Does iron transfusion cause fatigue?

From the FDA Drug Label

5 WARNINGS AND PRECAUTIONS

1. 1 Hypersensitivity Reactions Serious hypersensitivity reactions, including anaphylactic-type reactions, some of which have been life-threatening and fatal, have been reported in patients receiving Venofer.
2. 2 Hypotension Venofer may cause clinically significant hypotension.
3. 3 Iron Overload Excessive therapy with parenteral iron can lead to excess storage of iron with the possibility of iatrogenic hemosiderosis.

The FDA drug label does not answer the question.

From the Research

Iron Transfusion and Fatigue

• The relationship between iron transfusion and fatigue is complex, with some studies suggesting that iron supplementation can improve fatigue in certain populations 1, 2.
• However, other studies have found no significant association between iron status and fatigue in blood donors 3, 4.
• A randomized controlled trial found that intravenous iron supplementation had no effect on fatigue in non-anemic blood donors with iron deficiency 4.
• In contrast, a study on outpatients with hematologic disease found that red blood cell transfusion was associated with early and sustained improvement in fatigue-related quality of life 5.

Mechanisms and Populations

• The effects of iron transfusion on fatigue may depend on the population being studied, with different results seen in blood donors versus outpatients with hematologic disease 3, 5.
• Iron deficiency may cause fatigue through various mechanisms, including decreased oxygen delivery to tissues and impaired energy metabolism 1, 2.
• The type of iron supplementation (intravenous versus oral) may not affect the clinical outcome of fatigue improvement 2.

Clinical Implications

• Iron supplementation may be an effective strategy to improve symptoms related to iron deficiency, including fatigue, in certain populations 1, 2.
• However, the decision to transfuse iron should be based on individual patient needs and medical history, rather than a blanket approach 3, 4.
• Further research is needed to fully understand the relationship between iron transfusion and fatigue, and to determine the optimal treatment strategies for different patient populations 1, 3, 4, 5, 2.