Does I matter what kind of iron I take?

Currently I take carbonyl. But I have been told that carbonyl can increase my chances of developing kidney stones.

Can I switch to another kind of iron or are all kinds the same?

Never heard that one before. Carbonyl is one of the few types of iron we can easily absorb. I wouldn't change a thing. The other irons we do well with are heme iron and polysaccharide. Ferrous anything, not so much.

--gina

Yes, it matters!  I started having iron issues and had to go to a hemotologist, he told me we should be taking Carbonyl only.  He also told me, which I didn't know, that iron should be taken on an empty stomach, with vitamin C and NEVER with dairy since iron needs an acidic environment.

Since following this advice, my iron has improved.  You learn something new everyday!  :)

I have been struggling with the various side effects of having anemia following a surgical procedure i had in March. I had been working closely with my GP and a nurse in her office to get my bloodwork improved. She never recommended taking the iron on an empty stomach, never with dairy, etc..

These are very helpful tips, and makes me wonder if I shouldn't be working with a hemotologist to improve my bloodwork.

Thank you for all this great information!

When he told me that, I thought "Wow! I've been my own worst enemy."  We really need Drs to be up on this stuff!

Good luck.

It may be one of those YMMV things, but I have always had low ferritin and pre-op it was only 4. I switched to Proferrin post-op and in 6 weeks it is up to 49. I still may have infusions in my future, but I am a fan.

Ok, I'll keep doing what I'm doing then.

Thanks!

I would like to give my 2 cents on this subject. :)

First and foremost, pre-menopausal women are the bariatric surgical population most at risk for iron deficiency. With this said, if you are a candidate for birth control, this may be something for you to consider as this would significantly reduce your monthly blood loss. Personally, I skip my placebo pills and avoid the mess all together. :)

The average adult stores about 1 to 3 grams of iron in his or her body and menstration increases the average daily iron loss to about 2 mg per day in pre-menopausal females.

I should also note that your body only absorbs 20-35% of the iron you consume. This is independent of the type of iron. Total daily dose of elemental iron is what REALLY MATTERS.

The different types of iron:

Ferrous Sulfate

This is the most common and cheapest form of iron prescribed. Ferrous sulfate contains 20 percent elemental iron. For example, a 325-mg tablet will provide 65 mg of elemental iron. It is best to wait 2 hours after eating and take the medication on an empty stomach. Common side effects of ferrous sulfate are constipation, stomach upset and dark stools. The liquid version may also stain teeth.

Ferrous Fumarate

Ferrous fumarate, the type of compound in the commercial brand Hemocyte, is 33 percent elemental iron. A 325-mg tablet will provide 106 mg of elemental iron. The cost is typically higher than ferrous sulfate, but dosing is reduced from three pills to two pills because of the additional available iron per tablet. Ferrous fumarate is the most recommended iron product out of the ferrous complexes. This product is recommended for surgical weight loss patients by the ASMBS.

Ferrous Gluconate

Ferrous gluconate is formed with iron and gluconic acid. It is only 12 percent elemental iron, so a 325-mg tablet will provide 35 mg of elemental iron. Fergon is a well-known consumer brand. Ferrous gluconate is the least recommended iron product out of the ferrous complexes.

Iron Polysaccharide

This iron complex is bound to carbohydrate. It has less toxicity potential and GI issues but it is less absorbable for this reason. Capsules are 100 percent elemental iron and are not bound to a salt as the ferrous compounds are. Capsules come in dosages of 50, 100 and 150 mg of iron. The cost for a one-month supply, per the 2001 Red Book for Pharmacists, was 2 to 5 times more than that of ferrous iron salts. This product is not recommended for surgical weight loss patients by the ASMBS.

Carbonyl Iron

Carbonyl iron comes in a 50-mg tablet that is taken three times a day. The absorption of carbonyl iron varies, depending upon the production of gastric acid produced in the stomach, which is required to make the mineral soluble. Carbonyl iron enters the blood stream more gradually than other forms of iron because it dissolves more slowly. This is ideal in patients at risk for iron toxicity, but not DS patients because the delivery time ranges from 4 - 10 hours (it is released slowly; similiar to an extended release medication). The cost is comparable to a slow-release tablet of ferrous sulfate, but is significantly more than most forms of iron supplements. This product is not recommended for surgical weight loss patients by the ASMBS.

Heme iron polypeptide.

This iron is derived from bovine (cow) red blood cells. Iron derived from animal meat (aka "heme iron") is the most bioavailable form of iron. However, this product is also delivered over a slower period of time (4-10 hours) and I am not confident very much of it is absorbed in patients who have a shortened transit time and GI tract. The delayed absorption is the reason for the decreased GI issues. GI tolerance with iron is associated with the dose of iron. If you take a smaller dose (Proferrin is only 12mg) and absorb it over 4 hours, the side effects will be minimal, naturally.

Any form of iron that has an enteric coat or is time released will decrease GI issues, but also decreases absorption.
When assessing an iron supplement, you always have to look a the amount of available elemental iron per serving as well as whether or not you can tolerate a delayed release product (bypass and DS patients, not so much).
Most patients require iron infusions and this should be considered any time your ferritin level falls below 30. To obtain an iron infustion you will need a referral from your PCP.

I personally prefer prescription ferrous fumarate (106 elmental iron at least twice per day - in divided doses; at least 2 hours apart) as it is less costly and requires a much smaller daily amount. Constipation may be a side effect, but it is better than the complications associated with anemia. :)

Just my opinon. :)

Are you confusing carbonyl iron with carbonate calcium?   Carbonate Calcium can cause kidney stones.

Ahhhh, maybe that's it!

Thanks for clearing that up!