Can intravenous (IV) iron supplementation cause hormonal imbalances?

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Last updated: February 27, 2025View editorial policy

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From the Guidelines

Intravenous (IV) iron therapy is not typically associated with causing hormonal imbalances. The primary purpose of IV iron is to treat iron deficiency anemia by replenishing iron stores in the body, which helps with red blood cell production. Common IV iron preparations include iron sucrose (Venofer), ferric carboxymaltose (Injectafer), and iron dextran (INFeD), which are administered in healthcare settings under supervision. While IV iron can cause side effects such as headaches, nausea, hypotension, or allergic reactions, hormonal disruption is not a recognized direct effect, as noted in a study published in 2016 1.

Key Points to Consider

  • Iron deficiency itself can impact hormone function, particularly thyroid hormones, as iron is needed for proper thyroid hormone synthesis, but this is not a direct effect of IV iron therapy.
  • By correcting iron deficiency, IV iron might indirectly help normalize hormone function that was previously affected by the deficiency.
  • If you're experiencing symptoms suggestive of hormonal imbalance while receiving IV iron therapy, these symptoms are more likely related to your underlying condition or other factors rather than the iron treatment itself, as there is no strong evidence linking IV iron to hormonal imbalances 1.
  • Always discuss any concerning symptoms with your healthcare provider who can evaluate whether they're related to your treatment or require further investigation.

Evidence Summary

The most recent and relevant study on this topic, published in 2016 1, discusses the use of IV iron in patients with chronic kidney disease (CKD) and does not mention hormonal imbalances as a side effect. This study highlights the importance of IV iron in treating iron deficiency anemia and its benefits over oral iron supplements. An older study from 2001 1 also provides data on the effects of IV iron therapy in hemodialysis patients but does not address hormonal imbalances directly.

Clinical Implications

Given the lack of evidence linking IV iron therapy to hormonal imbalances, it is reasonable to conclude that IV iron supplementation does not typically cause hormonal imbalances. However, patients should always be monitored for any adverse effects, and any symptoms suggestive of hormonal imbalance should be thoroughly investigated by a healthcare provider to determine the underlying cause.

From the Research

Intravenous Iron Supplementation and Hormonal Imbalances

  • There is no direct evidence in the provided studies to suggest that intravenous (IV) iron supplementation causes hormonal imbalances 2, 3, 4, 5, 6.
  • However, IV iron therapy has been associated with hypophosphatemia, a condition characterized by low phosphate levels in the blood, which can be caused by increased secretion of the phosphaturic hormone, fibroblast growth factor 23 (FGF23) 5.
  • Hypophosphatemia can lead to various symptoms, including muscle weakness, osteomalacia, and fractures, but its direct impact on hormonal balances is not explicitly mentioned in the studies 5.
  • The studies primarily focus on the efficacy, safety, and potential side effects of IV iron formulations, such as ferric carboxymaltose and iron sucrose, in treating iron deficiency anemia in various patient populations 2, 3, 4, 6.
  • While the studies discuss the importance of monitoring serum phosphate concentrations and managing hypophosphatemia in patients receiving IV iron therapy, they do not provide evidence on the effects of IV iron supplementation on hormonal imbalances 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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