• Iron is an essential mineral that supports both body and brain health by helping deliver oxygen and produce energy.

    Iron and body health

    Iron is a key part of hemoglobin, the protein in red blood cells that carries oxygen from the lungs to muscles and organs. Adequate iron levels are important for physical stamina, muscle function, immune health, and temperature regulation. Low iron can lead to fatigue, weakness, shortness of breath, reduced exercise tolerance, hair loss, and increased susceptibility to infections.

    Iron and brain health

    The brain depends on iron to generate energy, produce neurotransmitters involved in mood and attention, and maintain healthy nerve signaling. Low iron may cause brain fog, poor concentration, headaches, mood changes, and restless legs symptoms, even before anemia develops.

    Bottom line

    Iron is essential for oxygen delivery, energy production, and normal neurological and physical function. Maintaining healthy iron levels supports day-to-day energy, mental clarity, and overall wellbeing.

  • People at higher risk include:

    • Women with heavy menstrual bleeding

    • Pregnant and postpartum individuals, due to increased iron requirements

    • Infants, children, and adolescents, especially during periods of rapid growth

    • Athletes, due to increased iron loss through sweat, gastrointestinal micro-bleeding, inflammation, and higher oxygen demands

    • People with gastrointestinal conditions (e.g., celiac disease, inflammatory bowel disease, bariatric surgery) that reduce iron absorption

    • Those with chronic blood loss, including gastrointestinal bleeding or frequent blood donation

    • Older adults, particularly with unrecognized blood loss or poor dietary intake

    • People following vegetarian or vegan diets, if iron intake or absorption is inadequate

    • Individuals with chronic medical conditions, such as chronic kidney disease, heart failure, or inflammatory disorders

    Bottom line

    Iron deficiency often develops silently. Identifying high-risk groups allows for early testing and treatment, helping prevent fatigue, cognitive symptoms, and reduced physical performance.

  • Iron deficiency exists on a spectrum, and symptoms can occur with or without anemia.

    Non-anemic iron deficiency

    This occurs when iron stores are low (low ferritin) but hemoglobin levels are still normal. It is common and often overlooked. Despite a normal blood count, people may experience fatigue, reduced exercise tolerance, brain fog, headaches, poor concentration, mood changes, and restless legs symptoms. This stage can significantly affect daily functioning, athletic performance, and cognitive efficiency.

    Iron-deficiency anemia

    This develops when iron levels drop further and the body can no longer make enough hemoglobin. As a result, oxygen delivery to tissues is reduced. Symptoms are typically more pronounced and may include marked fatigue, weakness, shortness of breath, dizziness, palpitations, pale skin, and reduced physical and mental endurance.

    Why this distinction matters

    Many people experience symptoms before anemia appears. A normal hemoglobin does not rule out iron deficiency. Measuring ferritin helps identify iron deficiency early, allowing treatment before anemia develops and symptoms worsen.

    Bottom line

    Iron deficiency can impair brain and body function even without anemia. Early recognition and treatment improve energy, cognition, physical performance, and overall wellbeing.

  • An intravenous (IV) iron infusion is a method for quickly bringing iron into your blood stream using a small tube inserted into a vein in your arm.

  • IV iron is a treatment option for people with low iron. You may require it if you: 

    • Cannot tolerate or cannot absorb iron from iron pills.

    • Have a surgery planned in the next few months.

    • Have chronic kidney disease.

    • Are in your second or third trimester of pregnancy and have anemia

    • Are unable to have blood transfusions for your anemia.

  • IV iron is not made with any human blood products.

  • If you are referred for IV Iron infusion only,

    • The referring physician/NP is responsible for prescribing IV Iron and completing any necessary paperwork required for Insurance / Ontario Drug Benefits Coverage and

    • Patient must bring their IV iron medication vial to the clinic on the day of the infusion.

    If you are referred for Neurological Symptoms due to Iron deficiency

    • NEO clinic will provide the prescription and handle any paperwork required

  • The cost depends on the specific iron formulation prescribed, the total dose required, and the dispensing pharmacy pricing.  Private insurance plans and ODB tend to cover part or all the cost and some of the formulations may have a patient support program. Approximate cost of the IV Iron medication is below.

    • Venofer: ~$120 per 300mg; DIN # 02243716

    • Monoferric: ~$290 for 500mg; ~ $575 for 1000mg; DIN # 024777777

    • Ferinject: ~$290 for 500mg; ~$575 for 1000mg; DIN # 02546078

  • Yes, you can directly purchase the IV iron medication at the clinic but will require a prescription from a physician / NP. You can submit the receipt for any reimbursement.

