The Iron Clinic

is often prolonged over many years.
In this study of 13,000 women most needed 1.9 years or iron tablets but half remained anaemic 3 years later! The alternative option is an iron infusion that can deliver a full treatment dose in just one visit.
It is so important to get correct advice and treatment The Iron Clinic

https://ashpublications.org/bloodadvances/article/doi/10.1182/bloodadvances.2024013197/517369/Iron-deficiency-resolution-and-time-to-resolution

IRELAND CLINIC - we are running an IV iron infusion pop up clinic Randox Health Holywood in Belfast next Thursday September 5th:

Prof Richards will be there

email us to [email protected] (if you need blood tests we can organise before)

https://www.dailymail.co.uk/health/article-13756995/dr-jennifer-gunter-tranexamic-acid-period-pain-relief.html

DR JEN GUNTER: Why won't doctors offer period pain pill? Tranexamic acid costs the NHS 10p per pill, per patient, and is known to reduce period pain by roughly half. So why do so few patients know about it?

What are Heavy Periods? the commonest cause of in otherwise healthy women: Medically this is > 80ml (that's One Litre p.a.!!)

BUT HOW do you assess?

In this study the absorption capacity of menstrual products were assessed. A tampon = 20-30ml of blood, so if you are having to change regularly then this is likely HEAVY. One in three women have heavy periods, of whom HALF will be iron deficient.
Treatment is:

Tranexamic acid - an amino acid that stabilises blood and reduces blood loss by about a third. Cheap, safe & effective.
Chat to GP to discuss options.
Check FERRITIN (iron store) if

Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding Background Heavy menstrual bleeding affects up to one third of menstruating individuals and has a negative impact on quality of life. The diagnosis of heavy menstrual bleeding is based primarily on history taking, which is highly dependent on traditional disposable menstrual products such as pads an...

in women can often be tracked back to pregnancy: a baby requires 1000mg of iron - that is all the mothers normal reserves (in ferritin) or an additional 50% on top of the normal absorption of iron over the pregnancy - BUT blood loss at childbirth can be significant- this is the human placenta - look at the size of those blood vessels!!! Haemorrhage can be significant and drain the mother of blood and iron - check mothers' ferritin in the run up and after childbirth if ferritin

POP UP CLINICS - www.theironclinic.com now have Iron Infusions across the UK:

MANCHESTER: September 11th & October 9th
Randox @ Trafford centre from 1300 - 1700
BELFAST: September 5th
Randox @ 2 Redburn Square, Holywood BT18 9HZ from 1000 – 1400
FULHAM: September 5th & October 3rd & November 7th
LEEDS: Every Week
www.whitehallclinic.com, 5 Wellington Place, Leeds, LS1 4AP
LONDON: Every Monday & Friday @ 101 Harley Street
Every Friday @ One Welbeck (Insured patients)

Please email us with a copy of your blood results to [email protected]
Or book directly here https://www.theironclinic.com/booking-an-appointment/

If needed, we can order your blood tests from https://randoxhealth.com/en-GB/healthtest-locations

All patients have an online consultation with one of our experts to understand their history, explain about all things iron, the role, dosing, pros & cons of an iron infusion as well as a plan for follow up and if needed treatment of the underlying cause. Patients are then booked directly for their iron infusion.

guidelines for America.
Delighted to be in Portland with 25 experts from haematology, gastroenterology, gynaecology and others to develop a consensus on how to diagnose and manage . Important points
1. Iron deficiency defined as Ferritin

🔬 Did you know that the mesmerizing colors of fireworks are the result of a chemical reaction between mineral elements and oxygen? Let's dive into the fascinating science behind it! 🎆
🔴𝗥𝗲𝗱: Strontium (Sr) creates this vibrant hue.
🟠𝗢𝗿𝗮𝗻𝗴𝗲: A mix of Strontium (Sr) and Sodium (Na) gives us this fiery color.
🟡𝗬𝗲𝗹𝗹𝗼𝘄: Sodium (Na) alone creates this bright shade.
🟢𝗚𝗿𝗲𝗲𝗻: Barium (Ba) is responsible for this refreshing green color.
🔵𝗕𝗹𝘂𝗲: Copper (Cu) is the magical element that produces this captivating blue.
🟣𝗣𝘂𝗿𝗽𝗹𝗲: The combination of Strontium (Sr) and Copper (Cu) results in this majestic purple shade.
⚪️𝗦𝗶𝗹𝘃𝗲𝗿 𝗮𝗻𝗱 𝗪𝗵𝗶𝘁𝗲: Titanium (Ti), Zirconium (Zr), and Magnesium (Mg) collaborate to create these shimmering colors.
🟡🔴𝗚𝗼𝗹𝗱: Interestingly, Iron (Fe) and small pieces of charcoal are responsible for this golden sparkle! 🎇
🔎 Exploring the chemistry behind fireworks adds a whole new level of appreciation for their dazzling displays. Next time you witness fireworks lighting up the sky, remember the science that makes it all possible! ✨🎇
🔬🔥🎆

