Types of Iron Infusion for Restless Legs Syndrome

Andy Berkowski, MD of ReLACS Health summarizes the six major types of iron infusion available in the US with regard to the treatment of restless legs syndrome (RLS) and the pros and cons of each.
For more details on iron infusion, read his dissertation/blog on the topic of iron infusions:
www.relacshealth.com/blog/which-iron-infusion-should-i-choose-for-restless-legs

[@conniepatel6809]

Dr Andy how can I find in nyc a true restless leg specialist that knows all about what I am learning following your videos I suffer severely and am soo sleep deprived besides this night jerking is destroying my knee joints from soo much tossing turning.not every neurologist knows about this disorder.

[@andyberkowskimd]

The frustration is understandable. Neurologists have not been interested in this condition for a variety of reasons. The 2023 American Academy of Neurology's upcoming annual meeting does not seem to have any lectures on RLS this year. There was only one lecture on RLS at this meeting in 2022, and I was the one who gave it! One would think this disease would appear in a national weeklong neurology conference for a neurological condition affecting 5% of the U.S. population, right?

[@primordialdreamsong]

My main side effect was one brown arm where the iron was injected. It has lasted for years. my iron and hemoglobin were so low, that I had transfusions as well.

[@andyberkowskimd]

Any time a needle/IV is put in, there is a risk of infiltration. This is another reason to avoid the cheaper infusions that require 5-6 separate infusions (and separate IVs, separate pokes) to get to 1000 mg for RLS.

[@primordialdreamsong]

This was no cheap job. The infusions were done at Georgetown Hospital, Washington, DC (one of the most highly ranked hospitals in the US) in its infusion clinic. @@andyberkowskimd

[@robertallee295]

Just had 510mg of FerraHeme , hoping it works well. Been having terrible insomnia and restless legs after a double blood donation.

[@mcarmella7842]

Thanks so much for the information. I suffer from RLS and have low iron. I've been trying to build up my stores through supplementation but infusion may be a quicker fix.

[@andyberkowskimd]

Iron infusion can improve iron levels to normal or high normal sometimes in as little as a 20 minute infusion, equal to that of supplementing for 6-12 months. The body also limits how much iron one can absorb through the bowels so there is a ceiling. Some do not tolerate iron supplements or do not absorb iron well for a variety of reasons. Iron infusion can provide a limitless supply of iron by going straight into the bloodstream. The problem with IV iron is that it is not recognized by insurance as a treatment for RLS and most physicians are not aware it is a first-line treatment for RLS either. It is hard to get someone to order an infusion and hard to get the infusion paid for/expensive out-of-pocket.

[@avinashbushra6361]

Please write the names of these iron infusions , their dosage, no of days .

[@andyberkowskimd]

Based on consensus guidelines from Allen et al. 2018 and other research evidence and clinical experience that 1000 mg of a strong formulation appear more effective than lower amounts or weaker formulations (e.g. iron sucrose/Venofer®, ferric gluconate/Ferrlecit®):
www.sciencedirect.com/science/article/pii/S1389945717315599?via%3Dihub
Feraheme® (ferumoxytol) 1020 mg x 1 or 510 x 2
INFeD® (low molecular weight iron dextran) 1000 mg x 1
Monoferric® (ferric derisomaltose) 1000 mg x 1
Injectafer® (ferric carboxymaltose) 750 mg x 2 (does not come in vials of 500 or 1000)