Conditions We Treat
Is IV iron right for you?
We treat a range of conditions where iron deficiency is causing significant symptoms and oral iron has failed or is not appropriate. Every patient is assessed individually by Dr Bhadresha before any treatment is offered.
Most common
Iron Deficiency Anaemia
Iron deficiency anaemia occurs when your body does not have enough iron to produce adequate haemoglobin, the protein in red blood cells that carries oxygen around your body. It is the most common nutritional deficiency in the UK, affecting approximately 1 in 3 women.
Symptoms include persistent fatigue, breathlessness on exertion, poor concentration, pale skin, brittle nails, and hair loss. Many patients are told their results are borderline or normal, yet continue to feel unwell. Iron levels should always be interpreted alongside symptoms.
IV iron is appropriate when oral supplementation has been ineffective, is not tolerated, or when a faster response is clinically required. A single Ferinject infusion can restore depleted iron stores fully in most patients.
Criteria for IV iron, in line with NICE guidelines
- Confirmed iron deficiency on blood testing (low ferritin, low transferrin saturation)
- Oral iron has been trialled and failed, or is not tolerated due to side effects
- Clinical need for faster iron repletion than oral iron can provide
- No contraindications to IV iron (first trimester of pregnancy, prior serious hypersensitivity reaction)
Source: Randox Health / Frontiers in Nutrition, 2025. NICE / National Diet and Nutrition Survey.
Source: Contemporary OB/GYN 2026. NHS Blood and Transplant audit 2019.
Pregnancy and Postpartum
Pregnancy and Postpartum Iron Deficiency
Iron demands increase significantly during pregnancy as the body produces additional blood to support the growing baby. Blood loss during childbirth further depletes iron stores, and postpartum women are among the most commonly affected by iron deficiency anaemia.
For new mothers, the consequences are profound. Severe fatigue at a time when energy is most needed, difficulties with breastfeeding and milk supply, low mood, and in some cases a contribution to postpartum depression. These symptoms are frequently dismissed as a normal part of new motherhood, when in many cases the underlying cause is treatable.
IV iron is safe from the second trimester of pregnancy and throughout the postpartum period. It is particularly valuable when oral iron is not tolerated or is too slow to make a meaningful difference in the critical early weeks.
Criteria for IV iron in pregnancy and postpartum
- Second or third trimester of pregnancy with confirmed iron deficiency anaemia
- Postpartum iron deficiency with haemoglobin below 100g/L or symptomatic anaemia
- Oral iron not tolerated or insufficient response after adequate trial
- Not in the first trimester of pregnancy (contraindicated)
Gastrointestinal
Inflammatory Bowel Disease
Crohn’s disease and ulcerative colitis impair the gut’s ability to absorb iron from food and oral supplements. Active intestinal inflammation further increases iron losses, making iron deficiency one of the most common and debilitating complications of IBD.
For patients with IBD, oral iron is often both ineffective and poorly tolerated. It can worsen gastrointestinal symptoms, irritate inflamed bowel, and simply fail to be absorbed in sufficient quantities. IV iron bypasses the gut entirely, delivering iron directly into the bloodstream where it is needed.
The British Society of Gastroenterology recommends IV iron as the preferred route of administration for iron deficiency in patients with IBD who have active inflammation or a poor response to oral therapy.
Criteria for IV iron in IBD
- Confirmed iron deficiency in a patient with Crohn's disease or ulcerative colitis
- Active intestinal inflammation impairing oral iron absorption
- Oral iron not tolerated or worsening GI symptoms
- Previous inadequate response to oral supplementation
Source: British Society of Gastroenterology, 2021.
Source: British Journal of Sports Medicine, 2022.
Sport and Performance
Athletic Performance
Iron is essential for oxygen transport, energy production, and muscle function. Elite and recreational athletes are at significantly higher risk of iron deficiency due to increased losses through sweat, foot strike haemolysis, and gastrointestinal bleeding during high-intensity training.
Even mild iron depletion without anaemia can significantly impair endurance, power output, and recovery. Athletes often describe feeling flat, unable to reach previous performance levels, and taking longer than expected to recover between sessions.
IV iron can restore depleted stores rapidly, allowing athletes to return to peak performance far more quickly than oral supplementation allows. We work with both elite and recreational athletes across a range of sports.