🏅 Let the Games Begin: The Role of Iron in Female Athletes 🏅

As the Olympics kick off today, let's celebrate the incredible female athletes who inspire us all. 🌟 Iron plays a crucial role in their performance, energy, and recovery.

💡 Why Iron Matters:
◾Oxygen Transport: Essential for carrying oxygen to muscles, crucial for endurance.
◾Energy Levels: Prevents fatigue, ensuring peak performance.
◾Recovery: Aids in muscle repair and reduces recovery time.

🔬 Did You Know? Women are more prone to iron deficiency due to factors like menstruation and increased iron loss during intense training.

💪 Stay Strong: Female athletes need to monitor and maintain optimal iron levels to perform at their best.

Here's to strong, empowered women dominating the games! 🏋️‍♀️🥇

🏅 Countdown to the Olympics 🏅

4️⃣ The Perceived Impact of Iron Deficiency and Iron Therapy Preference in Exercising Females 🩺💪

📚 We have just published a cross-sectional survey study titled "The Perceived Impact of Iron Deficiency and Iron Therapy Preference in Exercising Females of Reproductive Age." In this study, we explore the perceptions and preferences of exercising females regarding iron deficiency and iron therapy. 🏋️‍♀️💪

🌍 Iron deficiency affects approximately one-third of the global population, with women of reproductive age being particularly susceptible due to factors like menstruation and increased iron loss during exercise. Our study aims to shed light on the impact of iron deficiency on exercise performance and recovery, as well as the perceived efficacy of different iron therapies. 💊💪

💡 Key Findings:

🔹 Exercising females experience negative symptoms related to iron deficiency, including fatigue, decreased performance, and longer recovery times.
🔹 Iron therapies, such as oral iron supplementation and iron infusion, are perceived to improve energy levels, performance, and recovery time.
🔹 There is a preference for iron infusion treatment among exercising women in Australia compared to oral iron supplementation, likely due to perceived effectiveness and faster results. 💉💨

🤔 Important Note:
Individual experiences and preferences may vary, and consultation with healthcare professionals is crucial for personalized iron deficiency management. 🩺💡

Link here: https://pubmed.ncbi.nlm.nih.gov/37644963/

🏅 Countdown to the Olympics 🏅

With the Olympics only a few days away, we're excited to share insights on the importance of iron in women's health, particularly for our female athletes! 🌟

3️⃣ Iron Treatment in Endurance Athletes 🏅

📚 Is iron treatment beneficial in iron-deficient but non-anemic (IDNA) endurance athletes? A systematic review and meta-analysis 📚

🗒️ Overview 🗒️
This study examines the benefits of iron treatments on iron-deficient non-anemic endurance athletes. A meta-analysis of 17 studies revealed significant improvements in iron status and aerobic capacity from iron treatments.

💡 Key Findings 💡
🔹 Large improvements in serum ferritin (sFer), serum iron (sFe), and transferrin saturation (Tsat).
🔹 Moderate improvements in hemoglobin concentration ([Hb]) and VO2max.
🔹 Longer treatments (>80 days) had less effect on sFer.

🔬 Implications🔬
Iron treatments can enhance performance by improving iron status and aerobic capacity.

🌟 Takeaway: Endurance athletes should consider iron supplementation to optimize performance.

🏅 Countdown to the Olympics 🏅

2️⃣ Screening for Anemia in Female Athletes: A Game Changer 🏅

📢 With the Olympics only 3 days away, let's dive into a crucial topic: the need for anemia screening in exercising women. 🚀

💡 Understanding Anemia:
Anemia, characterized by a deficiency of red blood cells or hemoglobin, affects about 1 in 3 women during their lifetime. Despite its prevalence, awareness is often lacking, impacting the physical performance of female athletes. Currently, there's no specific screening program for anemia in exercising women.

