XP: Repliva, Iron Questions

What is an optimal level of iron for an RNY post op of 7 years? I've heard everything from 12 to 200!!???  Mine was 9.5 and my doc is starting me on Repliva. I didn't get too many responses to my request for reveiws on it on the main board.  I thought there would be more post ops who take it. Thanks all! J.S.

I normall dont have Iron probs but when I was pg I did.  Seems like it was 10 and they wanted it to be above 10.  I think.  I dont remember what he had me take though.  But oh I do remember the constipation.  lol lol Good Luck Denise

I've been taking Repliva for two years now I believe.  At my 1 year post op labs my iron was low.  I tried to use bariatric formulas of iron but it was never enough to bring mine up.  I had been anemic years before during a gynecological episode but other than that had never experienced low iron.  I began the Repliva and have had great iron levels since then.  It's easy to take, doesn't seem to bother my stomach or constipate - I'm already taking stool softeners since my rny anyway.  I have nothing but good things to say about it's ease and effectiveness.

Hi there, I just had my 4 yr bloods done & have the results handy. The reference range for IRON is: "40 - 175 mcg/dL" My result came out to "60" - so they consider that "In Range". According to the Repliva website -  Ther-Rx - Repliva 21/7™

Repliva 21/7 Tablets are clinically proven to deliver significant hemoglobin increases with less iron than traditional therapy

So if its Hemoglobin that we're talking about - the CBC Plates reference range listed as 11.7 - 15.5 g/dL. If you go off of that same scale & your only hitting 9.5 then yes, you are looking at being Iron deficient.  This is NOT something that you wanna mess around with! Check out pages 13 - 15 & Table A5 on p33. of the Bariatric Nutrition: Suggestions for the Surgical Weight Loss Patientfor more information (link posted earlier today) for more information

Iron

DRI and UL DRI: 8 mg/d for men, 18 mg/d for women 19–50 yr; UL 45 mg/d

Food sources: Meats, fish, poultry, eggs, enriched grains, dried fruit, some vegetables and legumes

Function: obin and myoglobin formation, Cytochrome enzymes, Iron-sulfur proteins Symptoms of deficiency:  Anemia, Dysphagia, Koilonychia, Enteropathy, Fatigue, Rapid heart rate/palpitations, Decreased work performance, Impaired learning ability

Stages of deficiency: Stage 1: Serum ferritin decreases 20 ng/mL Stage 2: Serum iron decreases 50
g/dL; transferrin saturation 16%Stage 3: Anemia with normal-appearing RBCs and indexes occurs Stage 4: Microcytosis and then hypochromia present Stage 5: Fe deficiency affects tissues, resulting in symptoms and signs

Diagnosis CBC:  low Hgb/Hct, low MCV, Decreased serum iron, Decreased percentage of saturation, Increased TIBC, Increased transferrin, Decreased serum ferritin (affected by inflammation or infection)

Treatment: Typically, for iron replacement therapy, 300 mg/d elemental iron given, usually as 3 or 4 iron tablets (each containing 50–65 mg elemental iron) given during course of day; ideally, oral iron preparations should be taken on empty stomach because food can inhibit iron absorption

Toxicity: Nausea, vomiting, diarrhea, constipation; iron overload with organ damage, acute systemic toxicity

PS - it occured to me that the reason you are getting such a varied (wide) range is b/c ppl are COMBINING the IRON range recommendations (40-175) and the Hemoglobin range recommendation **** 15.5). BUT thats just my speculation :) Im not a nurse or Dr. & I dont play one on TV.

Wow!  Thanks so very much!  I think you're right, and I appreciate your answer so much! J.S.

