Iron for men...A repost

Below is a copy and paste.  It was written by DX for the Men's Forum.  As you can tell, he is a very knowledgeable man.  He doesn't post much anymore...Just too busy.  But he always wrote really great stuff.
 For Men (skip if ‘old news…’ Lance, in case you are worrying about your iron…)Some Iron Man Rambling... ferrous is considered better because it is Easily absorbed. Read your labels! These show up on the shelves and in multi-vitamins as- Ferrous Sulfate, Ferrous Gluconate, and Ferrous Fumarate. The AAMC’s Biochemistry page lists- “Oral administration of Ferrous Sulfate Is the Most Commonly used Iron Supplement" But, even though when taken with a mild acid such as juice It has acceptable “Bio-Availability," It’s Not the best. Although ferrous sulfate is often recommended to treat iron deficiency, Frequent problems with the drug including gastrointestinal discomfort, Bloating and other distress, make it unacceptable to many patients Second most common Iron Supplement? – Ferrous Gluconate, Which is roughly equivalent in cost, produces fewer problems, And is preferable as the initial treatment of iron deficiency. (it also happens to be the compound used to color or “dye" ripe “black" olives) (so a few of these now and then have the added perk of Iron.) (also dropping a little “Factoid" in here- Cooking in an Iron skillet or pot will add substantial Iron to the foods you eat. Just a thought) Ferrous Fumarate is the often the Iron of By-Passers choice because It has the highest % of absorbable iron “of the ferrous versions." The Office of Dietary Supplements At The National Institute of Health, Lists Ferrous Fumarate As containing twice as much absorbable iron as F-Gluconate, and 3 times as much as F- Sulfate. (before breaking into a discussion of-“My Iron is Better…" some more info) I don’t take the Ferrous Types because I take a prescription Iron supplement. My Doctor says to, and my insurance pays for it. My prescription is POLY-IRON 150. (POLY-IRON) The Generic Name: iron polysaccharide Also comes in the Brand names- Fe-Tinic 150, Hytinic, Niferex, and Nu-Iron 150 Polysaccharide-iron complex, (What I’m on) A replacement form of iron that differs from the iron salts, Is a more recent option. Most patients tolerate this form of iron better than the iron salts, Even though the 150 mg of elemental iron per tablet Is substantially greater than that provided by iron salts (50 to 70 mg per tablet). Still, According to- The Harvard Center for Sickle Cell and Thalassemic Disorders “No study exists comparing iron uptake from polysaccharide-iron complex and ferric salts." There’s also Iron Bisglycinate, often sold as “Gentle Iron" Because it is easy on the digestive tract. The only “non-Vitamin Sales Site" info I have concerning iron bisglycinate Is from The American Journal of Clinical Nutrition- Which found- “No advantage of using ferrous bisglycinate as an iron fortificant." It is an Older article however from 2000 A 2006 article from – U.S. National Library of Medicine, National Institutes of Health, & Human Service http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract &list_uids=15864409&query_hl=3&itool=pubmed_docsum Showed that when taken or administered along with Ascorbic acid, The relative bio-availability (RBV) of seven different commercially available Elemental iron powders (actual only 5 on the market, 2 in testing trials) ---No significant overall ranking was possible. All that to say? Ask your doc! And if the Ferrous Sulfate gives you Constipation or gas Try another. But by all means take what ever one you use Along with some Vitamin C. With Vitamin C? There’s not enough difference between them to be Measured by Current (2006) Technology. So, Do you need it????????????????????????????? Iron levels should regularly be checked Along with your normal blood tests. The Normal range for Men is – 75 to 175 (mcg/dl) micrograms per deciliter of blood And 65 to 165 (mcg/dl) micrograms per deciliter of blood for Women. Typically the test That is part of the usual Mal-absorption/Nutrition Screen For WLS Patients is not an Iron specific Test, but rather A simple blood test that measures the number of red cells And the amount of hemoglobin in the blood. The normal amount is at least – 13g/dl (13 grams of hemoglobin per deciliter of blood) for men And 11g/dl for women. This test can determine if you are anemic, But does not identify the cause of the anemia directly. The leading cause of Pernicious anemia is from low B12, Which is also a “red-flagged" concern Of mal-absorption in WLS folks, So unless your Doc is specifically looking at Iron levels It may be missed. What to do? ASK! Again, ASK! “Doc, are you checking my Iron levels specifically? Or just my Hemoglobin?" “Does that test break out testing for B-12 problems From other causes of Anemia?" Just write these two questions on your arm Where they are gonna stick the needle to draw the blood. Why do you need to be “all up in the Doc’s Business?" Cause, It’s Your Business! Pernicious Anemia is fairly common, among WLS folk. It can be, and is most often caused by low B-12, But all the B-12 in the world won’t help, If you are running low on iron. Yes? So, just start taking some iron supplements to be Safe? NO! -again- NO! Have your Doc check. If your B-12 levels are low, And this is also a common occurrence for By-Passers, And you have been taking Iron Supplements And have a high Iron level, It will completely skew the lab results looking at B-12 levels And could totally Screw You Up! So, Ask your doc! And make sure he/she is looking specifically at/for both. Also, if you are just getting labs done once every 3 months Ask if the numbers are going up or down- Even if they are in Normal range. If three tests in a row, the numbers are dropping on your Iron But are still within Normal range, The Dr. will look and say- “Great! Well within normal range! See you in 3 months!" But if for instance- Your Iron level has gone- Test one- 128(mcg/dl) in the normal range! 