Stuff to know about iron

The ASMBS recommends we all take a multivitamin with 18 mg iron twice a day, so that’s a total of 36 mg.  They recommend menstruating women take an addition 18-27 mg iron a day.  So that’s a total of 54-63 mg iron for menstruating women.

We should get our iron checked every time we get labs done, though, and adjust how much we take based on our labs.

Now, some multis don’t have iron, and that’s OK.  Just take your iron separately.  I actually prefer a multi with no iron because then I can take my multi with my calcium, which seems to make scheduling all my two million vitamins a day a little easier.

See, we need to take our iron at least two hours away from calcium because calcium blocks the absorption of iron.

Now, it’s important to know there are many different types of iron, including ferrous sulfate, ferrous fumerate, ferrous gluconate and carbonyl iron.  We absorb some types of iron better than others.  Carbonyl is absorbed better than all the ferrous ones.  In addition, ferrous sulfate is infamous for causing constipation and sometimes causes nausea.

The reason ferrous sulfate causes constipation is because it’s not all elemental iron.  It’s some elemental iron and a bunch of iron salts.  The salts constipate you.  That’s also why you’ll notice the dosage is different on ferrous sulfate – you need 325 mg ferrous sulfate to get 65 mg elemental iron.

Vitamin C helps us absorb iron.  The recommended ratio is 200 mg C to every 30 mg iron (and that’s elemental iron).  So if you take 60 mg carbonyl iron, take 400 mg vitamin C.  If you take 325 mg ferrous sulfate, take 400 mg vitamin C (and some benefiber, ‘cause you’re gonna get stopped up).

There is another type of iron called heme iron, which we absorb really well.  It’s also nice because you CAN take it with calcium.  However, it’s costly.  Carbonyl is cheap.  Since most people absorb carbonyl well, that’s probably a better starting place.  If it doesn’t seem to be working for you, then try heme.

What happens if you don’t get enough iron?  You get tired, weak, have headaches, get dizzy, irritable, your nails get brittle, and if your iron gets low enough, you have trouble breathing and your heart starts to beat too fast.  So take your iron.

Good timing on this Kelly. I was trying to figure out what other types of iron to try since I'm not absorbing well.

Where's a good place to buy Heme iron?

Thanks.
Jan

Order it from vitalady.com.

Ask her about what dose you should take, too.

Thanks, indeed.

I admit -- I'm 2.5 years post up and didn't take ANY iron up until a few months ago.  It made my stomach upset so I said to hell with it.

My iron levels had been trending downward but were never dangerously low so I pretended all was fine.

Well..in March I got a new PCP and had my labs checked (last was at 2 yrs post-op in Oct '10) and my ferratin was at 5.  That scared me straight and I picked up some Bifera.  After 2 months, I checked my labs again and it was a 9.  I've not been taking it with Vitamin C and have been wondering if I should.... knowing the amount helps.

My plan right now is to start taking Vitamin C with the Bifera until I run out (have another month's worth).  I'll get my levels checked again and if I don't see signifigant improvement, I'll suck it up and purchase Proferrin for it's effectiveness.

It's just so pricey!

I'm guessing you were taking one of the ferrous salts if it upset your stomach.

A ferritin of 5 is terrifying.  I'm glad you're addressing it now and it sounds like you've got a good plan.

It's so easy to ignore stuff if it's just not great but not awful.  Once something starts dropping, though, it's almost certain to keep dropping unless we address it.  And sometimes some things can drop really fast.

The Proferrin is pricey, I'm taking it now.  It is very easy on the pouch AND I'm not having to be so conscious of timing like I was with other iron.

I'm also having iron infusions (#4 of 5 today) and feel so much better already.  I hope you get your numbers up soon.

I think part of my problem is that well...I got married 7 months ago and am pretty much living a fairy tale! 

I used to weigh 600 lbs and was so freakin' depressed I couldn't do anything.  Compared to what I felt like, even having low iron and b12 (my b12 was 115 in March '11 -- over 415 now and climbing), I feel fantastic!  I never stopped to realize that I could actually feel better.  :)

Thanks again for the info.

I take BA 60mg iron chewables. They're so good. It's like a sweet-tart. What bugs me is WHY, if it's common knowledge that vitamin c helps absorb iron, don't they put enough in it? It just blows my mind!! I take chewable vitamin c with it and it also tastes like candy but still.....

You'd think a company who specializes in providing products for wls people would understand the requirements! It makes no sense.

I have no idea why vitamin companies don't put enough vitamin C with their iron.  They make a big deal of advertising the fact that their iron contains vitamin C to help with absorption but then don't put in enough C to be any help at all.

That's not just the case with bariatric vitamin companies, either, lots of companies do it.  And most people don't know how much C they need so they think they are getting what they need.  It's really deceptive of companies to do that and yeah, they should know better.

Maybe we ought to email BA and other companies and ASK why they do it.

My guess would be it's at least partly to keep the vitamins from being too big.  Look at the size of your chewable iron and your chewable C and put them together.  How big would that chewable be?  Would it be big enough that many people wouldn't want to eat it?

I take iron I swallow and C that I swallow.  I actually swallow two iron pills (25 mg each) and one vitamin C (500 mg) in one gulp, but if you put them all in one pill, it would be big.  Now, one iron pill and half the vitamin C pill would not be that big, but it would be kinda big.  A lot of people don't like to swallow big pills.

However, what BA really ought to do, is sell their chewable iron AND sell chewable C and explain on their website and on the package of their iron that you should really buy the C along with the iron and why.

The 60mg chewable is fairly small.  It combined with the 500mg vitamin c is about the size of my Centrum chewables.  That is a big pill but ...

The calcium chewables from BA are HUGE. 

I don't know.  I might have to email them!