Are you asking for Iron level or Ferritin levels? Iron levels (37-145)  Ferritin (15-150)  You want to be in the higher end of these normal ranges...With malabsorption, the downward spiral is slow, but once it starts...It's so fast and so hard to get raised back up....So many people are taking the wrong iron for GB and are ending up having to get iron infusions because they get so low so fast.... Regular people have a hard time absorbing Iron Salts as it is but they have the needed anatomy to absorb these salts to begin with...(stomach acid and snmall intestines) ...We RNYers cannot absorb Ferrous sulfate efficently because we have NEITHER.  (not enough stomach acid in our pouches and the small intestines are by passed) So we get all the side efffects and take a toxic iron for NO REASON AT ALL and so many are getting infusions that might otherwise be avoided!   Repliva uses two different Irons in their formula along with two types of Vitamins C...Ferrous Fumarate (81 mg) and Iron as Amino acid chelate (70 mg)...They also use Vit C as ascorbic acid (140 mg) and Ester -C  (60 mg) which is a very absorbable and high quality Vit C.  They also use Folic acid and B-12 in their formula.  I read decent things about Ferrous Fumarate...however.....I had side effects with Ferrous Fumarate (left an awful repeating bloody taste in my mouth for hours and belly aches too)  and Ferrous Sulfate was much worse...but I did great with the Iron as Amino Acid Chelate...The probelm with that was it is so expensive for the amount I wanted to take. I was anemic with My Ferritin was 5...My Iron 22 and my HGB was 11.1 and many of my other blood counts were very low too. Plus I had high platelets (sticky blood) and High counts of deformed blood cells that were unable to carry oxygen or live long enough to keep my heart and brain healthy.  So I ran the risk of heart or brain damage as well as blood clots... When my doc gave me Ferrous Sulfate...I couldn't believe it...I knew that was the wrong iron and she went on vacation so I had to do my wn research...(after that I didn't trust her anyway and would have done my own research even if she didn't go on vacation)  So I found an iron that is not toxic like Iron salts even in VERY high doses, doesn't constipate, or cause severe cramps and pain like salts, and was as pure form of elemental iron that was much more absorbable even for GB persons.  I thought it was too good to be true.  I got mine from Vitalady.com...It's Carbonyl iron...I love her iron because it's chewable and has a good flavor and I know that it begins absorption in my mouth with saliva enzymes and VitC as ascorbic acid get that saliva flowing really good....because of it's tartness. It's liquid by the time it hits the pouch too so it doesn't sit there rusting and making your mouth taste metallic and bloody... Anyway...I took the idea of Repliva....and took the irons that with research of my own were the best iron for absorption, no-toxic and no side effects...It worked like a dream!!!! I got all my blood levels to normal Low, but normal (except still working on deformed cells)  My doc thinks she healed me...I never told her i ferilized my lawn with the iron she gave me! My specific formula was 325 mg Carbonyl Iron chewed with 500mg Vit C as ascorbic acid in the morning....and 108 mg Iron as a chewable amino acid chelate and a chewable Ester C at night. I also added 2 mg of copper as it is said to aid in absorption...I also added a zinc lozenge with my regular multivitamins and a B complex capsule.  In two months, my iron went from 22 to 55 Ferritin went from 5 to 16 and while these numbers along with normal ranges of blood counts too...my doc thinks I am in normal ranges and not to worry...I do feel much better, but I KNOW I could feel even more if I got my iron higher...I am aiming for 100's at the least and expect it will take months as long as I have a menstrual cycle. Every month, you lose blood and withthat blood you lose much of the iron you store up withthese supplements...and if you are not taking enough, you will never ever get the levels on the rise...This is why I decided to take a non toxic, high dosage of iron... It worked and while I am no doctor...I would challenge you to at least read some info about carbonyl iron and try it for yourself...It worked for me and several others who tried it recently too! Good luck

Hi there!  Thank you so much for all of this VERY useful information.  I like the kind of information that comes from personal experience. It was the ferritin that I was referring to, mine was 9.5.  Interestingly enough, my doc did not test my iron, just the ferritin. I too was told to take ferrous sulfate and boy is it making me sick.  I take it with a vitamin C, which is a horse pill that I have to cut in half.  Taking them both on an empty stomach twice a day is killing me.  I'm nauseas for hours afterwards. My Repliva prescription should be called in soon, and then I can fertilize my yard with the ferrous sulfate. :) Another problem I had with finding an iron supplement was that all of the ones at Walmart had sugar alcohol in them.  I cannot consume a single gram of sugar alcohol without severe g.i. distress, so I am really hopeful for the Repliva. Thanks again so much for taking the time for your detailed reply.  It is a huge help, and I've even bookmarked it. J.S. 

There are a few people that I have spoken to that have tried Repliva...Some say it worked great..and one said it did nothing for her and she still needed infusions....If you have any other deficiencies, you should try to work on those as well...and not focus on one or the other.  It seems that once one thing gets a little off balance, it causes something else to work harder to compensate.  I worked at all my low vits and everything improved with the iron as well.  To be honest, I didn't think I was going to get out of  the need for infusions.  I'm so glad I did!   I hope the Repliva works and gets you healthy again...I can't handle sugar alcohols either...They do not like me at all!  The Vit C doesn't seem to bother me...but it did a little when I first started taking it daily...Sometimes if I take my iron  (and Vit C) too late...I'll wake up in the morning with an achy pouch....I try to get all my vits in two hours before bed so that doesn't happen.  Good luck with it all and let us all know how you are doing and how you feel...I'm curious to see how you do on the Repliva...Are you doing it for 2 months and then retest?  Hugs

Optimal levels of iron depend on the type of level you are testing with relation to iron. IRON 49 - 151 TIBC 250 - 450 Fe Saturation % 20 - 50 According to any of those, 9.5 is super low.  I have to take Tandem (another new Rx iron like Repliva - I just liked the Tandem a little better) to keep my iron up.