Heart failure: have your iron levels checked!

Larissa Melville completed her traineeship in the editorial team of . After studying biology at Ludwig Maximilians University and the Technical University of Munich, she first got to know digital media online at Focus and then decided to learn medical journalism from scratch.

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According to the German Heart Foundation, 35 to 60 percent of patients with heart failure suffer from iron deficiency. Fatigue, a drop in performance, headaches and concentration problems are the consequences. These complaints are particularly stressful when the heart is weak. Because whoever has a weak heart is usually limited in their performance.

“It is still unclear whether the progression of heart failure and premature cardiac death are also favored by iron deficiency. However, the experimental results speak for it, ”reports cardiologist Professor Thomas Meinertz, Chairman of the Board of the German Heart Foundation. In addition, studies indicate that iron intake in the event of a deficiency not only improves physical performance, but also the general quality of life and reduces the number of hospital stays.

Iron deficiency possible even without anemia

Nevertheless, it has so far been unusual to check the laboratory parameters of iron metabolism in the case of cardiac insufficiency. The expert knows that the only reason for this is if the patient is anemia at the same time. But iron deficiency can also occur in heart failure independently of anemia.

"In general, iron is less well absorbed from the intestines in patients with heart failure and is more needed in the organism," explains Meinertz. Anyone who suffers from anemia at the same time may have microbleeding in the gastrointestinal tract through which they lose blood unnoticed.

Blood test creates clarity

"In view of the frequency and clinical consequences of iron deficiency, the iron metabolism should be routinely checked in all patients with cardiac insufficiency," says Meinertz. Important blood values ​​are ferritin (protein that stores iron), transferrin (protein that transports iron) and the hemoglobin value to rule out anemia. An iron deficiency exists if the ferritin value is below 100 µg / l, but also if this is between 100 and 300 µg / l and the transferrin is also less than 20 percent iron.

However, iron tablets do not help!

If you have been diagnosed with iron deficiency, you can take countermeasures by supplying iron: "However, iron supply via capsules containing iron is not possible because the intestine cannot absorb the iron supplied orally when the heart is weak," explains Meinertz. An effective supply can only be achieved through repeated intravenous administration of 500 to 1000 mg iron carboxymaltose. In long-term therapy, this injection must be given about every three months.

Lack of oxygen due to lack of iron

If there is too little iron in the blood, not enough hemoglobin can be produced. The red blood pigment is necessary to bind and transport oxygen. The result: Less oxygen in the blood leads to poor performance.

Researchers at the Hannover Medical School identified another possible reason for the drop in performance in the case of iron deficiency. A mouse study showed that the mitochondria, the energy power plants of the cell, also need the trace element. If too little iron is available, the mitochondria generate less energy - and the pumping heart muscle in particular needs this to a great extent.

Heart failure is one of the most common causes of death in Germany. In those affected, the heart's pumping capacity is so weak that the body can no longer be adequately supplied with blood in all situations. The lack of oxygen and nutrients also damages other organs such as muscles, kidneys and brain over time. The most common causes of heart failure include coronary artery disease (CHD) and high blood pressure.

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