New research results have shown that for women suffering from iron deficiency anemia (IDA) due to severe dieting and excessive bleeding during menstruation, intravenous iron therapy is more efficient and effective than traditional oral anemia medications.
A research team from Yale University in the United States stated that this was revealed through a comprehensive analysis of the menstrual cycles and iron requirements of American women aged 18 to 51. According to the study, while oral iron supplements may seem inexpensive, they have low absorption rates and many side effects, resulting in reduced actual treatment effectiveness. In contrast, intravenous iron supplements have a 100% absorption rate in the body, quickly restoring iron stores and significantly improving quality of life.
Research has shown that intravenous iron supplements have about 75% greater hemoglobin-raising effects compared to oral iron supplements, and the likelihood of showing a significant treatment response is about 45% higher. Additionally, while about 35% of patients discontinue oral supplements due to gastrointestinal side effects, the discontinuation rate for intravenous supplements is much lower.
This research result (Cost-Effectiveness of First-Line IV Versus Oral Iron for Iron Deficiency Anemia in Women with Heavy Menstrual Bleeding) was published on the 8th (local time) in the international journal 《Blood Advances》.
This study is also related to the reality of the domestic medical system, where most anemia patients are women and treatment practices centered around oral medications are entrenched. Previous research estimates that among the approximately 51.5 million people in the country, about 4.7 million (about 9%) suffer from anemia. By gender, about 3% of men and about 15% of women are anemia patients, with women being 4 to 5 times more likely than men.
Especially, anemia is prevalent among women of childbearing age. The most common cause of anemia in women is iron deficiency. It is estimated that 70-80% of anemia cases among Korean women are classified as iron deficiency anemia. Applying this to the entire population means that more than 3 million Koreans are suffering from anemia due to iron deficiency.
Chronic blood loss due to menstruation, increased iron requirements during pregnancy and childbirth, and the combined effects of dieting and nutritional imbalances increase the risk of iron deficiency anemia in women. In Korea, when anemia is confirmed, oral iron supplements are mostly recommended as the first-line treatment.
This oral iron supplement is an over-the-counter (OTC) medication that can be easily purchased at pharmacies and is sometimes regarded as a 'supplement', but it is actually a medication for treating iron deficiency anemia. Of course, there are many iron supplements in the form of health functional foods for iron supplementation, but these are for supplementation and prevention, not for treatment purposes.
In contrast, intravenous iron supplements can quickly replenish iron in the body with just one or a few administrations. American research has also suggested that intravenous iron supplements are more cost-effective in the long term compared to oral supplements. Considering the costs of taking oral supplements for several months and the time lost due to hospital visits, intravenous treatment is much more economical.
There are no official statistics showing the usage rate of intravenous iron supplements in Korea. However, in clinical practice, there are ongoing concerns that "intravenous iron supplements are not sufficiently used for anemia patients who need them." In the United States, it has also been confirmed that intravenous iron supplements are primarily used for specific patients such as those with cancer, heart failure, or kidney disease, rather than for general iron deficiency anemia patients.
A research team from Harvard University points out that this structure increases social costs. If patients discontinue medication due to side effects of oral supplements or if iron stores are not sufficiently restored, it can lead to decreased productivity, pregnancy complications, chronic fatigue, and more. This means that long-term burdens can unexpectedly increase. In particular, women experiencing heavy menstrual bleeding often lose a significant amount of iron, making it difficult to treat with oral supplements alone.
Overseas, there is already a movement to consider intravenous iron supplements as first-line treatment. The American Society of Hematology plans to revise guidelines to increase access to intravenous treatment for patients with iron deficiency anemia. Anemia is a relatively easy condition to treat. However, if left untreated, it can significantly reduce quality of life and affect pregnancy and childbirth. There is a need to consider policy changes to increase access to intravenous iron supplements.
[Frequently Asked Questions]
Q1. How are oral iron supplements and health functional iron supplements different?
A1. Oral iron supplements are over-the-counter (OTC) medications for treating iron deficiency anemia and have a direct therapeutic effect in replenishing iron in the body. Health functional iron supplements are used for nutritional supplementation and prevention, and their anemia treatment effects are not as strong as those of medications.
Q2. Why are there no statistics on the usage rate of intravenous iron supplements in Korea?
A2. This is because the Korean government or academic societies have never separately compiled statistics on the usage rate of intravenous iron supplements. Some studies present usage rates for specific disease groups (e.g., heart failure), but there are no official statistics for the entire anemia patient population.
Q3. Do all anemia patients need intravenous iron supplements?
A3. There are patients who can be adequately treated with oral iron supplements. However, for patients experiencing severe anemia due to heavy menstrual bleeding, pregnancy and childbirth, or gastrointestinal disorders, rapid iron replenishment is necessary, and intravenous iron supplements are more effective.
