iron pills gastropathy/gastritis

[ironictruth]

So, my ferritin levels went from 74 to 20 despite being on a high iron diet. Nothing alarming, but since I was training for a half marathon, and now a second one, I figured 20 was getting close to the danger zone and I started to supplement with iron back in May. My primary gave me the thumbs up.

I have had gastritis in the past and a pill cam in early August caught some mild gastropathy. Ironically, I was on liquid iron the last time I had gastritis. Never had a single bout of it until a few months after my first gluten challenge two years ago and now I cannot get it to heal all the way.

I continue to have pain and nausea in my upper right quadrant that is often associated with eating but not always. Sadly, running a hard run also worsens it for a bit.  I switched to low acid coffee, started zinc carnosine, and zantac before running two days ago. I have developed flu like aches, episodes of dizziness and my running is suffering horrible. I eat, sleep, take vitamins, eat more and drink enough water. My ferritin went up into the 30's in August and I just asked to have it     re-checked thinking that perhaps I am getting TOO much iron or maybe the swing upward was temporary which has happened to me before. I do not know if my doc will agree to re-check it. I hope so. I have a recent diagnosis of celiac,  just ran a half marathon, and was hoping to run another but the flu like feeling is not helping that cause.

Anyway, I am ranting. I started wondering if perhaps the freaking iron pills (they are gluten free) could be adding to the misery of my stomach not healing and then I found this recent article:

http://www.gastrores.org/index.php/Gastrores/article/view/804/876

Set aside my wondering if the woman in the first case scenario actually IS a celiac, the article makes me think we need a better way to get iron into us stomach-intestinally challenged individuals. The University of Chicago Celiac Center claims that as many as 50-60% of celiacs have some type of gastritis when diagnosed.

I already eat red lentil pasta 1-2 times weekly which is very high in iron. I eat salad almost daily during the work week. Red meat twice a week. Mixed plant protein nutrition drink twice a week. I am at a loss for how else to increase my iron stores and maintain them without subjecting my tummy to further insults.

I am open to any suggestions!  

[Victoria1234]

1 hour ago, ironictruth said:

So, my ferritin levels went from 74 to 20 despite being on a high iron diet. Nothing alarming, but since I was training for a half marathon, and now a second one, I figured 20 was getting close to the danger zone and I started to supplement with iron back in May. My primary gave me the thumbs up.

I have had gastritis in the past and a pill cam in early August caught some mild gastropathy. Ironically, I was on liquid iron the last time I had gastritis. Never had a single bout of it until a few months after my first gluten challenge two years ago and now I cannot get it to heal all the way.

I continue to have pain and nausea in my upper right quadrant that is often associated with eating but not always. Sadly, running a hard run also worsens it for a bit.  I switched to low acid coffee, started zinc carnosine, and zantac before running two days ago. I have developed flu like aches, episodes of dizziness and my running is suffering horrible. I eat, sleep, take vitamins, eat more and drink enough water. My ferritin went up into the 30's in August and I just asked to have it     re-checked thinking that perhaps I am getting TOO much iron or maybe the swing upward was temporary which has happened to me before. I do not know if my doc will agree to re-check it. I hope so. I have a recent diagnosis of celiac,  just ran a half marathon, and was hoping to run another but the flu like feeling is not helping that cause.

Anyway, I am ranting. I started wondering if perhaps the freaking iron pills (they are gluten free) could be adding to the misery of my stomach not healing and then I found this recent article:

http://www.gastrores.org/index.php/Gastrores/article/view/804/876

Set aside my wondering if the woman in the first case scenario actually IS a celiac, the article makes me think we need a better way to get iron into us stomach-intestinally challenged individuals. The University of Chicago Celiac Center claims that as many as 50-60% of celiacs have some type of gastritis when diagnosed.

I already eat red lentil pasta 1-2 times weekly which is very high in iron. I eat salad almost daily during the work week. Red meat twice a week. Mixed plant protein nutrition drink twice a week. I am at a loss for how else to increase my iron stores and maintain them without subjecting my tummy to further insults.

I am open to any suggestions!  