🔎 Research Highlights:
A study by Dr. Cory Dugan assessed a simple screening tool to predict anemia in exercising women. The study involved 300 women at a UK fitness festival, using a Female Health Questionnaire (FHQ) and a fingerprick blood test to measure hemoglobin levels.

📋 Key Findings:

◾12.3% of the women were found to have anemia.
◾ Heavy menstrual bleeding (HMB) was significantly associated with anemia.
◾ Women with anemia and HMB were more likely to take days off work due to symptoms.

💪 Implications:
Screening for HMB and anemia in female athletes is crucial. Early identification and intervention can improve overall well-being and performance. The study suggests that a simple screening tool like the FHQ could effectively identify those at risk and provide necessary interventions.

🌟 Why It Matters:
Anemia affects exercise performance by reducing work capacity and impacting VO2max, essential for optimal fitness. Addressing anemia helps women achieve their full potential in sports and fitness.

🔬 This research emphasizes the need for awareness, screening, and early intervention for anemia in exercising women. By tackling anemia, we can ensure female athletes continue to excel in their fitness journeys.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483825/

🏅 Countdown to the Olympics 🏅1️⃣

With the Olympics only a few days away, we're excited to share insights on the importance of iron in women's health, particularly for our female athletes! 🌟

1️⃣ Dr. Cory Dugan's PhD: Iron and Women's Health 🩺💪

Key Insights from Dr. Dugan's PhD

◾Prevalence: Iron deficiency is a significant issue among active females, affecting their performance and health. 🏃‍♀️🥇

◾Therapy & Management: Various therapeutic strategies are essential to combat iron deficiency. 💊🥗

◾Perceptions: Understanding how female athletes view iron therapy is crucial for effective treatment. 🗣️❤️

Dr. Dugan's research underscores the importance of routine screening and personalised iron therapy to ensure peak performance and well-being for female athletes. 🌟

For a deeper dive, check out the full research here
https://research-repository.uwa.edu.au/en/publications/iron-and-womens-health-a-multidimensional-exploration-of-iron-def

🔬 Popeye was Wrong 🔬 🚨 Preliminary Findings 🚨 Spinach has long been touted as a superfood, famous for its iron content. But is it really the iron powerhouse it's made out to be? 🥬💪

🔍 The Background 🔍 Iron deficiency is a common concern, with low ferritin levels indicating inadequate iron stores. To replenish these stores, one needs to absorb at least 1000mg of iron. But here's the catch: not all iron is created equal.

🍖 Dietary Iron 🍖 Iron comes in two forms: heme iron from meat and non-heme iron from plant-based sources like spinach. Heme iron, found in meat, is more easily absorbed by the gut, making it a preferable source. On the other hand, non-heme iron found in spinach is tightly bound and less bioavailable.

🥩 Red Meat vs. Spinach 🥩 Both 100g steak and 100g of spinach contain approximately 3.5mg of iron. However, due to differences in absorption rates, the body can absorb around 10-20% of iron from meat, but only 1-2% from spinach. This means that even though spinach contains iron, it falls short in meeting our iron needs. Unfortunately, Popeye was wrong and eating spinach is not a treatment for 🌾

🌟 Conclusion 🌟 In summary, while spinach may not be the iron-rich superhero we once thought it was, it still has its place in a balanced diet. However, to combat iron deficiency, it's crucial to consult healthcare professionals for appropriate supplementation. 💡

More research on this topic needed!

🔷🔷 Exploring the Link between Menorrhagia, Iron Deficiency, and Anaemia in Recreationally Active Females 🔷🔷

🔷 Introduction 🔷
Menorrhagia, or heavy menstrual bleeding, significantly impacts recreationally active females' health and well-being. Let's explore how this condition relates to iron deficiency and anaemia. 🌟💪

🔷 Key Findings from Recent Research 🔷
📊 Study Overview: Recent research highlights the prevalence of menorrhagia, iron deficiency, and anaemia among recreationally active females. 📈🔍

🩸 Menorrhagia Definition 📖: Heavy menstrual bleeding, or menorrhagia, is characterised by menstrual periods with abnormally heavy or prolonged bleeding. If you need to change your tampon or pad every hour for several consecutive hours, it is considered heavy. 🩸

❓ Causes: Hormonal imbalances, uterine conditions, and other underlying health issues can cause menorrhagia.

🩸 Symptoms: Excessive blood loss during menstruation can lead to fatigue and affect daily activities.

