Question:
Low Iron Sufferers...Help!

Hi everyone...I am 2 1/2 years post-op and have suffered from low ferritin levels for the past year. I go for a recheck next week and wanted to get advice from others. My last ferritin count was 6. My MD wants me at 100. I have been in single digits for the past year, even with taking Feosol 3x/day with Vitamin C to increase absorption. Of course I am always tired...and am tired of it!! What have you done or what has your MD suggested in this situation? I am trying to get my ducks in a row for my abdominoplasty...but want to feel better before I get into something else. Anyone have experience with IV iron? What do I ask for? My primary MD is changing, so I am going to have to fill the new one in on my history. Any advice would help! Also, fellow low irons, have any of you experienced chest pain b/c of the iron problem> My hemoglobin has not fallen yet, but I have had some chest pain that I just can't explain away. Thanks!    — thecobles (posted on March 16, 2005)

March 16, 2005
Hi, I have not had my surgery yet (still waiting for insurance approval) but I have suffered from low iron for several years. I began seeing a hematologist a couple of years ago after my hysterectomy didn't change my numbers at all. After alot of tests, I began IV iron treatments. I had no trouble tollerating them, they give you a bag of steriods and benadryl before to stop the side effects most people have and then the bag of iron dripped. Takes about 3 hours a session. I had 4 total about once every 3 months, and my iron has been normal ever since. I get checked about once every 3-4 months now, and my last two were normal. But I would recommend a specialist not just your PCP or family MD.
   — Debbie M.

March 16, 2005
I have not had this problem, but my cousin does. Once they determined her problem, her docs ordered a blood transfusion and later on IV iron. I think she only had to do that one time. After that she was able to maintain her levels with oral iron (she stays away from ferrous sulfates and takes the ferrous gluconate). I would try working with a hemotologist to get the levels up, I don't think any reputable PS would operate with levels that low. Good luck.
   — Ali M

March 16, 2005
Jennifer, I too was taking Feosol. My hemoglobin was 8.6 the week of Thanksgiving last year, and my ferritin level was 2!!! It turns out that we don't absorb the feosol. My doc put me on prescription iron, Chromagen Forte, twice a day, and last month my hemoglobin was 11.9 and ferritin was 19. I am still taking it. I am going for f/u labs today. I had surgery 6/27/03. I have never had iron infusions.
   — DebT

March 16, 2005
i have had the same problem. The feoSol is ferrous sulfate. that's where the problem is and it's too bad that some surgeons are not "in the know" about this. They just don't keep up with the latest research which shows we cannot absorb the ferrous sulfate. Choices should be, Triniscon (script) , amino iron, gluconate, ferrous furamate, carbonyl iron. There are afew others out there. Just DO NOT take ferrous sulfate. I use carbonyl iron which is readily available at the drug store. I get mine from CVS if you have one near you. Mine went from low single digits to 84 in about three weeks. Good luck!!!!!!!! Delores 2/10/03 Open RNY 228.6/118lbs.
   — Delores S.

March 16, 2005
I use Chromagen Forte or Ferrogels Forte. Both are a elemental Iron and require a prescription. I use it every day and I am now two years post op and all my lab work shows my Iron levels to be above normal.
   — oznog4

March 17, 2005
Jennifer, While I don't really have a solution for you, I just wanted to say that you are not alone! I sound like Debbie that responded below. My numbers, as of 3/11, were hemoglobin 8.5 and ferritin 2.6. Neither of which my doctor was very happy about. Needless to say, I am exhausted from the inside out. I have thalassemia, so before I had a gastric bypass I didn't absorb iron nor was I ever suposed to take it, but now I am in a really bad position. I am so thankful I read your question, because I had no idea that we didn't absorb Feosol post bypass. Even with my thalassemia, doc insisted I take the iron because with none stored up, there is no chance of an overload. I guess I better give her office a call to advise her of what may help me bring the number up a little. I am desperately trying to avoid a transfusion. Thanks again for asking the question. Good luck to you! Angela- 252/150/125
   — Angela T.

