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Low Iron???

on 12/23/09 7:37 am - Oxford, GA
RNY on 07/21/09 with
Mertty Christmas all!!!

What do you all do to increase your iron levels? I was taking otc iron pills, then bariatric iron pill, and now rx iron pills. But my iron levels are still critically low.

What do you all take/eat to make sure your iron levels arent low?

Patience is Trusting God's Timimg!

on 12/23/09 7:40 am - OH
How much are you taking?  How low is your iron?  Are you taking it with vitamin C?

I take 50 mg carbonyl iron, over the counter.  I'm not clear if there is a difference between otc and bariatric and prescription iron.  I have the idea that iron is iron, but I could be wrong.

on 12/23/09 7:44 am - Oxford, GA
RNY on 07/21/09 with
I take Proferrin es 12mg tabs twice a day.
I dont take it with my vitamin c

Patience is Trusting God's Timimg!

Pam T.
on 12/23/09 8:04 am - Saginaw, MI
My understanding is that proferrin only works on ferritin levels, not the general iron levels.
What is your doctor recommending for dosing?

My Recipe Index is packed full of yumminess!
Visit my blog: Journey to a Healthier Me  ...or my Website

The scale can measure the weight of my body but never my worth as a woman. ~Lysa TerKeurst author of Made to Crave


on 12/23/09 9:54 am - OH
I don't really know much about Proferrin.  I do know that vitamin C aids in the absorption of iron.  What kind of iron is in Proferrin, do you know?  It may be that some types of iron are absorbed better than others.

Andrea U.
on 12/24/09 6:27 am, edited 12/24/09 6:28 am - Wilson, NC
Proferrin is heme iron -- non-chemical iron so it's nothing like anything else on the market.

It's the closest thing to eating red meat that you can get in a pill.

ETA: Linkage

Iron Post:

I discuss my current experiment with the heme iron, Proferrin, here.  Information about it from the Iron Disorders Institute:

About Proferrin(tm):  Performance studies indicate that iron absorption rates are between 15% and 20% withoute erythropoietin (EPO) therapy and as high as 30% with EPO therapy even in patients with high serum ferritin values (>600 ng/ml).  In one study, the change in serum iron from Proferrin(tm) was nearly 23 times greater than from an identical dose of ferrous fumarate.  Also, study participants were able to tolerate up to 60 mgs per dose on an empty stomach with fewer gastrointestinal side effects; a common complaint from patients taking traditional oral iron preparations.  An additional benefit of heme iron supplementation is that patients can take it with their meals, unlike ionic iron preparations, which must be taken on an empty stomach between meals.

Andrea U.
on 12/24/09 6:31 am - Wilson, NC
That's the beauty of proferrin -- you don't have to take it with C.

What levels are low?  Serum iron?  transferrin?  Sat levels? 

Diff irons help different things.

on 12/23/09 8:40 am

I get iron infusions as necessary -- last infusion was a few months ago:  Dextran.  And, it worked!  I am no longer anemic.

My iron STORES, ferritin are still low --- but this is an improvement.  

eight-Loss Surgery Brings Risk of Iron Deficiency - ABC News

Nothing new here, just a very straight-forward article:

Weight-Loss Surgery Brings Risk of Iron Deficiency - ABC News Anemic-blood-cells 

NEW YORK (Reuters Health) - Weight loss surgery can help you lose weight, but it's also likely to leave you unable to absorb iron, a new study suggests: Iron deficiency is a common problem after stomach bypass surgery to treat severe obesity -- and standard iron supplements may not be enough to prevent it in some patients.

Researchers found that among 67 Chilean women who had undergone the most common form of weight-loss surgery, 39 percent developed low blood counts, also known as anemia, within 18 months of surgery. That anemia was most often due to a deficiency in iron, which the body needs to produce healthy red blood cells that carry oxygen.

In contrast, less than two percent of the women had been anemic before surgery, the researchers report in the American Journal of Clinical Nutrition.

