Since Going on GFD Iron Levels have dropped -Why?

[vvicin02]

I am really puzzled. I just had blood work done to see how I have been progressing my diet. I requested it because I just haven't been feeling all that great. I was shocked to see that my iron levels dropped to 56 mcg/dl from 73 mcg/dl four months ago. I thought my diet would improve the health of my intestines and absorb iron. I have not yet received my celiac panel results but either I am doing a terrible job with my diet and CC or my diet lacks iron and proper nutrients. My history shows that over the last 7 months since I started my GFD my iron numbers have been dropping (88, 72, 56)  - while my ferritin levels have improved. What the heck is going on? Any idea? 

[cyclinglady]

I am not a doctor, but if your ferritin (iron stores) are improving you are most likely absorbing iron.  As far as iron blood levels, your results are still in the normal range.   Any idea what they were say, five years ago or longer?   Your doctor would need to check your hemoglobin level or size of blood cells to see if you are anemic.  

Did they recheck your antibodies for celiac disease?  

[vvicin02]

Thank you cyclinglady. My one concern is that the iron levels have been on a down load trend. My hemoglobin has been pretty consistent over 5 years - around 13.5 the RBC also looks around same over the past 5 years - around 4.5.  Iron seems to range from 56 - 78 in the past 5 years. So I guess this might be my norm. I am waiting on my antibodies results for celiac disease in a few days. I guess that will tell me if I am doing a poor job with my diet. You agree?

[cyclinglady]

Remember, the tests for celiac disease (antibodies) were designed to help diagnose celiac disease and not for dietary adherence.   Unfortunately, they are the only “tool in the toolbox” that is non-evasive.   Doctors typically look for a downward trend.  

It can take over a year for antibodies to recover. They might even remain elevated even when your small intestine has healed.  That happened to me.  I was so discouraged that my antibodies were not coming down and a repeat endoscopy showed a healed small intestine.  What was keeping my antibodies elevated?  Most likely my other autoimmune issues which can flare up — gluten free or not.  

Measure your success by how you feel and give yourself well over a year to heal as celiac disease is systemic.  If you still have issues, get another endoscopy.  My last one revealed Chronic Autoimmune Gastritis.  At least I knew I was doing gluten free correctly!  

[Posterboy]

vvicin02,

Try reading this thread I think it will help you.

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 could try and explain it again but it takes too long (and too many words). ..so I will try and be brief (at least for me)

Also see this research and the role of gastric acid in iron absorption.

https://www.ncbi.nlm.nih.gov/pubmed/7286584

notice the drop in iron levels are not linear but quoting "absorption falls only when acid secretion is markedly reduced" and why yours is falling now. .  .even though your iron levels have been low normal for a while . ..your stomach acid was/is still strong enough to absorb some iron but once that threshold is reached .. .there will be a marked drop in iron levels.

see also this research that explains why this happens the way it does. .. and the difference in iron types.

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

quoting

"Numerous animal, as well as human support the conclusion that the absorption of iron is affected by gastric acidity [2,30,73,74]. Dietary iron is present in food as either non-heme (66%) or heme iron(32%), and the non-heme iron’ s absorption is markedly improved by gastric acid. Gatric acid helps the non-heme iron containing food sources to dissociate the iron salts, helps to solubilize the iron salts which allows them to be reduced to the ferrous state, which allows the formation of complexes with ascorbate, sugars and amines which in term, facilitates absorption [2,30,73,74]. Numerous clinical conditions associated with achlorhydria/hypochlorhydria[atrophic gastritis, pernicious anemia, gastric resections, vagotomy] have been shown to be associated with decreased iron absorption and/or iron-deficiency anemia [2,3,30,73,74]"

I hope this is helpful but it is not medical advice.

2 Timothy 2: 7 “Consider what I say; and the Lord give thee understanding in all things” this included.

Posterboy by the grace of God,

[GFinDC]

I am pretty sure that calcium interferes with iron absorption.  So it might help to limit calcium (dairy, nuts, etc) around times of consuming iron rich foods (eggs, spinach etc.).

[vvicin02]

I want to thank you everyone for their feedback. It really helps.

