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Eisenmangel, Müdigkeit und Restless-Legs-Syndrom

Iron deficiency, Fatigue and Restless-Legs-Syndrome

Wiener Medizinische Wochenschrift volume 166, pages 447–452 (2016)Cite this article

Zusammenfassung

Eisenmangel ohne Anämie ist ein weit verbreitetes Gesundheitsproblem, welches oft unentdeckt bleibt. Klinisch stehen neurologische und psychopathologische Probleme wie Müdigkeit und Konzentrationsschwäche im Vordergrund, aber auch in der Entstehung von Restless-Legs-Syndrom (RLS) spielt Eisenmangel eine entscheidende Rolle.

Die genaue Pathogenese ist oft nicht bekannt, jedoch weiß man, dass Eisen an verschiedenen zentralen Stoffwechselprozessen im Körper beteiligt ist. Insbesondere bei Fatigue und RLS geht man von einer reduzierten Aktivität der Tyrosinhydroxylase aus – einem zentralen eisenabhängigen Element der Dopaminsynthese – wodurch es zu Mangelzuständen kommen kann.

Im Rahmen der Therapie gilt die orale Eisengabe als Eckpfeiler der Substitutionstherapie, da sie besonders kostengünstig und sicher ist. Die parenterale Eisenbehandlung ist indiziert, falls die primäre orale Therapie nicht erfolgreich ist oder nicht toleriert wird. Zum Auffüllen der Eisenspeicher werden etwa 500–1000 mg benötigt. Diese können fraktioniert in Dosen von 200 mg (Fe-Saccharose) oder bei Fe-Carboxymaltose auch in 1–2 Einzeldosen appliziert werden. Eine Kontrolle des Ferritinspiegels sollte frühestens 8 Wochen nach der letzten parenteralen Verabreichung erfolgen.

Summary

Iron deficiency without anaemia is a widespread health problem that often remains undetected. In this context, neurological and psychopathological problems like fatigue and poor concentration are a major issue, but also in Restless-Legs-Syndrome (RLS) iron deficiency is a key element.

The exact pathogenesis is often unknown, however, it is known that iron is involved in several very important metabolic processes in the human body. In particular when it comes to fatigue and RLS, it’s assumed that reduced activity of tyrosine hydroxylase – a central iron-dependent element of dopamine synthesis – can lead to deficiencies.

As part of the therapy, oral iron supplementation is considered to be treatment of choice since it’s most cost-effective and well tolerated. Intravenous iron treatment is indicated if primary attempts were not sufficient or not tolerated. To successfully replenish iron storages, about 500–1000 mg are needed. Doses of 200 mg can be administered (iron sucrose) or 1–2 single doses as for ferric carboxymaltose. A check of ferritin-levels not earlier than 8 weeks after last administration is recommended.

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Authors and Affiliations

  1. Loha for Life, Med. Kompetenzzentrum Eisenmangel, Heiligenstädterstraße 50–52, 1190, Wien, Österreich

    Bettina Wurzinger & Peter König

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  1. Bettina Wurzinger
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  2. Peter König
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Correspondence to Bettina Wurzinger.

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B. Wurzinger und P. König geben an, dass kein Interessenkonflikt besteht.

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Wurzinger, B., König, P. Eisenmangel, Müdigkeit und Restless-Legs-Syndrom. Wien Med Wochenschr 166, 447–452 (2016). https://doi.org/10.1007/s10354-016-0497-3

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  • DOI: https://doi.org/10.1007/s10354-016-0497-3

Schlüsselwörter

  • Eisenmangel
  • Müdigkeit
  • Restless-Legs-Syndrom

Keywords

  • Iron deficiency
  • Fatigue
  • Restless-Legs-Syndrome