It's well known that nutritional deficiencies are a risk after the type of surgery examined in the trial, known as Roux-en-Y gastric bypass, the most common and most effective form of weight- loss surgery for severe obesity.

The procedure involves stapling off the upper portion of the stomach to create a small pouch that restricts the amount of food a person can eat at one time. The surgeon also makes a bypass from the pouch that skirts around the rest of the stomach and a portion of the small intestine, limiting the body's absorption of nutrients.

The new findings suggest that impaired iron absorption, rather than reduced iron intake, is the major cause of long-term deficiency after gastric bypass, according to the researchers.

Tests done six months after surgery showed that, on average, women were absorbing just one-third of the iron from food that they had before surgery.

What's more, their absorption of iron from supplements showed nearly as great a decline. And many women became deficient in iron despite taking supplements after surgery, according to the researchers, led by Manuel Ruz of the University of Chile in Santiago.

All of the women in the study were put on vitamin and mineral supplements after surgery, though not all took iron pills. Those who did were prescribed 18 milligrams per day -- the standard recommended iron intake for women younger than 50.

That amount, Ruz and his colleagues write, appears "largely insufficient to prevent iron deficiency and iron deficiency anemia."

The researchers say that some patients may need to take newer, more readily absorbed iron formulations, or receive infusions of the mineral rather than pills, to prevent a deficiency.

According to the American Society for Metabolic & Bariatric Surgery, about 220,000 Americans had some form of weight-loss surgery in 2008, with gastric bypass accounting for the majority.

SOURCE: American Journal of Clinical Nutrition, September 2009. 

on 12/23/09 9:02 am - AR
My surgeon's 2 favorite irons to prescribe are Repliva and Tandem because of their lack of side effects. 

He gave me samples of both and let me pick which one I liked better after trying each of the samples for a few weeks each.  I decided on Tandem.

It worked very well to increase my iron levels.

I was able to stop taking it after a few months when my iron levels came back up and stayed up.  I don't take any extra iron now and my levels stay fine. 

Good luck!

on 12/23/09 9:16 am - AR
I forgot to add about what you could eat (since you asked what you could EAT to help iron levels).

This is just a basic run-down.  You can google iron rich foods for more complete, better lists I'm sure. 

Best Heme Iron (kind found in red meats & animal products) Rich Foods:
Beef, Chicken or Pork Livers

Best Non-Heme Iron (kind found in breads, grains, vegetables, eggs, nuts, etc) Rich Foods:
Enriched Breakfast Cereal
Pumpkin Seeds
Cooked beans/lentils

Iron Absorption Enhancers/Helpers:
Fruits: orange, orange juice, cantaloup, strawberries, grapefruit, etc
Vegetables: broccoli, brussel sprouts, tomato, tomato juice, potato, green & red peppers
White Wine
Vitamin C

Iron Absorption Inhibitors/Hinderers:
Whole Grains & Bran
Vegetables: spinach, chard, beet greens, rhubarb & sweet potato
Red Wine
Coffee & Tea
on 12/23/09 9:23 am - Oxford, GA
RNY on 07/21/09 with
My doctor recommends that I only take 2 per day which is only 24mg. He ask for me to come back to his office in 2 weeks, He has been doing a CBC every month.

Melting Mama,
Thanks so much for posting that information. It has relieved my mind some.

After Christmas I plan on going to my local vitamin store for some liquid vitamin.

Patience is Trusting God's Timimg!

Missy C.
on 12/23/09 1:07 pm - Hendersonville, TN

I am having the same problem.  My iron stores (i.e. my ferritin levels) are critically low.  that number would be 5 again.  I had the same number in June.  It got better but it never was able to catch up to where it needed to be.  I was put on Pruvate which is 150 mg a day.  and then I was was just switched to something else.  Haven't picked it up yet.  It is 90 mg.  2x a day. 