Criteria for IV iron in athletes
- Confirmed iron deficiency on blood testing with performance-related symptoms
- Ferritin below 30 micrograms/L in a symptomatic athlete
- Oral iron trialled and insufficient or not tolerated
- Clinical assessment confirming iron deficiency as the primary cause of symptoms
Neurological
Restless Legs Syndrome
Restless legs syndrome (RLS) is a neurological condition causing an irresistible urge to move the legs, typically worse at rest and in the evening. Iron deficiency is one of the most well-established causes of secondary RLS, as iron is essential for dopamine production in the brain.
Correcting iron deficiency in patients with RLS can significantly reduce or resolve symptoms, often more effectively than medications used to manage the condition. Oral iron is frequently insufficient to raise brain iron levels adequately, whereas IV iron has been shown in clinical trials to produce meaningful symptom improvement.
Criteria for IV iron in restless legs syndrome
- Confirmed diagnosis of restless legs syndrome
- Serum ferritin below 75 micrograms/L (lower threshold than standard IDA)
- Symptoms causing significant impact on quality of life or sleep
- Oral iron inadequate to raise ferritin sufficiently
Source: Sleep Medicine Reviews, 2023. NICE Clinical Knowledge Summary: Restless Legs Syndrome.
Source: NICE Guideline NG88: Heavy Menstrual Bleeding, 2021 update.
Women's Health
Heavy Periods (Menorrhagia)
Heavy menstrual bleeding is one of the most common causes of iron deficiency in women of reproductive age. Monthly blood loss exceeding normal levels depletes iron stores gradually but significantly, leading to chronic anaemia that can be difficult to correct through diet or oral supplementation alone.
Women with menorrhagia often face a cycle of attempting to restore iron levels through oral tablets, only for the next period to deplete them again. IV iron offers a way to restore stores fully in a single session, providing a meaningful window of recovery and wellbeing before the cycle begins again.
Criteria for IV iron in menorrhagia
- Confirmed iron deficiency anaemia in a patient with heavy menstrual bleeding
- Oral iron not tolerated or insufficient to maintain adequate iron levels
- Symptomatic anaemia significantly impacting quality of life
- Gynaecological cause being investigated or managed concurrently
Malabsorption
Coeliac Disease
Coeliac disease causes damage to the lining of the small intestine, significantly impairing the absorption of iron and other nutrients. Even in patients who are well-controlled on a gluten-free diet, iron absorption may remain inadequate due to ongoing gut inflammation or established mucosal damage.
Iron deficiency is one of the most common presenting features of coeliac disease and can persist despite strict dietary adherence. For these patients, oral iron supplements face the same absorption barriers as dietary iron, making IV administration the most reliable route to repletion.
Criteria for IV iron in coeliac disease
- Confirmed coeliac disease with iron deficiency anaemia
- Inadequate response to oral iron supplementation
- Persistent iron deficiency despite adherence to a gluten-free diet
- Symptoms significantly impacting daily function
Source: Coeliac UK / British Society of Gastroenterology, 2022.
Source: NICE Guideline NG24: Blood Transfusion, updated 2026.
Post-operative
Post-Surgical Anaemia
Surgical procedures involving significant blood loss frequently result in iron deficiency anaemia. Recovery from surgery is significantly impaired by low iron levels, as the body requires adequate iron to repair tissue, produce new red blood cells, and restore energy levels.
NICE guidelines recommend iron supplementation for patients with pre-operative anaemia and support its use in the post-operative period. IV iron is particularly valuable following major surgery such as bowel resection, joint replacement, gynaecological surgery, or caesarean section where blood loss has been substantial.
Criteria for IV iron post-surgery
- Iron deficiency anaemia confirmed following surgery
- Significant intraoperative or postoperative blood loss
- Oral iron not appropriate or insufficient for required speed of recovery
- Clinical need to optimise recovery and reduce fatigue
Not sure if you qualify?
Book a consultation with Dr Bhadresha. She will review your blood results, assess your symptoms, and give you a clear answer.
Ready to get started?
Same-week appointments. No waiting lists. Doctor-led from start to finish.
Or email hello@londonironinfusionclinic.co.uk ·