🔷Iron Deficiency🔷
💡 Role of Iron: Iron is essential for the body's oxygen transport system.
🩺 Impact: Low iron levels can lead to fatigue, weakness, and reduced exercise performance.

🔷Anaemia🔷
😴 Symptoms: Fatigue, weakness, and decreased stamina are common symptoms.
🏃‍♀️ Effects on Activity: Anaemia compromises athletic performance and overall energy levels.

🔷 Research Findings 🔷
The study revealed a strong correlation between menorrhagia and iron deficiency, leading to a high prevalence of anaemia in this population. Key statistics include:
📉 Prevalence of Menorrhagia: Significant among the studied group.

🩸 Iron Deficiency Rates: High, due to excessive menstrual blood loss.
😴 Anaemia Incidence: Common among those with menorrhagia and iron deficiency.

🔷Tips for Management and Prevention🔷
🩺 Consult Healthcare Professionals
🥗 Dietary Modifications
💊 Iron Supplements
🧘‍♀️ Lifestyle Tips - message us for more info

🔷Conclusion🔷
Understanding the link between menorrhagia, iron deficiency, and anaemia is crucial for improving the health and performance of recreationally active females. By raising awareness and implementing effective interventions, we can empower women to lead healthier, more active lives. 🌟💪❤️

🔗 For more detailed information, you can read the full article by Cory Dugan here.
🔗 URL: https://www.jsams.org/article/S1440-2440(24)00142-7/fulltext

Remember to consult with healthcare professionals for personalised advice.

Anaemia after Surgery is common: In this study Prof Toby Richards team followed 5000 patients at 101 hospitals in 13 countries. Anaemia was associated with increased risk of complications needing readmission to hospital and a decline in physical function (frailty): We propose that IV iron would be a good treatment for patients after surgery

Postoperative anaemia increases unplanned readmission: an international prospective cohort study of patients undergoing major abdominal surgery Preoperative anaemia is observed in one-third of patients who present for surgery, and is associated with increased postoperative complications, length of

🌟 Iron Absorption: Unveiling the Mysteries of This Essential Mineral 🩸
Iron absorption is a fascinating and complex process that our bodies rely on to stay healthy and energized. Let’s dive into the journey of how iron makes its way from our food into our bloodstream, and explore the factors that can influence this vital process. 🌿🩸

🚀 The Journey Begins: Iron Absorption 101
Iron absorption kicks off in the duodenum, the first part of the small intestine right after the stomach. Picture your stomach as a high-tech "acid washing machine" – it uses its powerful acid (with a pH less than 1.8) to break down iron from the food we eat, creating a mix that flows into the duodenum. 🍽️🔬

🛤️ Pathways of Iron Absorption: The Two Routes
Iron takes one of two distinct pathways to get absorbed, much like passing through different gates at an airport.

1️⃣Haem Iron (Animal-based sources): This type of iron has a VIP pass – it uses a special transporter known as HCP (Haem Carrier Protein), acting like an "E-passport gate." Around 10-20% of haem iron gets absorbed this way. 🥩✈️

2️⃣Non-Haem Iron (Plant-based sources): Non-haem iron needs more processing. It first undergoes reduction by an enzyme called Ferro-reductase and then enters the duodenum through a generic "gate" called DMT-1 (Divalent Metal Transporter 1), sharing this gate with other minerals like magnesium and zinc. Only about 1-2% of non-haem iron gets absorbed through this route. 🥦🚢

🔒 Regulation and Transportation: The Iron Customs Control
Once inside the cells lining the gut, iron is stored in ferritin before it gets transported into the bloodstream. Here, Hepcidin plays the role of "customs control." It regulates the activity of ferroportin, the gate that exports iron into the blood, ensuring iron gets loaded onto transferrin and transported to where it’s needed. 🚚🧳

⚙️ What Affects Iron Absorption?
Several factors can influence how well our bodies absorb iron:

1️⃣Acid Suppression Medication: These can interfere with stomach acidity, reducing iron absorption. 💊
2️⃣Coeliac Disease: This condition affects gut cells, particularly in the duodenum, hindering iron absorption. 🚧
3️⃣Bariatric Surgery: Procedures like gastric sleeve or bypass can directly impact the absorption process. 🏥

Remember, iron absorption doesn't happen through skin patches or sprays – it all takes place in the duodenum!

