Iron Infusion Reactions?
Hi, my doctor has diagnosed me with Iron Deficiency Without Anemia (normal iron & hemoglobin levels, but extremely low ferritin levels) and has recommended I go forward with iron infusion therapy (I will be trying to get pregnant later in the year, so it's imperative that I get my levels up rapidly).
I am overwhelmed/terrified by the stories I have read about bad reactions, like anaphylaxis and cardiac arrest (this is particularly touchy to me as my Dad died as a result of an allergic reaction to a medication administered during surgery leading to cardiac arrest). It also didn't help that the last time I was at my hematologist's office, someone rushed into the room needing my doctor ASAP as someone there was having a reaction to their infusion.
I am currently being treated for Mast Cell Activation Syndrome (MCAS) with a regimen of 10mg cetirizine (Zyrtec - H1 blocker) 2x/day, 40mg famotidine (Pepcid - H2 blocker) 2x/day, and 1mg oral Ketotifen (mast cell stablizer) 2x/day.
I also have some minor issues with methylation due to my MTHFR gene mutation, and prescribed 15mg L-Methylfolate (Deplin) daily, as well as a methylated B vitamin supplement.
I also have been diagnosed with asthma, postural orthostatic tachycardia syndrome (POTS) & Ehlers-Danlos Syndrome (EDS).
- Thoughts on/experiences with iron infusion brands? I'm leaning towards Feraheme or Monoferric (if they're available). Full disclosure, the black box warning for Infed scares me and the hypophosphatemia issues have scared me away from Injectafer. Ferrlecit & Venofer sound like they would take a lot longer--but do people tend to tolerate them better?
- I have read that it's not good to take Benadryl before iron infusions--does this mean I should avoid taking any or all of the above listed antihistamines & mast cell stabilizer prior to infusion? Any pre-medication recommendations?
- I've read that in the case of an anaphylactic reaction to an iron infusion, they will pump you with Benadryl. But allergists always say that if you're in anaphylaxis, Benadryl and other antihistamines are not good and instead you need epinephrine and to get to an ER. So which is it?
*I know that I will get at least one response that emphasizes how rare reactions are. But I have so many health issues that I worry could pre-dispose me (including MCAS, which right now, I have allergic reactions to tons of things all the time), I just want to be prepared and make the most informed decision I can, and have a reliable plan in place, should something go wrong. Thank you so much in advance!
Posted Jun 15, 2025, 2:52 AM UTC