Poet_Kelly. . .Iron ? for you

Hi Kelly, 

Question for you if you don't mind. . .do you know if there are any injectable iron supplements?  Does such a thing exist?

I was just prescribed new iron tabs, it's a once daily, 21-day regimen, Repliva, I think it is called?  I haven't gotten them yet, the pharmacy didn't have them in stock.  You get a 28-day pack once a month, whi*****ludes 7 days of placebo pills.  My iron wasn't horrible or anything but it was a little low and the daily 750 mg of ferrous sulfate + 1,000 mg of Vitamin C he had me on was killing me and even using laxatives, stool softeners and eating a ton of fiber wasn't working so I told him I couldn't do it anymore I needed something easier on the stomach but that would get my iron levels up where he wants them. 

Apparently my protein (I believe it was my albumin level he said) was very low too, barely 3, so I have to really up my protein. He wants me adding 1 or 2 protein shakes back in a day.   My Endocrinologist and Dietitian think that my body has been sucking up all of the protein I ingest, and basically has siphoned off all of my protein stores because I wasn't taking in enough calories/protein for my body to function with my normal daily activities with the amount of exercise that I was doing.  I guess that would make sense with my protein level being so low now in my lab work.  My 6 month levels were fine but I wasn't exercising much back then and I have since added in cardio and weight lifting.    

These were on my 1-yr labs.  The only other thing out of whack was my triglycerides, which were elevated at 187.

Thanks, 

Lynn   

I don't know of any iron injections, but you can get iron by IV infusion.  Usually those are only done if your iron is extremely low, and usually they are done at a hospital or outpatient place like where you would go to get chemotherapy or something like that.  They take a few hours to do.

I'm not familiar with Repliva.  However, I imagine 750 mg ferrous sulfate caused horrible constipation.  Ferrous sulfate is well known to do that.  That's one reason I prefer carbonyl iron, it usually does not have that effect.

Ah, OK, I looked up Repliva.  It's a combination of ferrous fumerate, which is a pretty good source of iron for us, and a chelated form of iron which the company that makes it (Albion) says is absorbed in the part of the small intestine that has been bypassed in RNY folks, so we won't absorb that component of it.  However, if your iron is just a little low, the amount of ferrous fumerate you'll be getting may be enough to bring it up.  I'm not sure why it contains the seven days of placebo pills, though.  Seems to me like it would be more beneficial to take iron every day, just just for three weeks out of four.

Thanks Kelly!

I was taking 130 mg daily of carbonyl iron and my iron levels actually dropped!  That's why he switched me over to the 750 mg of ferrous sulfate, which yeah, the constipation was horrible to say the least!!!  The Repliva is supposed to be much easier on the GI system, which makes sense from what you described. 

The 21 days on and 7 days off is supposed to somehow aid in absorption with giving your body a short "break" . . . I don't know the hows or the whys behind that line of thinking or if there are studies to back it up but apparently the Repliva has shown good results in RNY folks so I am going to try it for 3 months and then get my levels re-checked and see what's what.  

I'm nowhere near needing infusions, I was just more curious than anything if there was an injectable iron and I figured if it was out there, you would be the person to ask about it, 

Thanks again!

See, the 750 mg ferrous sulfate was about the same amount of elemental iron that you'd been taking with the carbonyl.  So I'm not surprised it didn't make much difference.  It sounds like a lot more iron, but most of it was just the iron salts, which is what makes you constipated.

Ferrous fumerate is much more elemental iron, so it shouldn't make you so constipated.

Let me know how it works for you.  Since it's by prescription, there have to be studies to back it up.  Not necessarily studies on RNY folks, probably just on "normal" people with low iron, but prescription stuff doesn't get approved without lots of studies.

If you get a chance and feel like asking your doctor or pharmacist if they can explain how the seven day break helps you absorb iron, I'd love to hear the reasoning for that.  I have not heard that before, but like I said, if it's prescribed that way, there must be some studies that back it up, so I'd like to understand how it works.

Ahhhhh gotcha, it makes so much sense when you explain it. . .it doesn't make nearly as much sense when I try and figure it out on my own lol.  I get confused with the different types of iron and which works how!!!

I will definitely do that!  I will talk to the Pharmacist about it when they get it in stock and I can go pick it up.  Since it's a new prescription for me, they will ask me if I want to talk to the Pharmacist anyway and I am curious about that myself!  I will post whatever information I find out