Quality -of-life scores ( Piper Fatigue Scale MD 0.73 , 95 % CI 0.29 to 1.18 ; I2 = 0 % ; studies = 3 ) and peak oxygen consumption ( MD 2.77 mL/kg/min , 95 % CI -0.89 to 6.43 ; I2 = 36 % ; 2 studies , 32 participants ) were associated with very low- quality evidence , and we remain uncertain about the role of intravenous iron for these metrics .
Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient population s , beyond stating that it may result in a small , clinical ly insignificant increase in haemoglobin concentration .
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies , and has a number of physiological manifestations .
Early , or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity .
Oral iron preparations have a high incidence of intolerable side effects , and are ineffective in certain forms of iron deficiency .
Consequently , intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency .
The newer , more stable iron preparations in particular purport to have a lower incidence of side effects , and are now used across a range of different patient population s. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency .
Effects of iron supplementation and depletion on hypoxic pulmonary hypertension: two randomized controlled trials.
CONTEXT Hypoxia is a major cause of pulmonary hypertension in respiratory disease and at high altitude . Recent work has established that the effect of hypoxia on pulmonary arterial pressure may depend on iron status , possibly acting through the transcription factor hypoxia-inducible factor , but the pathophysiological and clinical importance of this interaction is unknown . OBJECTIVE To determine whether increasing or decreasing iron availability modifies altitude-induced hypoxic pulmonary hypertension . DESIGN , SETTING , AND PARTICIPANTS Two r and omized , double-blind , placebo-controlled protocol s conducted in October-November 2008 . In the first protocol , 22 healthy sea-level resident men ( aged 19 - 60 years ) were studied over 1 week of hypoxia at Cerro de Pasco , Peru ( altitude 4340 m ) . In the second protocol , 11 high-altitude resident men ( aged 30 - 59 years ) diagnosed with chronic mountain sickness were studied over 1 month of hypoxia at Cerro de Pasco , Peru . INTERVENTION In the first protocol , participants received intravenous infusions of Fe(III)-hydroxide sucrose ( 200 mg ) or placebo on the third day of hypoxia . In the second protocol , patients underwent staged isovolemic venesection of 2 L of blood . Two weeks later , patients received intravenous infusions of Fe(III)-hydroxide sucrose ( 400 mg ) or placebo , which were subsequently crossed over . MAIN OUTCOME MEASURE Effect of varying iron availability on pulmonary artery systolic pressure ( PASP ) assessed by Doppler echocardiography . RESULTS In the sea-level resident protocol , approximately 40 % of the pulmonary hypertensive response to hypoxia was reversed by infusion of iron , which reduced PASP by 6 mm Hg ( 95 % confidence interval [ CI ] , 4 - 8 mm Hg ) , from 37 mm Hg ( 95 % CI , 34 - 40 mm Hg ) to 31 mm Hg ( 95 % CI , 29 - 33 mm Hg ; P = .01 ) . In the chronic mountain sickness protocol , progressive iron deficiency induced by venesection was associated with an approximately 25 % increase in PASP of 9 mm Hg ( 95 % CI , 4 - 14 mm Hg ) , from 37 mm Hg ( 95 % CI , 30 - 44 mm Hg ) to 46 mm Hg ( 95 % CI , 40 - 52 mm Hg ; P = .003 ) . During the subsequent crossover period , no acute effect of iron replacement on PASP was detected . CONCLUSION Hypoxic pulmonary hypertension may be attenuated by iron supplementation and exacerbated by iron depletion . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00952302
Quality -of-life scores ( Piper Fatigue Scale MD 0.73 , 95 % CI 0.29 to 1.18 ; I2 = 0 % ; studies = 3 ) and peak oxygen consumption ( MD 2.77 mL/kg/min , 95 % CI -0.89 to 6.43 ; I2 = 36 % ; 2 studies , 32 participants ) were associated with very low- quality evidence , and we remain uncertain about the role of intravenous iron for these metrics .
Current evidence is insufficient to show benefit of intravenous iron preparations for the treatment of non-anaemic iron deficiency across a variety of patient population s , beyond stating that it may result in a small , clinical ly insignificant increase in haemoglobin concentration .
BACKGROUND Iron deficiency is one of the most common nutritional deficiencies , and has a number of physiological manifestations .
Early , or non-anaemic iron deficiency can result in fatigue and diminished exercise capacity .
Oral iron preparations have a high incidence of intolerable side effects , and are ineffective in certain forms of iron deficiency .
Consequently , intravenous iron preparations are increasingly used in the treatment of non-anaemic iron deficiency .
The newer , more stable iron preparations in particular purport to have a lower incidence of side effects , and are now used across a range of different patient population s. OBJECTIVES To assess the effects of intravenous iron therapy in the treatment of adults with non-anaemic iron deficiency .