You on facebook?  So am I.  Search for Missy French Coffman
HW/ 338  Starting Weight w/clinic /324  Surgery/307  Current/175 Goal/168

Melody L.
on 12/23/09 3:52 pm - Keizer, OR
My iron stores are low as well, not sure what my most recent number was, but it was 12 the last time they tested it and when they tested it again later all I was told was that it was still very low.  I have been trying to take the iron supplements but no matter what I take with them to combat the constipation I end up extremely constipated anyway.  I have a prescription for iron, the second one they have tried, but it still causes the horrible constipation even when taking Docusate and Senna with it.  I have always had a bit of a problem with anemia however, so I knew I would probably struggle with low iron post op since it's a common problem to begin with.
~Melody~  5'6" Tall, 42 years old

on 12/23/09 4:59 pm
RNY on 12/28/09 with
Hi Rhondazn, This is going to be a pretty long post because I want to give you some info on low iron levels and what the experts recommend you do (check with your doc first of course - I'm no MD. This info comes from the National Institutes of Health nts.html )

It sounds like you are taking a lot of iron, but there may be a problem with your body "absorbing" it (see below). Also, too much iron is not good either. You didn't mention how long ago you had your surgery... did your surgeon rule out a bleed? Kathy

What Causes Iron-Deficiency Anemia? Not having enough iron in your body causes iron-deficiency anemia. Lack of iron usually is due to blood loss, poor diet, or an inability to absorb enough iron from the foods you eat. Blood Loss When you lose blood, you lose iron. If you don’t have enough iron stored in your body to make up for the iron loss, you’ll develop iron-deficiency anemia. In women, low iron levels may be due to blood loss from long or heavy menstrual periods or bleeding fibroids in the uterus. Blood loss that occurs during childbirth is another cause for low iron levels in women. Internal bleeding (bleeding inside the body) also may lead to iron-deficiency anemia. This type of blood loss isn’t always obvious, and it may occur slowly. Some causes of internal bleeding are:
  • A bleeding ulcer, colon polyp, or colon cancer
  • Regular use of aspirin or other pain medicines, such as nonsteroidal anti-inflammatory drugs (for example, ibuprofen and naproxen)
  • Urinary tract bleeding
Blood loss from severe injuries, surgery, or frequent blood drawings also can cause iron-deficiency anemia. Poor Diet The best sources of iron are meat, poultry, fish, eggs, and iron-fortified foods (foods that have iron added). If you don’t eat these foods regularly, or if you don’t take an iron supplement, you’re more likely to get iron-deficiency anemia. Vegetarian diets can provide enough iron if the right foods are eaten. For example, good nonmeat sources of iron include spinach and other dark green leafy vegetables, certain types of beans, dried fruits, and iron-fortified breads and cereals. During some stages of life, such as pregnancy and childhood, it may be hard to get enough iron in your diet. This is because your need for iron increases during these times of growth and development. Inability To Absorb Enough Iron Even if there's enough iron in your diet, your body may not be able to absorb it. This may be due to intestinal surgery or diseases of the intestine, such as Crohn’s disease or celiac disease. Prescription medicines that reduce acid in the stomach also can interfere with iron absorption. Dietary Changes and Supplements Iron You may need iron supplements to build up your iron levels as quickly as possible. Iron supplements can correct low iron levels within months. Supplements come in pill form or in drops for children.
Large amounts of iron can be harmful. Thus, you should take iron supplements only as your doctor prescribes. Keep iron supplements out of reach from children. This will prevent them from taking an overdose of iron.
Iron supplements can cause side effects, such as dark stools, stomach irritation, and heartburn. Iron also can cause constipation, so your doctor may suggest that you use a stool softener.
Your doctor may advise you to eat more foods that are rich in iron. The best source of iron is red meat, especially beef and liver. Chicken, turkey, pork, fish, and shellfish also are good sources of iron. The body tends to absorb the iron from meat better than iron in other foods. However, other foods also can help you raise your iron levels. Nonmeat foods that are good sources of iron include:
  • Spinach and other dark green leafy vegetables
  • Peanuts, peanut butter, and almonds
  • Eggs
  • Peas; lentils; and white, red, and baked beans
  • Dried fruits, such as raisins, apricots, and peaches
  • Prune juice
Iron is added to some foods, such as cereal, bread, and pasta. You can look at the Nutrition Facts label on a food to find out how much iron it contains. The amount is given as a percentage of the total amount of iron you need every day. Vitamin C Vitamin C helps the body absorb iron. Good sources of vitamin C are fruits and vegetables, especially guava, red sweet pepper, kiwi, oranges and orange juice, green pepper, and grapefruit juice. If you're taking medicines, ask your doctor or pharmacist whether you can eat grapefruit or drink grapefruit juice. This fruit can affect the strength of a few medicines and how well they work.
Other fruits rich in vitamin C are strawberries, cantaloupe, papaya, pineapple, and mango.

