TALKING TO YOUR DOCTOR ABOUT IRON DEFICIENCY IN CHRONIC HEART FAILURE

If you have been diagnosed with chronic heart failure you will probably have regular appointments with your doctor to see how you are feeling and to check your medication. However, if you are experiencing symptoms of iron deficiency it is important that you discuss this with them.

Knowing if you have iron deficiency or not is important as it can have a big impact on your life, and also on your prognosis. If you have chronic heart failure and iron deficiency you will be less able to exercise and could have a lower quality of life than someone with chronic heart failure alone.1,2

This might mean you need to have a rest during the day and have difficulty doing things like gardening or spending time with family.2

Having iron deficiency can also mean you are more likely to need a heart transplant than someone without iron deficiency and your risk of dying increases too.3

If you think you may have iron deficiency you can use the Symptom Browser to find out more, and also to help you prepare notes for when you see your doctor. It’s useful to think beforehand about what your doctor might need to know to understand your symptoms and what might be causing them, but also to write down any questions you have for them.

For example, your doctor might want to know:

  • Have you been taking your medication regularly?
  • Are you following any dietary advice you have been given?
  • How often to you get out for a walk, or do exercise?
  • Do you feel tired every day? Do you take a nap every day?

Questions you might ask:

  • I’m so tired all the time, could I be anaemic?
  • I get out of breath doing the simplest thing, is there anything I can do?
  • Was my haemoglobin checked at the last blood test? What were the results?

How Will Your Doctor Test for Iron Deficiency and/or Anaemia?

Anaemia occurs when there aren’t enough red blood cells in your blood or you have low haemoglobin levels.4Haemoglobin carries oxygen in the blood from the lungs to the rest of the body. Your doctor can check whether or not you are anaemic by performing a Complete Blood Count. This helps your doctor to find out the number of red blood cells and amount of haemoglobin in your blood.5

The table beneath shows the haemoglobin level that may be considered ‘low’ by your doctor. The cut-off values that define anaemia can be different for different groups of people.

Gender/Age Blood Test Guideline Values Your Doctor May Use When Checking for Anaemia*
Haemoglobin
Men > 15 years old Haemoglobin count to define anaemia Below 13 g/dL6
Women > 15 years old (non-pregnant) Haemoglobin count to define anaemia Below 12 g/dL6
Women > 15 years old (Pregnant) Haemoglobin count to define anaemia Below 11 g/dL6

*The guideline values and the units provided in this table are for your reference only and it is possible that your doctor uses different guideline values or units. Talk to your doctor about what your results mean. 

Iron Deficiency

Your doctor may also test your blood for iron deficiency either as part of the first blood test, or in a follow-up test. Several different results from your blood test can help a doctor to understand whether or not you are iron deficient. These include:

TSAT, or transferrin saturation, a test to measure the amount of iron that is being transported in your body7
Serum* ferritin, which indicates the amount of iron stores you have in your body8
Serum* iron, the total amount of iron present in the serum of your blood7

* Where mentioned, serum is the fluid part of the blood once the blood cells have been removed

The table beneath shows the values that may be used by your doctor to determine if you are low in iron.

Blood Test 2016 ESC Guideline For Heart Failure value recommendations9*
Serum Ferritin <100 µg/L
Ferritin 100-299 µg/L
Transferrin saturation (TSAT) < 20%10

*The guideline values and the units provided in this table are for your reference only and it is possible that your doctor uses different guideline values or units. Talk to your doctor about what your results mean.

If it turns out that you have iron deficiency or iron deficiency anaemia, your doctor will be able to recommend the best treatment option for you. This could be a simple change to your diet to include more iron-rich foods, over-the-counter iron supplements, or a prescription of oral or intravenous iron.  For more information on ways to manage iron deficiency click on Treatment Options.