1 month later- Test two- 95(mcg/dl) in the normal range! 3 months later- Test three- 82(mcg/dl) in the normal range! By the time you get to test four, 6 months later, At this descending rate- You’ll have about 4 months of not doing well Before the test that determines that You’ve fallen below the 75 to 175 (mcg/dl) Normal range. Yes? So- ASK!!! And ASK if you can have your numbers, Photocopies of your lab results. As Great as your Doc is, he/she is looking to see If you are in Normal ranges. Unless your Dr. is “House" on TV Pulling off diagnostic miracles each week In a one hour episode, Chances are, they are not going to be looking at your Tendencies and movements within the normal ranges Anywhere as near as YOU would. Once you get past the first year of Post-Op, Lab tests are typically only twice a year. Don’t risk a few months of ill-health While waiting for another test to come around. With a B-12 deficiency, it is corrected fairly quickly with Some B-12 injections, and the “store-houses of B-12," Your muscles, can be replenished fairly quickly. But if you get behind on your Iron? Iron infusions through an IV A couple of days a week for a few weeks. That Bone marrow is a slow warehouse to get in and out of. The treatment Suks! So, all of this to say- Stay On Top Of Your Iron! Now, * stepping onto a lower soapbox *- A couple of other bits to know- Iron competes for the same “receptors" on your intestines as Calcium. If you take a Calcium Supplement (and you most definitely should) Make sure you don’t take it at the same time as your Iron. Each, will get in the way of the other’s absorption. Not that they “cancel each other out." They just “plug" each others pathways of absorption So you don’t get the Full benefit of either. Take your Calcium and Iron at least 2 to 3 hours apart And you should have no problems getting the full benefit of each. The acid of Vitamin C helps break down the Iron and make it More absorbable, so it is good to take these together. Other thing? When taking an Iron Supplement, and some of it is Not absorbed It passes on into the lower intestine, where for most of us It does a great job of “firming up" and in many instances, “locking up" Our Bowel’s Contents. This can make going to the pot- Like trying to pass a Dumbbell! A big one! When taking Iron Supplements, the more they are absorbed, The less this effect on the stool. So take the Vitamin C! Yes? Also up the 3 F’s- Fiber, Fluid and Fats, to keep your “Moves-Smooth!" One of the symptoms of Too Much Iron is in fact Constipation And this is one of the things that may crop up if you just start “Taking Iron Supplements, just to be safe!" Unlike the case with getting Too Much Protein, B-Vitamins, C’s and such- Those will just pass on through in feces and urine, Too Much Iron can cause Big problems ranging from the Constipation And even Diarrhea to Liver and Heart Damage. So don’t just Start up supplementing without Doc’s Orders. And Last- Don’t take Iron Supplements in a tablet form with an enteric coating. Enteric Coating is that Thick, Candy like Coating on some “Extended-Release" Meds. By the time the Coating has worn off, It’ll be ready to exit out the “End of the Line," And none of the benefits will see your insides, But rather, will arrive Intact, in your Toilet. In fact, don’t take anything with an Enteric Coating. Those are intended to get the stuff past The harsh corrosion of the stomach. Not an issue for By-Passers. Yes? So, that’s all the Poop on Iron That I could remember this evening! The whole- “I’m not getting enough Iron" Thing Is typically one that Men never face. But with having a Gastric Bypass, This is suddenly just as much an issue For Us -(33% to 50% of Us) As it is for those who get regular visits from Aunt Flo!Best Wishes- Dx

Wow, great post and a lot to think about.  I just got some lab tests back and lo and behold they said that my iron was low and told me to start taking Vitron C.  I believe they have the enteric coating mentioned toward the end of this post so now I am going to question that.  Good news is that I am meeting with my surgeon next Wednesday and will be armed with the questions in this post and see if I should get a prescription for a better more absorbabl form of iron.  Again, thanks for re-posting this as I surely needed the information and it is very timely!!

 Bottom line, IMHO, is take carbonyl iron supps. , such as Feosol (available at Wal-Mart) or, even better, VitaLady's Tender Iron, whi*****lude just the right amounts of Vit C. and Magnesium Citrate in each capsule to maximize absorption.      Iron should never be taken with caffeine-containing drinks, as they have just the opposite effect ..  


   btw, great to hear that DXer is still alive and kickin' ..  We miss him here!