low iron levels and vitamins

I am 9 years post op from RNY and have been a very bad patient. I never got blood work done until recently and have been very inconsistant with taking vitamins. I am trying to get back on track WRT taking vitamins and getting my levels up.

Since getting my labs done on April 5th I have started taking:

1 50,000iu Vitamin D/daily
3 doses Calcium Citrate plus D/daily  total 1890mg calcium 1500mg D
2 doses Prenatal multivitamin
1 B12 5,000mcg/daily sublingual
3 Perfect Iron (Carbonyl) 75mg/daily
1 Vitamin C 500mg/daily

My levels are as follows:
Hemoglobin 11.7 (normal)
hematocrit 37.1 (normal)
MCV 80.0 (low)
MCH 25.2 (low)
RBC Distribution Width 15.4% (high)
iron 18 (low)
tibc 495 (high)
sat tibc 4% (low)
Calcium 9.1 (normal)
vitamin D 11 (low)
PTH 78 (high) indicates Secondary HyperParaThyroidism
B12 182 (low)

My Dr. called and wants me to start taking rx iron ferrex 150mg (polysaccharide elemental iron) twice daily for 3 months. What level of iron would indicate getting iron infusions? Does the 150mg/twice daily sound like it will get my levels up? Am I taking enough B12 to get my level up? Am I taking enough vitamin C for the amount of iron I'm taking? Am I taking enough Calcium and Vitamin D? 

Any advice is appreciated.

Thanks,
Marjorie

Fortunately, your hematocrit is still in good shape, so you can probably avoid infusions if you start getting religious about taking the iron. This info is from my hematologist:

Hematocrit- The percentage of red blood cells which make up your blood. (Normal is 45-62% in men and 37-48% in women)

Ferritin- The protein that carries iron around in the blood. (Normal is 12-300ng/mL in men and 12-150ng/mL in women)

Iron- A mineral needed to incorporate hemoglobin into red blood cells. (Normal is 75-175 in men and 65-165 in women)

Transferrin is the glycoprotein that iron is bound to in the bloodstream. The saturation is the percentage of transferring binding sites which are filled. (Normal is 20-45%)

At my worst pre-infusion test, my numbers were: Hematocrit: 25%, Ferritin: 1, Iron: 9, and Transferrin saturation: 2%. I felt like a slug, and you don't want to get that bad off, trust me. I was barely making it through the day without naps.

Your vitamin regimen looks pretty good to me. Hopefully after 3 months, you'll be back in great shape!

 I am 5 years post op from RNY and I actually have been getting my panels done yearly and been pretty good about taking my multi's and calcium because I have been trying to get pregnant.  Up until recently my levels were all looking good, but this year my PCP told me my ferritin was low and to start taking an iron supplement daily.  I had some of the Celebrate Vitamins iron+c 30 mg tablets in my cabinet already so I started taking them two weeks ago.  Since then I have been miserably constipated and bloated.  And I have still been feeling tired and sluggish...and I have experienced several dizzy spells recently as well.  I too was wondering about iron infusions, as a friend and fellow RNY patient mentioned them to me.  She has had iron deficiency problems for awhile and was experiencing issues with oral supplements as well.  At what point do PCP's usually go towards the infusions?

The doctor who discovered my deficiency was at my university's health care clinic. She referred me to a hematologist to discuss what to do about the iron.

His preference was for me to try supplementing orally and eating an iron-rich diet for awhile, but once the numbers didn't budge after several months of that they decided to do infusions.

Venofer (ferrous sucrose) was the type of infusion that ultimately ended up working very well for me. Honestly, if you can get the oral tablets down, take them. I've heard that Vitron-C is pretty easy on the stomach. The infusions aren't terrible, but they have their own risks and not-fun side effects.

Also, make sure you're getting your B12! B12 and iron play well together and it's easier to absorb iron when your B12 is in good shape.

Good luck to you! If you have other iron-related queries, I'm happy to answer to the best of my knowledge. I was in treatment for anemia for several years and have a pretty good understanding of things from my hematologist.