  • IV Iron infusion /administration cost is $225 per visit. This fee covers the cost of administering IV iron in the clinic, including nursing time, supplies, patient monitoring during and after the infusion, use of clinic space, and emergency preparedness. Infusion costs are not covered by OHIP in an outpatient community clinic setting and are billed directly to the patient at the time of booking your appointment. An invoice and receipt will be provided for potential reimbursement through private insurance, employer benefits, or for tax purposes. If the infusion cost is a concern,patients are encouraged to discuss this with their healthcare provider, as referral to a regional hospital-based infusion service may be considered where appropriate.

  • Most patients tolerate IV iron infusions very well. IV iron is considered safe for patients of all ages and is also safe during the second and third trimesters of pregnancy. Severe allergic reactions are very rare, occurring in approximately 26 per 100,000 infusions. Some patients may experience mild and temporary side effects during or after the infusion. These can include headache, muscle, joint, or back pain, flu-like symptoms after the infusion, irritation or discomfort at the injection site, facial flushing or hives, nausea or vomiting, and temporary changes in blood pressure or heart rate. Clinic staff closely monitor patients during and after the infusion to ensure safety.

  • There is no fixed schedule for IV iron replacement, as the frequency depends on the severity of iron deficiency, the underlying cause, and whether that cause has been corrected. After a complete course of IV iron, iron stores often remain adequate for approximately 6 to 12 months in many patients, though some may require earlier re-treatment. Patients with ongoing iron loss or impaired absorption, such as those with heavy menstrual bleeding, chronic gastrointestinal blood loss, malabsorption, chronic kidney disease, chronic inflammatory conditions, or recurrent deficiency during pregnancy, may require repeat IV iron every 3 to 6 months. Evidence from studies in females with ongoing menstrual blood loss suggests that many menstruating patients who are unable to maintain iron stores with oral supplementation require repeat IV iron approximately once per year, and in some cases up to twice per year, depending on bleeding severity and iron losses. In contrast, a single course may be sufficient when iron deficiency is due to a temporary or reversible cause. Decisions regarding repeat treatment are guided by symptoms and follow-up blood work rather than a fixed timeline, with ferritin and transferrin saturation typically reassessed 8 to 12 weeks after infusion and periodically thereafter.

    • To help reduce side effects and improve comfort, patients are encouraged to stay well hydrated in the 24 hours before and after the infusion, as IV iron can sometimes lower blood pressure.

    • Stop oral iron supplements three days prior to the IV iron infusion.

    • Diphenhydramine (Benadryl) should not be taken as a pre-medication, as it can lower blood pressure and cause side effects such as dizziness, flushing, sedation, or confusion.

    • Arrive at the clinic at least 15 minutes before their scheduled appointment and bring a valid OHIP card along with a list of current medications including doses and frequency, or a pharmacy blister pack if available.

    • Patients are welcome to bring personal electronic devices to help pass the time. The entire visit typically takes about 90 minutes. Complimentary guest Wi-Fi is available.

    • The clinic is a scent-free environment and avoid wearing perfumes or scented products.

    • Family members or caregivers may accompany patients but will be asked to wait in the waiting area.  In most cases, patients are able to drive themselves to and from their infusion appointment.

    • Upon arrival, patients will check in at the reception desk. A nurse will then complete a brief pre-infusion assessment, insert an intravenous line, start the IV iron infusion, and monitor the patient closely throughout the visit. The infusion itself usually takes about 30 minutes, depending on the type of IV iron used and individual tolerance. After the infusion is complete, patients are observed for an additional 30 minutes to ensure there are no adverse reactions. If no concerns arise, patients may return home and resume normal activities.

  • Iron deficiency is diagnosed using blood tests that assess iron stores and red blood cells.

    Key tests used

    • Ferritin – the most important test; reflects iron stores. Low ferritin confirms iron deficiency, even if hemoglobin is normal.

    • Complete Blood Count (CBC) – checks hemoglobin and red blood cells to determine if anemia is present.

    • Iron studies (as needed) – may include serum iron, transferrin, and transferrin saturation to clarify the diagnosis.

    Important to know

    • Iron deficiency can be present without anemia.

    • A normal hemoglobin does not rule out iron deficiency.

    • Ferritin is essential for early detection and treatment.

    Bottom line

    Iron deficiency is best diagnosed with a combination of ferritin and blood counts, allowing identification of both non-anemic iron deficiency and iron-deficiency anemia.