Understanding the intricacies of iron absorption helps us appreciate the importance of maintaining adequate iron levels. As research continues, we'll uncover even more insights into this essential process. Stay curious and keep exploring! 🧪🔬💡

The First Line treatment for Heavy Periods is Tranexamic acid. Tranexamic acid is an amino-acid i.e. part of a protein, (like alanine / glutamine etc. common in drinks and supplements) its cheap and available in many countries from the pharmacist without the need for a doctors prescription. It works by stabilising blood loss and can reduce bleeding by a third. In many women it can be transformative. We recommend this to women with HMB that we see with

🚀A very brief timeline: Evolution of Iron Treatment (From Hippocrates to Intravenous Iron Therapy) 🚀
Iron therapy has come a long way since the days of ancient medicine. Let's take a journey through time to see how our understanding and treatment of iron deficiency have evolved. 🌟

🏛️🏛️ 460 BC: The Wisdom of Hippocrates 🏛️🏛️
Hippocrates, often regarded as the father of medicine, made a profound statement:
"Those diseases which medicines do not cure, iron cures; those which iron cannot cure, fire cures; and those which fire cannot cure, are to be reckoned wholly incurable." 🔥

This ancient wisdom highlights the importance of iron in treating various ailments. Hippocrates recognized iron as a critical element in health, laying the foundation for future medical discoveries.

🍷⏳ 1687: Iron Filings in Red Wine ⏳🍷
Fast forward to 1687, and we find an interesting, albeit unconventional, method of iron supplementation. People began adding iron filings to red wine 🍷 to boost their iron intake. This practice was based on the understanding that iron is vital for health and could be absorbed more readily when dissolved in wine.

While this method might seem peculiar today, it reflects the innovative spirit of early medicine. The idea was to combine the beneficial properties of red wine with the essential mineral iron, albeit in a rudimentary form.

💉💉 2024: Intravenous Iron Therapy - The Gold Standard 💉💉
Today, we have come a long way from those ancient practices. Intravenous (IV) iron therapy has become the standard of care for treating iron deficiency and anemia, especially in cases where oral supplementation is inadequate or not tolerated. 🏥

IV iron therapy is administered directly into the bloodstream, ensuring rapid and efficient delivery of iron to the body. This method is particularly beneficial for individuals with severe iron deficiency or chronic conditions that hinder iron absorption. The development of IV iron therapy has revolutionized the treatment landscape, providing a reliable and effective solution for those in need.

🔬 Iron in the Body: An Essential Element
Iron, symbolized as Fe in the periodic table, plays a crucial role in our bodies. Let's explore the distribution and functions of iron in the human body.

🩸 Iron in Blood and Red Blood Cells
Iron is primarily found in red blood cells, specifically the protein called haemoglobin. Haemoglobin gives blood its red colour and enables the transport of oxygen throughout the body. In fact, approximately 2500 milligrams of iron are utilized in the production of haemoglobin.

🔍 The Role of Mean Cell Volume (MCV)
MCV, or mean cell volume, refers to the average size of red blood cells. The level of haemoglobin within the cells directly impacts their size. A higher haemoglobin content results in a larger MCV. Conversely, iron deficiency leads to a gradual decrease in MCV over time, indicating a potential long-term iron deficiency.

⏳ The Lifespan of Red Blood Cells
Red blood cells have an average lifespan of approximately four months. As these cells age, they become fragile and are eventually removed from circulation, by the spleen. The debris are excreted but the iron is recycled for future use.

🔄 Iron Recycling and Storage
Iron is transported within the body by a protein called transferrin and stored in a protein called ferritin, which acts as a "biscuit tin," capable of holding around 1000 milligrams of iron. This reserve is sufficient for various purposes, such as supporting the growth of a baby or is enough to replace two liters of blood.

🌡️ Regulation of Iron Balance
Under normal circumstances, the body efficiently recycles iron, with only minimal natural losses (approximately 2-3 milligrams) through the skin and gut surface. The absorption of iron from the gut is regulated by a hormone called hepcidin. In healthy individuals, a blood ferritin level above 50 indicates stable absorption of approximately 2-3 milligrams per day..

🩸 Iron Deficiency and Treatment
Iron depletion occurs as ferritin levels decline from 50 towards 30, hepcidin levels change, leading to an increase in absorption to 4-6 milligrams per day. In such cases, supplementation with a low-dose iron multivitamin combined with a well-balanced diet may be sufficient.

In cases of iron deficiency (ferritin