We all have issues with malabsorption while our villi are healing. So although you are probably getting enough iron into your diet, it might not be absorbed properly. Were you getting any symptoms of low iron? For now, maybe you should look at your symptoms instead of getting upset about your numbers. Also I know you need to eat Vitamin C at the same time as iron to get it absorbed the best. Personally I have a terrible time keeping my iron up, as I cannot take supplements without them killing my stomach or digestive system.

I know there's people who know a whole lot more than me who'll chime in soon  

[ironictruth]

28 minutes ago, Victoria1234 said:

We all have issues with malabsorption while our villi are healing. So although you are probably getting enough iron into your diet, it might not be absorbed properly. Were you getting any symptoms of low iron? For now, maybe you should look at your symptoms instead of getting upset about your numbers. Also I know you need to eat Vitamin C at the same time as iron to get it absorbed the best. Personally I have a terrible time keeping my iron up, as I cannot take supplements without them killing my stomach or digestive system.

I know there's people who know a whole lot more than me who'll chime in soon  

The flu aches, performance slowed and dizziness. But I am not sure if that is the cause, hence my asking the doc for the panel again. Waiting to hear. 

Hoping I can can the iron to see if it helps my tummy. My supplement had vitamin c in it. 

[Ennis-TX]

I have to take vitamin C with my iron. I found a nice liquid one I mix in with my other supplement twice a day. I also eat a very high iron diet....and have VERY low ferratain. But I am body building and weight training 3-4 days a week. I find pea protein and cocao is very high in iron. I eat 1/4-1/2 cup of cocoa nibs a meal, couple of scoops of pea protein a day also. And use the pea protein in daily shakes.....Funny thing, I used to have iron issues so bad I got cravings to eat dirt....I literally wanted just chocolate covered dirt. I adopted the ground cocoa nibs that I eat by the hand fulls for this and the cravings subside.  I think the highest my ferratain has been in years was 6.

OH with the aches up your magnesium levels, if you training harder your body is going to need MUCH more.

[ironictruth]

10 minutes ago, Ennis_TX said:

I have to take vitamin C with my iron. I found a nice liquid one I mix in with my other supplement twice a day. I also eat a very high iron diet....and have VERY low ferratain. But I am body building and weight training 3-4 days a week. I find pea protein and cocao is very high in iron. I eat 1/4-1/2 cup of cocoa nibs a meal, couple of scoops of pea protein a day also. And use the pea protein in daily shakes.....Funny thing, I used to have iron issues so bad I got cravings to eat dirt....I literally wanted just chocolate covered dirt. I adopted the ground cocoa nibs that I eat by the hand fulls for this and the cravings subside.  I think the highest my ferratain has been in years was 6.

OH with the aches up your magnesium levels, if you training harder your body is going to need MUCH more.

Thank you Ennis. I do take magnesium. 

I forgot I have a certified gluten-free hot cocoa with 20% iron in it. 

I will try the nibs and pea protein! I think my drinks I mix with water are plant protein based. 

[Ennis-TX]

4 minutes ago, ironictruth said:

Thank you Ennis. I do take magnesium. 

I forgot I have a certified gluten-free hot cocoa with 20% iron in it. 

I will try the nibs and pea protein! I think my drinks I mix with water are plant protein based. 

https://criobru.com/shop
 

I buy these in bulk, they are roasted and ground cocoa nibs. Your supposed to brew them in a french press. I just eat them....you have find the ones you like best, I like to mix them up a bit the ghana french roast has a very deep flavor like a dark roasty cocoa, the light roast is smoother. They do not have my old favorites any more, and the Ecuador one is pretty good. You will find you have to mix them in a bowl with a sweetener or candy them. They are a bit hard and take some getting used to eating them. I like to use them with a sugar free granulated sweetener like swerve in a 3-1 ratio of spoons of ground nibs to sweetener then sprinkle it over porridge, ice cream etc.  5lbs last me about 2 months >.<

[Estes]

I bet $5 you have an ulcer.  I took iron for years and doc says it caused my ulcers.  I went off iron and took meds for the ulcers and the pain and nausea went away.

