Carbonyl vs heme iron

I just had some labs run, and have come back as anemic. The doctor is going to run more tests, however I have been take carbonyl iron as I understood it absorbed well and didn't cause constipation issues (not sure what is causing that, but something still is..lol). I've seen discussion on heme iron as well. Any thoughts on which is better just to be prepared when I see the PCP again?

 I don't know the answer to your question, but I just wanted to say good luck getting this all straightened out!

Hugs, 

Liz

Thanks, Liz. I appreciate the good thoughts.

Most people seem to absorb carbonyl very well but a few people don't for whatever reason.  How much carbonyl have you been taking?  Are you taking it with vitamin C?  At least two hours away from calcium?

I would consider switching to heme if the carbonyl isn't working for you.  You might wanna email vitalady to talk about the best dose - I think the dose is different than with carbonyl.  There is a good chance your PCP won't know anything about heme iron or have any information about which type of iron is absorbed best, although yours might.

Kelly,
I'm taking 60mg elemental with 400 mg C two caps each day, so 120 mg elemental with 800mg C. And, I'm pretty good about taking the pills on time in relation to the calcium. I actually use an alarm to stay on top of the times. I'm pretty sure my PCP won't be up on heme, so I wanted to be a little prepared prior to my visit. My iron is slowly coming up, so I believe he's planning to do tests for other causes as well.
Ken

OK, then it sounds like you are one of those few people that just do not absorb iron well at all after this surgery.  I mean, we al have some trouble absorbing iron after RNY but you're taking a good amount with the right amount of C.  I take about half of what you are taking and my iron is great.

I don't know why that happens but it seems like there are some people that have problems absorbing certain nutrients, much more than the average.  Like, there are a few people that have to get well over 100 gram of protein a day in order to keep their protein levels normal.  And I am thinking of Andrea (wlsvitagarten.com) who did not seem to absorb iron no matter how much she too****il she switched to heme.  Actually, you might wanna check out her site, you can probably get lots of info on heme iron there.

The tender irons are very good but you have room to increase your dose - you can take up to 5 per day and you can take them all in one dose.  2 per day is a starting dose but once a person is anemic, a higher dose is needed. As far as constipation goes, it is rare - it can be from your calcium or if you are taking narcotics.  You can try using miralax in any liquid daily - it has no taste and can be used daily. Others use magnesium oxide to help with constipation - you might to do a separate post about this one.  My surgeon also recommends the combination of stool softeners with Senna - 2 of each per day.

If you take the tender irons 5 per day and your iron and ferritin levels are still too low, then I would recommend going to heme - or as many do, a combination of the 2 - they work well together.  The tenders are cheap and work great for most if used in the proper dose where the heme is probably stronger but very expensive - it is called Proferrin and you get it at the same site - vitalady.com.

The tender irons need to be taken properly - atleast 2 -4 hours away from your calcium and thyroid medication if you take it. It comes with vitamin C in it but I find that taking it with a little OJ, can't hurt - if you can tolerate the sugar - I use trop 50 - half the sugar, half the calories.

The heme - works differently - not sure all the specifics but you don't need vitamin C with it and you can take it with calcium but not with thyroid.  So, if you take the tenders and heme, they can't be taken at the same time - one in the am and one in the pm - with calcium in the middle and with the heme.  You also need to break the heme tablets in half before taking them - helps you absorb them better.

I don't know how low your iron or ferritin are - so I can't really recommend how much to increase your tenders to but you can go up to 5 per day. If your ferritin is under 20, then I would take all 5.
Then get retested in 2 months to see if it is working. If your levels are up, then continue what you are doing - if not, add 2 heme per day.  After that, if nothing works, then you need to look into IV iron infusions.  But give the oral iron a chance.  I had an iron of 25 and was anemic - hemoglobin 10.1 - wasn't able to take iron for various medical reasons for about 2 months.  Once I went back on the tenders - 3 per day, I had my blood tested 6 weeks later and my hemoglobin was already back to 11.9 and my iron was up to 100.  the stuff works.

You can also be anemic due to B12 deficiency and folate deficiency.  Do you know what your B12 or folate levels are?  You want your B12 levels to be atleast 1200-1800 but anything less 500 can put you at risk for nerve damage and left long enough, it can become permanent.  Your folate level you want greater than 24.  It can also be B6, B1 or copper.

Thanks. This is great info. My labs are a bit confusing to me at this point, but I haven't had chance to talk to doctor (got labs by email with only a short email from doc saying I am anemic and he wants more tests).

Iron was 45 in March and 69 now, so it is increasing.
TIBC went from 262 to 264
Ferritin dropped from 216 to 195
Red blood cells was 5.06 last November, 4.98 in march, 4.96 in May, and now 3.65 ... Dropping pretty steadily.
Hemacrit and hemoglobin are both also below the bottom norm level.
Since my b12 has been high (above top limits of test) and was just done in May, we didn't do that or folate, which was also good in May. I'm assuming these are among what he will draw today to try to determine where the issue is.
Ken

My ferritin levels were 4.2. I would love a ferritin level of 195. My ferritin is now 6.2. I actually need to get tested today.. I hope it goes up another few points.

Ken, do you run/jog? I was asked to decrease the intensity of my workouts by my doctor until my iron improves. I was told that the intensity of exercise can have an impact on RBC count too.

Michelle

Michelle,
No running for me. The ole knees couldn't take it I'm sure. I do use the treadmill three times a week, but at just a brisk walking pace. I've really cut back on my workouts in the last few weeks as I've been pretty worn down. I guess due to the anemia.
Ken