March 17, 2005
I agree with the others here, it's the absorption problem with the sulfate. Carbonyl iron is an excellent choice, I believe. It is very easy on the stomach and the most absorbable form. Good luck with getting your levels up. If you can't find it in the retail stores, try vitalady.com.
   — Carlita

March 17, 2005
I have been dealing with low iron for the past two years. I am 1 year post op from my rny surgery. My hemoglobin was 7 in Jan. I noticed I felt really tired around the holidays, but didn't think anything about it. My level in Nov. was 12, and dropped to 7 by Jan 1,05. My PCP was very worried, and sent me to a Hematologist. I had an iron infusion 2/05 and one 3/05. I also was diagnosed with a very large fibroid, and that is what was causing my heavy cycles and that led to my anemia. I see that you already had a hysterectomy and it didn't bring your levels up. I sure hope mine continue to stay up. I did take ICAR-c and it is a carbonyl iron. The Hematologist said I could triple the normal dose and it would take 6 to 9 months to get up to normal, or 2 infusions and be normal 6 to 8 weeks. I feel so much better. I dropped 5lbs in 3 days. My body wouldn't let go of any weight, with me being so anemic. I did experience chest pains before my infusions. My PCP told me *NOT* to exhert myself in anyway, until my levels got up. She said I needed to go straight to the emergency room if I had chest pains, shortness of breath or dizziness. We don't have enough oxygen in our blood cells and our heart has to work really hard. I would see a specialist and take it easy until you find out. Debbie
   — D. K.

March 17, 2005
Taking your question from the back end, very low iron can indeed cause a heart attack. My dad is 87 (normie) and has chronically low H&H/iron. When it does a sudden dive, he has angina OR a full fledged heart attack. His doc put him on fe sulfate, and I just rolled my eyes, since it's a lousy iron even for normies, but since my dad had a bowel resection, the stool hardening properties could be a plus, even if the iron is useless. I give him polysaccharride, as well. He has other issues, so it helps, but can't overcome the other issues. For myself, I use carbonyl iron, Tender Iron, easy on the GI system, works specifically well on ferritin, oddly. Don't know why that is, but apparently it's the molecular size. That is my preferred iron, even tho the pills are low dose per pill. They are cheap, small and easy to take. You are taking iron with vit C, not with dairy, caffeine, eggs, whole grains or any other vites, minerals or meds, alone together for an hour, right? Hopefully, they are also testing for bleeding and such, and not just writing all of it off to malabsorption, because then you'd be fighting a losing battle. But if you passed the "card" test and get some adequate iron, hopefully you can build yourself back up to feeling human again.
   — vitalady

November 8, 2005
I too am 2 1/2 years post-op from gastric bypass. My ferritin levels are currently a 4.5. I started IV iron transfusions last Monday. I had my second treatment yesterday. I felt really great after my first treatment, but started my period on Tuesday. Now I am feeling really run down. I have a total of 8 treatments. They are giving me a medication iron called Ferrlicet (sp?). It is one of the more expensive IV iron treatments. I am allergic to penicillin and sulfa drugs so he wanted to give me one that had less chance for reactions. So far I haven't had any and I don't think I will. My doctor also told me that because I have heavy periods I should see a gynecologist to see if there is something that can be done to help in this blood loss. I also have heart palpitations but the doctor told me it is a side effect of the low iron levels. I had to go to the doctor the other day again, because I have been extremely dizzy. Some primary doctors don't have a clue as to what we post op gastric bypass patients need. If you can, you might want to find one that does know more about it. I had to go to another doctor, because my primary doctor said that taking oral irons should help and I should be feeling better. Well, I wasn't and my iron levels were just on the downslide. Hope you get to feeling better and hope this helps.
   — txswtthang

March 6, 2006
I suffer from severly low iron deficiency also. I do suggest you see a hemotologist. I had the same problem a few yrs ago. I saw him and he went thru my chart. Told me i had been like this for a long time...I started infusions, they really helped. They got my iron up to where it needed to be after 4 sessions of them. Now 2 yrs down the road i am at the same point again. I actually see my hemotologist this am to schedule the iron infusions again. I have tried the Ferrious Fumarate (which we absorb the best post op) and iron rich foods, my hemotologist said i do NOT absorb iron thru foods or pills. So the infusions gets my iron up to par, my body stores the iron, then when it is depleted again i have more infusions. This time i waited a bit to long...I am so sore, tired all the time, heart racing.. just basically feel like crap. I am anxious to get to feeling better again...so see a hemotologist, they are trained for stuff dealing with the blood. kk@goal
   — tinalivesay

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