 

That does not explain all your symptoms though.  I ran a marathon then had babies.  Now I am 42 with celiac.  I am choosing not to run that much anymore because I need those nutrients and healing to feel healthy.  Running would drop all than into "unhealthy" again.  When I don't eat well, sleep well, push too hard...I get all the other symptoms you mentioned.  Like my body screeming at me to put on the brakes and make a kale smoothly.

[ironictruth]

3 hours ago, Estes said:

I bet $5 you have an ulcer.  I took iron for years and doc says it caused my ulcers.  I went off iron and took meds for the ulcers and the pain and nausea went away.

 

That does not explain all your symptoms though.  I ran a marathon then had babies.  Now I am 42 with celiac.  I am choosing not to run that much anymore because I need those nutrients and healing to feel healthy.  Running would drop all than into "unhealthy" again.  When I don't eat well, sleep well, push too hard...I get all the other symptoms you mentioned.  Like my body screeming at me to put on the brakes and make a kale smoothly.

No ulcers in April, but yes, I think iron pills are contributing. I do not feel super hungry but red lentil pasta, ground beef and kale pasta sauce is on the menu tonight! 

I am only doing halfs. Was hoping I can maintain my nutrients. I eat a lot. No weight loss. 

Will see what the doc says about rechecking it. Maybe it is something else. 

[Posterboy]

ironictruth,

I see people have already mentioned the Vitamin C trick to help iron absorption.

Read this thread about IDA I think you will find it very informative if you have not already read it.

https://www.celiac.com/forums/topic/119240-diagnosed-with-ttg-iga-level-of-128-three-days-ago-trying-to-conceive-or-should-i-hold-off/?tab=comments#comment-981475

I linked to this research in the thread but I never see anybody else mention this but Beta Carotene think Carrots is very good about changing the pH at which Iron can be absorbed thus improving digestion.

Here is the research on Beta Carotene.

http://jn.nutrition.org/content/128/3/646.full

entitled "Vitamin A and β-Carotene Can Improve Nonheme Iron Absorption from Rice, Wheat and Corn by Humans"

they note quoting

"Solubility tests demonstrated that vitamin A and β-carotene are capable of solubilizing iron at pH 6. It seems that β-carotene is more efficient that vitamin A at least for ferrous fumarate. This is may be due to a greater stability of β-carotene to storage, handling and pH changes."

I hope this is helpful.

Also you didn't say what form of Magnesium you are taking.  Magnesium Citrate or preferably Magnesium Glycinate works best (no diarrhea issues sometime citrate's can cause)

***this is not medical advice but I do hope it helps you with your IDA/iron levels.

posterboy,

[knitty kitty]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4778084/

"Of the solid oral formulations, ferrous sulfate was the most damaging to the upper GI tract followed by ferrous gluconate, ferrous succinate, and finally, ferrous carbonate tablets."

"Kaye et al.¹² also found an association between PPI use and iron deposition. It is unclear whether this finding is due to an increase in PPI use for the symptoms caused by iron-induced erosion, or whether the alkaline environment caused by the PPI may aid in iron deposition in the gastric mucosa.^"

 

^{Maybe switching to a different form of iron (not ferrous sulfate) in a liquid would help.}

^{Increase iron by cooking in cast iron  pans.}  

^{Take iron with vitamin C.}

^{Eat more Liver!  This is my favorite way!} 

 

 

 

[Posterboy]

ironictruth,

I want to follow up on Knitty Kitty's reasoning.

I read over it the first time I read your post.  When I saw her post on PPI's then it struck me.

I think it is the Zantac.

see this link

https://www.ncbi.nlm.nih.gov/pubmed/15455980

quoting

"Our observations support the probability that the profound hypochlorhydria induced by omeprazole may indeed impair the optimal absorption of orally administered iron in iron-deficient individuals, precluding them from obtaining therapeutically adequate amounts to establish the positive balance necessary for the resolution of anemia and the replenishment of stores."

and this link quoting

https://www.ncbi.nlm.nih.gov/pubmed/21150767

"Omeprazole and possibly all proton pump inhibitors decrease the absorption of oral iron supplementation. Iron-deficient patients taking proton pump inhibitors may have to be treated with high dose iron therapy for a longer duration or with intravenous iron therapy."

