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How would you approach iron supplementation in a beta thalassemia trait patient with restless leg syndrome?

For a patient who cannot tolerate PO iron, does the presence of the beta-thal trait and resultant theoretical risk of iron overload preclude IV iron administration even if ferritin <75? Is there additional laboratory testing to assess iron loading potential that you would use beyond TSat%?
2 Answers
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Hematology · Georgetown University School of Medicine
Answered on

Thalassemia does not alter my decision. I don't use PO iron for RLS as it is enormously more toxic. A ferritin of 75 is a light-year away from iron overload, and a total dose infusion of IV iron can be administered with impunity. This patient should be treated with a gram of LMW iron dextran over on...

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Mednet Member
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Hematology · Rochester General Hospital
Answered on

It is fine to replenish iron if the patient is deficient, regardless of underlying thalassemia trait.

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