Vegetables high in vitamin C include vegetable and tomato juices, Brussels sprouts, kohlrabi, broccoli, sweet potato, cauliflower, and kale.

Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.
How Is Iron-Deficiency Anemia Treated? Treatment for iron-deficiency anemia will depend on the cause and severity of the condition. Treatments may include dietary changes and supplements, medicines, and surgery. Severe iron-deficiency anemia may require treatment in a hospital, blood transfusions, iron injections, or intravenous (IV) iron therapy.
The goals of treating iron-deficiency anemia are to treat its underlying cause and restore normal levels of red blood cells, hemoglobin, and iron.
  Treatments for Severe Iron-Deficiency Anemia If your iron-deficiency anemia is severe, you may get a transfusion of red blood cells. A blood transfusion is a safe, common procedure in which blood is given to you through an IV line in one of your blood vessels. Transfusions require careful matching of donated blood with the recipient's blood.
A transfusion of red blood cells will treat your anemia right away. The red blood cells also give a source of iron that your body can reuse. However, transfusions are only a short-term treatment. Your doctor will need to find and treat the cause of your anemia. Iron also may be injected into a muscle or through an IV tube into a vein. However, IV iron therapy presents some safety concerns. It must be done in a hospital or clinical setting by experienced staff. This therapy usually is given to people who need iron long-term but can’t take iron supplements by mouth or who need to be treated for iron-deficiency anemia right away.  

on 12/23/09 5:15 pm - OH
12 mg twice a day isn't really that much.  The ASMBS recommends 18 - 27 mg per day for RNY patients who have normal iron levels.  So if you're very low, it seems like 24 mg a day probably isn't going to be enough.  But it sure doesn't seem like a lot to me.

on 12/23/09 5:24 pm
RNY on 12/28/09 with
Thanks Kelly, I actually have printed out all the postings in this theme so I remember to watch the iron levels. (as Rosanna DannaDanna used to say "it's ALWAYS something.").
on 12/24/09 8:16 am - Oxford, GA
RNY on 07/21/09 with
Thanks everyone for the posts.
You know you see the word critical and you start to panic.
Before surgery I was slightly Anemic, but since surgery I am very anemic.
My sugery was done on 7/21/09
since then I now have gout, and I had blood clots. I am taking meds for the gout and blood thinners for the clots (which level is also low).
I go back to the doctor the first of the year.
We will figure it out soon I hope

Patience is Trusting God's Timimg!

on 12/19/10 9:27 am
I've never had much success with iron pills, and have tried almost every one in the book. I started early in high school. My anemia is largely auto-immune related, so my RNY is slightly irrelevant. I'd be anemic even if I did not have the RNY. So I cheat. I get the infusions.

Once my TIBC and ferritin are in the toilet, I go for a fix. Takes some people a few rounds to find an iron infusion that does not hurt or sick-make, but I see it like a spa treatment. I get to put my feet up, lie back with a blanket, and play video games or sleep. And every so often a nice lady with a cart comes by with magazines, snacks, and beverages.

Beats any pill by a mile!