Iron Confusion

I am totally confused.  I am 5 months out, doing good on eating and taking vitamins that doctor recommends.  I went to my primary care doctor yesterday to have my blood pressure checked and see if I need my prescription renewed.  I mentioned to her that I just got off my monthly and it that during it I was totally wiped out, low energy, tired.  She mentioned that I probably need a iron supplement and to start taking one in the meantime she took my blood to check for anemia. 

So I sent my RN/Coordinator from the doctor's office who did my surgery and is knowledgeable with the DS an email asking her if there is a certain kind of iron supplement I need to take to help absorb.  My response from her is that I should not be taking iron supplements, they don't absorb and are too hard on the stomach if I am low on iron I will need an infusion.  So I am not sure what to do.  I wish doctors/nurses/etc would understand this procedure more so they can quit confusing us and help us better.

This is why I DO NOT follow my surgeon's advice on supplementation. If I did, I'd only be taking a multivitamin and some calcium!

I follow Vitalady's plan. She sells something called "Tender Iron" which is better absorbed and easier on the stomach.

I take 5 per day all at once (300 mg total) and have had no stomach issues. (I started by taking one daily and increased my dosage each wee****il I reached my full dose). 

Ditto what Amy said.

Plus with your iron you'll want to add 3mg of copper too.

The lab work will tell the tale. At 6 months my labs showed me as slightly anemic. I started taking 2 of the vitaldy's tender iron a day. I have labs again next week so then I will know if that is working.

There are several kinds of iron. Some people seem to absorb one better than the other. I know Proferrin is a different and more expensive type of iron that seems to help some people that don't get any help from regular (carbonyl) iron. You really have to see what works for you but I don't see a reason to start with infusions unless you are way..... low or oral supplementation just isn't doing the trick. Some people just don't absorb but many do fine.

Proferrin (brand name) is supposed to be easier on the stomach but I have never had a problem with the carbonyl iron that Vitalady sells. Although just like Amy says you should gradually work your way up to decrease the chance of stomach upset.

Also, iron fights with a lot of other things, so be careful when you take it to get full advantage. I take mine with Vitamin C right before bed.

And yes - I hate when people in supposed authority dispense advice that is BS - or at least misinformed.

If you crash your iron and ferritin labs too far an infusion is probably needed but not all DSrs have trouble with iron supplements. My iron and ferritin were sluggish pre-op and immediately post-op. I was able to bring all my iron markers up, and in some cases a little over, using a combo of Vitalady's Tender iron and Proferrin (heme iron). I was taking 300mg of the Tender (carbonyl iron) in the mid to late afternoon and 2 Proferrin tablets snapped in two at bedtime. It took about a year to bring everything up to awesome levels but it worked. My dietitian has reduced my dose to see if I can hold my labs on a lower dose. We're experimenting because nobody is exactly the same.

Keep us posted on what they find on your blood tests. Good luck!

--gina

Most iron absorption takes place in the duodendum. Because most of the the duodendum is bypassed, iron absorption is affected.

I cant absorb iron at all. I needed infusions at about nine months out. I took two different iron absorption tests, one after taking carbonyl iron and another one after taking proferrin. I absorbed neither. After I failed the carbonyl, I asked my hema if he wanted me to start taking the proferrin right away. He told me not to bother until we knew that I would absorb it. Iron has a lot of special requirements....dont take it with calcium, dont drink coffee, dont take too much at once it can be constipating....and proferrin is expensive! Maybe he took pity on me and told me not to start it right away! Regardless, I failed that absorption test as well.

After two rounds of infusions (5 infusions a week apart, each time), 6 months apart, I had a uterine ablation. My six month follow up showed I was no longer low on iron. My levels have been consistent and I am thrilled.

Which is a big factor for women. If you are still having periods, you are losing iron every month. Your supplementation needs are likely going to be different than a post-menopausal woman or a man.

If you feel your levels are low, get your iron and ferritin tested asap. Once low, it took me at least a month to get the infusions. I think the hema had to prove that oral supplementation would not work (proven by the absorption tests), in order to be confident that insurance would cover them. Now, its clear sailing whenever I need them.

You can enter "iron and DS" in the search bar and bring up loads of past threads that address iron. I found it very helpful when I was going through my initial iron issues.

Wow!  I had really low iron as well and was told if it didn't resolve I would need iron infusions, so I went to a hemotologist.  He told me to take only Carbonyl Iron, which we absorb it so much better (you have to read the labels, Feosol makes one, I take Vitalady Tender Iron.)  Also, take it with a vitamin C, that helps absorbtion take it as far away from your antacid as possible, and wait 2 hours (at least) after eating a dairy product.  He also said to take on an empty stomach, but the Tender Iron says food is OK.  This has worked for me, but I would recommend an appointment with a hemotologist he can give you a plan just for you!  Good luck.  :)

Before I would go on infursions I would try the RX proferrin Forte.  I was also in your boat,severe anemic (caused by the band).  Proferrin forte doesn't have all those nutritional restrictions as other forms of iron  and has caused me no GI distress, unlike the other forms or iron,  depending on your levels, I started taking 3 day, now I take one a day and my levels are great. 

mpstewart2000:    You need to take a look at your OWN lab report.  Pay special attention to your FERRITIN level.  If that is low, go for iron infusions.  My hematologist infuses when my ferritin gets below 50.  When I first was infused, my ferritin was 9.  I was fainting at work upon standing. 

I have taken Proferrin Forte by prescription now since 2010.  Only after my iron infusions I started absorbing it way better than before.  Alot of hematologists advise to stop taking oral iron because they think we aren't able to absorb it.  Mine said to keep taking my Proferrin, so I did.  My ferritin is still going up on Proferrin alone now.

THE LESSON HERE is to track your own labs.  Get yourself a spreadsheet and start tracking your own lab results.  Get to know your own numbers and watch your own "trends". 

Don't be afraid of iron infusions.  I got mine in the chemo lab at the local out-patient center.  It takes about an hour each time, so take something to read.  You will feel SO MUCH BETTER when your levels are high again, it will be phenomenal.