17 weeks pregnant - low iron

Hey all!  I have a few questions for the people on here that have done this before.

This is my 1st pregnancy - I had RNY 11/07.  My iron was low before the surgery, and when I found out I was pregnant - I had my labs drawn by my ob doc (which I posted here about 12 weeks ago) and my vitamin D was low, iron was low normal (29 with a reference range of 28-70) and everything else was fine.  Was told to take prenatal, as well as calcium, iron and b12 supplements.

Well I went to my surgeon for a check up and they did some more labs - I was told my iron was 28 but this time with a reference range of 50-70, so they want me to talk to my OB about supplementing with additional iron.  Has this happened to anyone else before?  Why the difference in the reference ranges?  Thanks for all your help!

Chrissy

There are actually about 10 different iron tests -- each with a different reference range.  Unfotunately, most docs just say "your iron is low" rather than "Your ferritin is in the toilet" or "your blood serum iron level sucks" or even " Your iron saturation level really could use some help."  Thus the differences in ranges.

Iron is typically the first to drop in pregnancy.  Many people have to get infusions during pregnancy so this is not unusual. 

I'd suggest supplementing with anything except ferrous sulfate -- and if you can avoid them, all of the ferric salts (fumarate and gluconate).  Constipation is more prone during pregnancy and these are known for this wonderful side effect.  Carbonyl does not contipate, but is harder to find.

I hope you are taking 2000mg of calcium citrate given your D level -- and additional D.  These are vital during pregnancy as well.

Thanks Andrea... the supplement I am taking is Vitron-C which has 200 mg of ferrous gluconate in it as well as vitamin C.  I am taking about 1200-1500 mg of calcium citrate with vitamin D daily too - I get alot of calcium in my diet so my surgeon's nutritionist said it was fine. 

What's funny is that my OB - who is a high risk ob has said that my iron was "fine" and then my surgeon is saying it's "low"... but both levels were 28 with different reference ranges - I wish I knew if it was ferritin or serum iron or what

Now another question.  In the morning I take my sublingual B complex and calcium, then at night I take my prenatal with the vitron-c.  Should I be spacing these out differently?  Would that help absorption at all?  I have been feeling so tired - and chalking it up to the pregnancy - but thetiredness is really nothing new - for a while now my heart races when I stand up or go up a flight of stairs and sometimes I get dizzy if I change positions too fast - I hope this can be remidied.  Do you have any suggestions...?  Sorry for all my questions and thanks for all your help.  I just want my baby to be OK :( and I don't want to end up having iron infusions

Well, without knowing what the levels actually are, it's hard to tell exactly how fast the boat you are in is sinking.

For example -- my serum iron level, hct, and hgb are "within normal ranges" but my ferritn is circling the drain.  Technically I'm not anemic.. but that's down the road if I can't get my numbers back into "land of living" ranges.  Thanks Kaitlin and Daniel for stealing my reserves!  Ungrateful little vikings...  Point is, they could be looking at different tests, and different tests could register completely differently.

Anyway, depending on what levels are tested will depend on how much iron you need.  But I'm going to guess right now that one pill isn't going to pull you from the brink.  I don't want to depress you with how much I'm taking and still not making up any ground.

B****he dizziness is probably postural hypotension.  Hypotension is very common during pregnancy due to the extra blood volume.  Add some salt and be sure you are getting plenty of fluids in.

And if your D is that low, you need more than what's in a calcium pill.  Trust me -- experience.  Current studies say that NORMIES need 2000iu just to maintain.. not only are you designer gutted, but you're incubating an alien who wants your calcium to build bones.  You need more D.

The surgeon won't go so far as to tell me to take more iron - she wrote "ask your ob about additional iron supplementation"... so I'm not sure - I will take feeling crappy for the next 6 months - just as long as my little peanut is ok - that is what I'm worreid about.  MY H & H are normal.  I'm not sure about ferritin or not.  The initial number that my ob drew was serum iron - but I don't know if the surgeon did ferritin or serum.

Not to be a complete pain - but do you think I should switch up how I am taking my supplements (that is order/time?) to increase absorption

The biggest thing about iron is that it needs to be 2 hours away from anything containing over 300mg of calcium.  So if you're eating / drinking something with milk in it, look at the daily value for calcium and add a '0' to the percentage -- ie if it's 20% DV calcium, it has 200mg in it.  Also, avoid taking iron around any whole grains -- it doesn't like them.

Hi question for you about Vitamin D... I'm not yet pregnant, but trying. My vitamin D level checked recently was 36. The surgeon's office was fine with this because it is steady (not increasing or decreasing since last check). I take (1) D3 1000mg daily. I know my level is on the low end of normal, but she didn't seem to think I needed to increase it.

If I get pregnant, do you think I'd need to take more to get it higher? Do you think in general I should try to get it higher?... I'm just not sure I trust the surgeon's office as they recommend ferrous sulfate for iron, and are OK with pt's taking Calcium Carbonate for iron...

Thanks for any help!

Lisa

Well, *I* wouldn't be happy with 36 before getting preggers, much less after.  The time to shore up vitamin reserves is before the alien bean decides to steal all of your reserves -- they are greedy little *******s that way.

With that in mind, I'd be taking at LEAST 5000iu supplemental D3.  The best form, of course, is a water miscible form that we can get fairly cheaply from vitalady.com.

Current studies show that cancer risk drops SIGNIFICANTLY when levels are 50 or above.  Breast cancer levels drop by half when you have a level above 80.  36 ain't gonna cut it.  In fact, there are recommendations to raise the minimum D level TO 50, which of course will make you deficient.

Yikes, OK, this is good for me to know.  I will definitely be upping my D intake, and looking to get a new one as the one I have is just your standard OTC form. 

Where do you find all of your information? Seems like most of what I've learned is from other WLS patients, rather than from the surgeon's office (They don't seem to have a clue...)

Thanks so much for your help!

Lisa

I read.  Alot.  And it sticks.  Really kinda geeky.  I can spout crap about all sorts of things.  Just depends on what I'm into at the time.