And I know Zantac is H-2 blocker and not a PPI's but the effect is the same.

I wrote about my experience with low stomach acid being diagnosed as high stomach in my posterboy blog post.

https://www.celiac.com/gluten-free/blogs/entry/2106-is-ncgs-andor-celiac-disease-really-low-stomach-acid-misdiagnosed/

And I know why people take it . . . to relieve the symptom's but if they (symptom's) keep coming back when you stop taking them you are having acid rebound a classic symptom of stopping the medicine.

chris kresser covers this topic well.

https://chriskresser.com/what-everybody-ought-to-know-but-doesnt-about-heartburn-gerd/

going low carb can help or even ketogenic (low carb on steroids) if removing carbs helped the heartburn then it will also help lessen the rebound symptom's.

I hope this his helpful. . . but I find most people when they start acid reducer's rarely get off of them.

It is called attachment rate in medical lingo and it acid rebound of (PPI's) are part of the reason why they replaced H-2 in the marketplace because they block more of the stomach acid than H-2 blockers and are thus harder to get off of once started.

If your stomach acid was truly high as you hear.  Eating food would only lower the stomach acid improving the condition.  Timeline say's it is already too low to absorb Iron and thus lowering if further by taking an H-2 blocker lowered your Iron levels to critical levels because you could no longer absorb the food you were eating.

I think of Stomach acid like lime on a field.  It changes the pH to an optimal level to absorb nutrients.

Low Stomach Acid equals low Nutrient absorption especially those nutrients that need a strong acid (like Iron) for absorption.

This is the best research article I have seen on the subject.

entitled "Association of Long-term Proton Pump Inhibitor Therapy with Bone Fractures and effects on Absorption of Calcium, Vitamin B12, Iron, and Magnesium"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974811/

see their section on Iron absorption.

Again I hope this is helpful.

posterboy,

 

 

[cristiana]

I struggle with iron - even taking ferrous glucanate can sometimes cause symptoms. This summer I have been struggling with gastritis caused by, I believe, a combo of aspirin damage, iron and stress.  I think things are slowly improving but I  am still taking Zantac.  I desperately need iron as I was borderline anemic a few months ago.  I've managed to get it up to 18 by diet and taking small doses of liquid Floradix.  What I do is make sure I've eaten first as I find food acts as a buffer  and I mix it with about 150ml of orange juice and a lot of water.   

It is miserable having that stomach pain but if I'm having a bad day I used Slippery Elm (I drink it like tea) and I find it helps a lot.   

I am trying to get less stressed about things, which helps a lot.  You are already exercising, but I find walking is very helpful - in fact, just a day of sitting around on the computer seems to make me feel worse.  If I am moving a round a lot, it is usually a much better day.  

I try to stick to regular, small meals (will take a snack if I am out and there is no other food option available).  But one thing I find really helps is to never miss my evening meal and to serve it at the same time every day.  If I miss it, I do find I get a lot of pain.  If I eat it on time I have a good evening.

 

[cristiana]

On 9/30/2017 at 10:52 AM, cristiana said:

I struggle with iron - even taking ferrous glucanate can sometimes cause symptoms. This summer I have been struggling with gastritis caused by, I believe, a combo of aspirin damage, iron and stress.  I think things are slowly improving but I  am still taking Zantac.  I desperately need iron as I was borderline anemic a few months ago.  I've managed to get it up to 18 by diet and taking small doses of liquid Floradix.  What I do is make sure I've eaten first as I find food acts as a buffer  and I mix it with about 150ml of orange juice and a lot of water.   

SORRY! I have just posted something under a new topic - Floradix/Floravital.  I've just discovered that I've been glutening myself taking Floradix.  There is a gluten free version I should have been taking insted called Floravital - make sure that if you have this range in your country that the version you are taking is gluten free.  I'm sorry for any confusion/harm caused.   The confusion arose as the product packaging is so similar.