What is an iron infusion? When you need one, how it works and what it costs

An iron infusion is a treatment that puts iron straight into your bloodstream through a drip in a vein. It's used for confirmed iron deficiency when iron from food and tablets isn't enough, isn't absorbed well, or works too slowly. Here's when you need one, how it works, how quickly it helps and what it costs.

What is an iron infusion?

Your body needs iron to make haemoglobin, the protein in red blood cells that carries oxygen. When you're low, you tire more easily and can feel short of breath or dizzy. Treatment usually starts with iron tablets. An infusion skips your gut and goes directly into your blood, so a large amount of iron can be given in one treatment. Tablets often take three to six months to do the same.

When do you need an iron infusion?

A doctor may recommend an iron infusion when blood tests confirm iron deficiency and:

• tablets haven't helped enough after a few months;

• you can't tolerate tablets, for example because of stomach or bowel problems;

• your body doesn't absorb iron well, for example with coeliac disease, inflammatory bowel disease or after weight-loss surgery;

• you keep losing iron, for example through heavy periods;

• your levels need to rise faster, for example before an operation.

Symptoms alone aren't a reason for an infusion. Tiredness can also come from thyroid problems, poor sleep or other deficiencies, so we always test your blood first.

At what level do you get an iron infusion?

There's no single cut-off that applies to everyone. The key value is ferritin, your body's iron store. In adults, ferritin below about 30 µg/L usually points to iron deficiency. Inflammation can push ferritin up, so a deficiency can still be there at a higher value. That's why a doctor looks at the whole picture: ferritin, haemoglobin, transferrin saturation, CRP, your symptoms and whether you've already tried tablets.

Without a referral, we do the blood test at Curitt. We measure ferritin, haemoglobin, transferrin saturation, total iron-binding capacity, CRP and a full blood count. Because tiredness often has more than one cause, we also check vitamin D, vitamin B12 and thyroid function, and glucose if your doctor thinks it's needed. You don't need to fast, unless your doctor tells you otherwise.

With a GP referral, your GP sends recent blood results that confirm iron deficiency along with the referral. Our internal medicine specialist reviews them and calculates your dose, so you usually go straight to the infusion.

How does an iron infusion work?

1. A call with a doctor. A short video call about your symptoms and whether an infusion could be right for you.

2. A blood test. We confirm whether you're really deficient. If you've had blood tests in the last six months, you can upload them.

3. Diagnosis and dose. The doctor confirms the diagnosis and calculates your dose from your results, weight and situation.

4. The infusion. At the clinic, the iron goes in through a drip in your arm, supervised by a doctor. The whole appointment takes 45 to 60 minutes, and you stay for 30 minutes afterwards with the doctor close by.

You can eat and drink normally beforehand. Most people can drive themselves home.

How quickly does an iron infusion work?

Many people notice more energy within a few days to a few weeks. Haemoglobin usually rises gradually over the following weeks. Ferritin can read artificially high straight after an infusion, so we recheck your blood after four weeks, with a video consult about the results. Your doctor then decides whether you need anything more.

How many infusions will you need?

Many people need just one. A larger deficiency can need a higher total dose or a second infusion. If the cause continues, such as heavy periods, the deficiency can come back, and your doctor will talk with you about how to prevent that.

Side effects and risks

An iron infusion is safe when it's given under medical supervision. Most people have no side effects or only mild ones, such as a headache, nausea or a temporary change in taste. An allergic reaction is rare, which is why every infusion is supervised and emergency equipment is on hand. If iron leaks out of the vein, it can stain the skin brown. That's rare, and we watch for it during the infusion.

If you're pregnant or might be, tell us when you book. Iron infusions aren't given in the first trimester.

What does an iron infusion cost, and is it reimbursed?

At Curitt an iron infusion costs €899 all-in: the blood test beforehand, the doctor's consultation, one infusion with up to 1,000 mg of iron including the medication, and a follow-up blood test after four weeks. If you need a higher dose or more infusions, we go through the plan and the total cost with you before treatment.

If your GP refers you through ZorgDomein, your health insurer covers the infusion. You then only pay any deductible (eigen risico) you haven't used yet. Without a referral, you can book directly and pay yourself.

Where can you get an iron infusion?

Iron infusions are often given in hospital, after a referral to a specialist. You can also go to a specialised clinic. At Curitt in Amsterdam and Utrecht you can book without a referral, and with a GP referral through ZorgDomein it's reimbursed.

See the treatment and book an appointment, or read how your GP can refer you.