Iron Infusions?

 Hey Fellas.  Hope you're all doing well.

I have a question about iron infusions.  I've been reading more and more about increased need for iron infusions after all types of WLS except the lap band.  The highest risk surgeries appear to be the duodenal switch and rny because of the malabsorptive properties but the vsg carries the same possibility but that is limited because the bowel is still intact.  Now - in reading more and more posts there was one overwhelming trend - the posters were all women.

I'm not being sexist - but there are differences in some physiology between the sexes.  I couldn't find any posts here in the men's message board.

My question:  Have any of you guys ever had to have a(n) iron infusion(s)?  

Thanks guys!

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!  Incredible post.  This Mr. Dx certainly knows his stuff.  All very important facts he pointed out about better Fe absorption with Vit C and to NOT take Fe with Calcium because of competition.  And from what I've read he's certainly correct with the Iron infusions!

That being said - have any of you folks ever had to succomb to the Iron Infusions?  It seems that many of our female counterparts have.  My hope is that with appropriate supplementation this is controllable.  What is difficult, it seems, is knowing when to begin supplementation with Iron as there's a lot of lab values to be on top of to indicate the necessity.

Thanks for the post! (Keeping this one on file!)

   With my habitually low readings, I have been able to keep things balanced with taking 2 of Vita-Lady's Tender Iron supps a day.  They are carbonyl iron (apparently not mentioned in DXer's article, for some odd reason), which I have heard is the most absorbable form of iron.  She also has added just the right amout of Vit. C. to help maximize absorption.  

   That's right, btw, about not taking your calc supps within 2 hours of iron ...  I think also you're not supposed to take them with caffeine, but maybe that's calcium .. 

I have not gotten to that point yet.
My iron was low on my last labs, so they increased my intake.

They didn't want to jump right to infusions.  According to the doctor a lot of people have allergic reactions to the iron infusions.  So they wanted to try increasing my chewable dosage first.

Scott

 Thanks for your input Scott!

In people who have not had Bariatric Surgery, women tend to have a lower iron level than men due to their periods.  So it is not surprising that you noticed more women having a problem following weight loss surgery.

If you get the switch, then you will have very different supplement needs than the RNYers on here. There aren't many men that post on here who have had the ds. I hope you have posted your concerns on the ds forum as they will be better able to advise you.

This is the regimine that I follow from vitalady. It is the baseline regimine that most dsers on here follow www.gblcreations.com/Resources/Gina/ProgramDRNY_ERNY_BPDDS3- 2010.pdf

  Not me, at least not yet ..  If I don't start taking my irons supps. again soon though I may (I ran out a couple of months ago and got lazy and didn't re-order them  ) ..   My blood tests always show BARELY normal, or slightly below, hemos, but then I was a bit that way even before surgery ..   

  I think you're right, though ..  I can't recall knowing any male DSers that needed infusions, and this includes members of our local group ..   Some of the gals have had a horrible time with it, though .. requiring them on almost a regular basis .. 

 Thanks for your input!  I could deal with an infusion every 18 months or so but, yes, I've heard of some of the ladies needing them much more regularly and that'd be hard to deal with - though I suppose you've gotta do what you've gotta do!!