Heart Failure and Iron-Deficiency Anemia

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Iron-deficiency anemia, the most common form of anemia, can develop when your body doesn’t have enough iron to make healthy red blood cells. It usually occurs as a result of blood loss, chronic conditions, or poor dietary habits, and if it goes unrecognized or untreated, serious complications can result. One of the biggest dangers of untreated iron-deficiency anemia is damage to your organs, including heart failure. Heart failure is a serious condition in which your heart can’t pump enough blood to your body. Although heart failure can be effectively treated, it’s a chronic condition that patients will live with for the rest of their lives. That’s why it’s best to prevent heart failure by maintaining a healthy lifestyle and treating conditions like iron-deficiency anemia.

Understanding Iron-Deficiency Anemia

Your body uses iron to make hemoglobin a molecule within your red blood cells that carries oxygen to the tissues in your body. But when you are anemic and your hemoglobin levels are low, oxygen isn’t transported throughout your body as well as it should be. This is what leads to the common symptoms of iron-deficiency anemia, including fatigue, shortness of breath, pale skin color, fast heartbeat, cold extremities, dizziness, weakness, and headache.

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Iron-Deficiency Anemia and Heart Failure

It’s estimated about one-third of people with heart failure are also anemic. When your body isn’t getting enough oxygen due to iron-deficiency anemia, your heart starts to work harder and pump blood faster to make up for it. Over time, this can cause damage to your heart, and if your heart can’t keep up with your body’s demand for oxygen, you can develop heart failure.

Anemia also affects your kidneys. If your kidneys don’t work properly, fluid can build up in your body. The extra fluid places additional stress on your heart, which can eventually lead to heart enlargement and failure. It can become a vicious cycle: as your anemia gets worse, so can the functions of your heart and kidneys, and vice versa.

Treating Iron-Deficiency Anemia

The earlier you can treat iron-deficiency anemia, the better. It’s important to first address what is causing the anemia. Childbearing-age women are at risk for iron-deficiency anemia due to blood loss from heavy periods or giving birth. Internal bleeding, such as with ulcers or some types of cancer, can also lead to iron-deficiency anemia. If the origin of bleeding can be identified, your doctor can identify methods of stopping it.

The next step is to build up your iron stores. Increasing the amount of iron in your diet is helpful, so try to incorporate iron-rich foods like meat, leafy greens, and iron-fortified breads and cereals. Keep in mind, however, many cases of iron-deficiency anemia will also require the addition of iron therapy, either in the form of an oral supplement or as intravenous (IV) iron that is infused directly into a vein.

Oral iron supplements come in different formulations and strengths, and your doctor can help determine if one is right for you. If you have a more severe case of anemia, or if you can’t tolerate the side effects of oral iron, you may be a candidate for an iron infusion. An iron infusion needs to be administered in a doctor’s office or clinic, often over several hours.

Researchers are continuing to study the best way to treat both iron-deficiency anemia and heart failure. Recent studies have shown intravenous iron to improve both heart failure symptoms and exercise tolerance more than oral iron supplements, but long-term results are still needed. Research also remains underway to develop new therapies that boost your body’s production of red blood cells and help the symptoms of heart failure in the process.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Feb 14
  1. Anemia in Heart Failure- Still Relevant? Journal of the
    American College of Cardiology. http://heartfailure.onlinejacc.org/content/early/2017/10/31/j.jchf.2017.08.023
  2. Iron-Deficiency Anemia. American Society of Hematology. http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx
  3. Iron Deficiency Anemia. Mayo Clinic.
  4. Iron-Deficiency Anemia. National Heart, Lung, and Blood
    Institute. https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia
  5. Iron Deficiency and Anemia
    in Heart Failure: Understanding the FAIR-HF Trial. Medscape.
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