is not a formality. Reactions, when they happen at all, happen early, and this is the reason the infusion is given in a hospital rather than at home.
- You go home the same day. Normal activity, normal food, normal medicines. If a second sitting is needed it is booked for a week later.
- You come back at eight to twelve weeks for a repeat haemoglobin and ferritin, so that we know whether it worked and whether the cause has been dealt with.
An iron infusion, as it actually happens
Twenty two seconds, filmed in our own day care room. A cannula goes into a vein in the arm, the iron is diluted in a small bag of saline and runs in over about thirty minutes, and the patient is watched for half an hour and goes home the same day.
Safety, stated plainly
Modern intravenous iron is well tolerated, and the preparation used here is ferric carboxymaltose, which allows a large dose to be given in a single short infusion. That does not make it a casual treatment, and this page is not going to pretend otherwise.
- Serious allergic reactions are rare and are possible. The infusion is therefore given in the hospital, with a doctor on the premises, trained nursing staff and resuscitation facilities, and you are observed afterwards.
- A brief flushing, or tightness in the chest or back, can happen in the first few minutes. It settles on its own when the drip is paused and restarted slowly. It is not an allergy and it does not mean you can never have iron again.
- Staining of the skin can occur if the drip leaks out of the vein, and it can be long lasting. Tell the nurse at once if you feel stinging or see swelling at the cannula.
- Phosphate can fall after treatment, particularly with repeated courses. It is checked when it needs to be.
- Not given if you have had a reaction to intravenous iron before, if you have iron overload, or during the first three months of pregnancy. Active infection usually means waiting.
An antihistamine is not given routinely before the infusion. It does not prevent a true allergic reaction, and it can itself cause flushing, drowsiness and a drop in blood pressure that look exactly like one, which leads to a safe infusion being stopped and a patient being wrongly labelled as iron allergic. It is used where there is a reason for it, such as asthma or several previous drug allergies.
Who we see for this
Women with heavy periods
The commonest cause we see, and the one most often put up with for years. Replacing the iron and treating the cause go together.
After bariatric surgery
Iron absorption falls after sleeve and bypass surgery, and tablets frequently cannot keep up. Lifelong monitoring is part of the aftercare.
People who cannot take tablets
Nausea, constipation and stomach pain end most oral iron courses early. A course that is not finished does not work.
Chronic disease and pregnancy
Kidney disease, heart failure, inflammatory bowel disease and pregnancy after the first three months, on the advice of the treating doctor.
Common questions
How much does an iron infusion cost at Caspian Healthcare?
A 1000 mg sitting is ₹1,800 and a 500 mg sitting is ₹1,550, and that is the whole amount for the sitting. It covers the injection, the cannula, the giving set, the saline, nursing time and the observation period. The doctor's consultation and your blood tests are charged separately.
How long does an iron infusion take?
The infusion itself runs over about 30 minutes. You are then observed for a further 30 minutes before you go home. Allow about an hour and a half at the hospital in total, including registration.
Why can I not just take iron tablets?
Many people can. Tablets are the first choice when they work. They are given up on for three common reasons: they upset the stomach badly enough that the course is never finished, the gut is not absorbing iron because of coeliac disease, previous bariatric surgery or long-term acid suppression, or the losses are faster than tablets can replace, as with heavy periods or repeated bleeding. Tablets also take months to refill iron stores, and an infusion does it in one or two visits.
How many sittings will I need?
Most people need one or two. The total dose is worked out from your body weight and your haemoglobin, and no more than 1000 mg may be given in one week, so a total above 1000 mg is split into two visits a week apart.
Is an iron infusion safe?
Serious allergic reactions are rare but they are possible, which is why the infusion is given in the hospital with a doctor on the premises, trained nursing staff and resuscitation facilities, and why you are observed afterwards. Some people get a brief flushing or a tight feeling in the chest or back in the first few minutes. That settles on its own when the drip is paused and restarted slowly, and it is not an allergy.
When will I feel better?
Tiredness usually starts to lift within one to two weeks. The haemoglobin rises over the following month or two. We check your haemoglobin and ferritin again at about eight to twelve weeks, which is the only way to know whether the treatment did what it was meant to do.
Do I need an appointment?
Yes. See the doctor first with your reports, because the dose depends on your weight and your haemoglobin and the infusion is prescribed at that visit. Call +91 89193 41154 to book.
Book, or ask first
Bring any recent blood reports you have. If you have none, they can be done in the building and most results are ready the same day. See our laboratory, or read about diabetes and obesity care if that is why you are here.
10-3-761/8, Vijay Nagar Colony, Hyderabad 500057. Open 24 hours.
Recheck reminder
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