low ferritin
Just spoke with my PCP's nurse. My ferritin is low. PCP wants me to take 325mg of Ferrous Sulfate daily. I explained to the nurse that I already take ferrous fumurate as that is what gastric bypass pts should take........nurse says "how much are you taking?" I tell her 29mg daily. she says "Well thats not enough, Dr wants you to take 325mg, you'd have to take over 10 pills a day of that kind" Are you kidding me.....so I have to explain to her they are different kinds of iron, no I should not take 10 pills a day of iron fumurate 
........so she is going to talk to the MD. Anyone have any suggestions as to if I should take more then the 29mg of iron and I don't take vitamin C should I add Vit C to aid in absorbsion?????
........so she is going to talk to the MD. Anyone have any suggestions as to if I should take more then the 29mg of iron and I don't take vitamin C should I add Vit C to aid in absorbsion????? 
Why do you say gastric bypass patients should take ferrous fumurate? Carbonyl iron is much easier on the stomach, less likely to cause constipation, and may be better absorbed.
Yes, you should take vitamin C with your iron. I think the formula is 200 mg vitamin C to 30 mg iron. That's 30 mg elemental iron, so if you took 325 mg ferrous sulfate, that's only 65 mg elemental iron, so you'd need about 400 + mg vitamin C.
Yes, I would take more than 29 mg iron. Apparently 29 mg is not enough for you. The ASMBS recommends 18 - 27 mg iron for people if their labs are all good. Since yours aren't all good, you need more.
How low is your ferritin? What are your other iron numbers?
Kelly
Yes, you should take vitamin C with your iron. I think the formula is 200 mg vitamin C to 30 mg iron. That's 30 mg elemental iron, so if you took 325 mg ferrous sulfate, that's only 65 mg elemental iron, so you'd need about 400 + mg vitamin C.
Yes, I would take more than 29 mg iron. Apparently 29 mg is not enough for you. The ASMBS recommends 18 - 27 mg iron for people if their labs are all good. Since yours aren't all good, you need more.
How low is your ferritin? What are your other iron numbers?
Kelly
Your nurse is an idiot. You were already taking the amount of iron that your doc wanted you to take -- just a different form.
Actually, we don't absorb many of the ferrous forms well -- but we absorb gluconate the absolute best in ferroous forms. Sulfate is the absolute worst.
See, ferrous forms are called ferric salts. They are measured in two ways: They are measured in the total weight of the molecular amount "325mg ferrous sulfate" and they are measured in the amount of elemental iron. So it would look something like "325mg ferrous sulfate equivalent to 65mg elemental iron" or thereabouts. Your ferrous fumarate would be the same way. Just look closely at the bottle.
Carbonyl would be the best ionic form to get. I'm with Kelly on that one. Because it's not a salt form of iron and is straight elemental, it is easier on the digestive system (ie no bloating, no cramping, no constipation) and has been shown to absorb better in our low gastric acid environments.
However if you want the absolute best form of iron in terms of absorbancy, it would be heme iron -- but it's more expensive. It's a trade-off.
But to bring up your ferritin? (And I speak from experience here) you will need carbonyl or heme -- ferrous forms won't do it in a timely manner -- if at all.
Actually, we don't absorb many of the ferrous forms well -- but we absorb gluconate the absolute best in ferroous forms. Sulfate is the absolute worst.
See, ferrous forms are called ferric salts. They are measured in two ways: They are measured in the total weight of the molecular amount "325mg ferrous sulfate" and they are measured in the amount of elemental iron. So it would look something like "325mg ferrous sulfate equivalent to 65mg elemental iron" or thereabouts. Your ferrous fumarate would be the same way. Just look closely at the bottle.
Carbonyl would be the best ionic form to get. I'm with Kelly on that one. Because it's not a salt form of iron and is straight elemental, it is easier on the digestive system (ie no bloating, no cramping, no constipation) and has been shown to absorb better in our low gastric acid environments.
However if you want the absolute best form of iron in terms of absorbancy, it would be heme iron -- but it's more expensive. It's a trade-off.
But to bring up your ferritin? (And I speak from experience here) you will need carbonyl or heme -- ferrous forms won't do it in a timely manner -- if at all.
I'm gonna say what Kelly said, but in a different way.
You are taking 29mg of elemental iron. I personally don't think it ever was enough. Our local RNY go out on 150mg elemental. + vit C.
I don't like any ferrous forms, personally, They tend to be brutal and not well absorbed. Fe sulfate is not absorbed, the ASMBS finally agrees, but they only go to step 2, which is the fe fumarate. Most have never heard of carbonyl. So, while your fe fumarates are what is said, which is fe fumarate is better htan fe sulfate, it doesn't make it "a good thing"., and then, you're only taking about 20% of what you need.
Fe sulfate is measured in iron SALTS, so 325 mg = 65 mg elemental iron. Don't be surprised if the docs have never heard the difference. To be equal, you'd only need TWO of your FF, ok, 58mg to be equal to 1 FS at 65mg.
Iron salts? Elemental? The best analogy I can give is gasoline. You pull up to the tank and you choose your pump based on the octane, that is, the amount of actual FUEL in the gallon of liquid you will buy. In the olden days, we always bought as close to 100% as possible, but now, we're pretty happy with 87! LOL
So, when you pay for ONE GALLON, you're only netting 87% actual fuel.
Does that help?
You are taking 29mg of elemental iron. I personally don't think it ever was enough. Our local RNY go out on 150mg elemental. + vit C.
I don't like any ferrous forms, personally, They tend to be brutal and not well absorbed. Fe sulfate is not absorbed, the ASMBS finally agrees, but they only go to step 2, which is the fe fumarate. Most have never heard of carbonyl. So, while your fe fumarates are what is said, which is fe fumarate is better htan fe sulfate, it doesn't make it "a good thing"., and then, you're only taking about 20% of what you need.
Fe sulfate is measured in iron SALTS, so 325 mg = 65 mg elemental iron. Don't be surprised if the docs have never heard the difference. To be equal, you'd only need TWO of your FF, ok, 58mg to be equal to 1 FS at 65mg.
Iron salts? Elemental? The best analogy I can give is gasoline. You pull up to the tank and you choose your pump based on the octane, that is, the amount of actual FUEL in the gallon of liquid you will buy. In the olden days, we always bought as close to 100% as possible, but now, we're pretty happy with 87! LOL
So, when you pay for ONE GALLON, you're only netting 87% actual fuel.
Does that help?
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
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