Yesterday, I receive my celiac panel results. My Tissue Transglutaminase IgA dropped to 121 Units from 150 Units 3 months ago. Still high but at least it is going down. My other numbers improved, such as my Tissue Transglutaminase IgG dropped to 14 which is normal. However,  Gliadin IgG Antibody stayed at the same number 48 units from 3 months ago. I am making slow progress - I hope. Really takes a long time to recover, especially at 61 years old.  Oh well, I am getting there. As for my iron, with my current GFD it is clear that I am no way near the 8 mg daily requirements. The old days I could have a bowl of cheerios and I would be set. I need to look at adding more iron in my diet. I eat meat, pork and poultry but I guess that is not enough. Boy between the lack of fiber and iron on GFD it is a real challenge..lol

[GFinDC]

This article on Healthline is where I read about calcium interfering with iron absorption.  It also says citric acid helps promote iron absorption.  So eating a cheeseburger doesn't help your iron level nearly as much as eating a hamburger with a squirt of lemon juice.

https://www.healthline.com/nutrition/iron-deficiency-signs-symptoms#section11

It can take months to recover iron levels even with supplementation.  We just don't absorb it well.  Plus with celiac damage to the small intestine we don't absorb foods well regardless.

People can have GI symptoms from taking large doses of iron supplements.  So it is probably better to take more moderate amounts daily than a larger dose once a week.  The same goes for vitamin D.  Vitamin D is better absorbed in a moderate daily dose than in a large weekly dose.

This link lists some iron rich foods.  I don't agree with eating tofu though as soy is a risky food and not great for intestinal health.  So take that one out of their list IMHO.

https://www.healthline.com/nutrition/11-healthy-iron-rich-foods

You can take psyllium husk capsules for extra fiber.  Psyllium husks are available at lots of health stores/pharmacies.  Here's one source, there are many others.

https://www.swansonvitamins.com/swanson-premium-psyllium-husks-610-mg-300-caps?otherSize=SW802

Many gluten-free processed foods are not fortified with extra vitamins and preservatives like their gluten counterparts are.  So you are not getting your vitamin pill in a slice of bread or bowl of cereal now.  Instead of vitamins many gluten-free processed foods are loaded with extra carbs and sugar.  So not a great trade really except that the gluten is gone.

[frieze]

i wonder if there is something involving celiac on a molecular level, that is allowing the body to store iron now, that you could not before?  organic bovine liver, once or twice a month may help...  and the tincture of time.

[Fenrir]

Hello,

 

i have a background as a medical lab tech so I know labs backwards and forwards. 

It’s not uncommon for iron to drop when you make a big chsnge in diet. Wheat is often fortified with iron so your intake likely went down as well. 

If your hemoglobin and hematocrit are OK and iron levels don’t go below normal there’s probably nothing to worry about at this time. 

[vvicin02]

Thank you so much. My hemoglobin is good and no indication of anemia. I think you are correct that my diet is probably the factor here. Before I was diagnosed I ate all sorts of bran, wheat and cereal that was fortified with iron - which explains why my iron numbers were much higher then. I am looking at supplementing my iron without vitamins. Now my ferritin is normal but I do not want to create another problem. This insight has really been helpful from all you folks. Thank you.

[Posterboy]

vvicin02,

This kind of dovetails with what GFinDC said earlier.

Healthline article are well written and it gives you many helpful tips.

The most common tip people give when taking Iron is to take it with Vitamin C.

But taking it with Beta Carotene probably would help as much ...I found this research a few years ago but most people don't know the connection.

https://www.ncbi.nlm.nih.gov/pubmed/10613757

Anemia Central has a nice article about how Iron and Vitamin D levels are connected.

https://anemiacentral.com/vitamin-d-and-iron/

But both Iron and Vitamin D can become low when your stomach acid is too low to dissolve the nutrients ...so the Small Intestine can then absorb them.

This was in thread ...fairly new research (less than 5 years old) that confirms low/no stomach acid independently can cause IDA. see link below entitled "Is achlorhydria a cause of iron deficiency anemia?"

https://www.ncbi.nlm.nih.gov/pubmed/25994564

they concluded it was . ..and what I think is happening here but that is only my opinion but I have seen it work with my friends who are willing to try some Betaine HCL (Powdered Stomach Acid) to improve their digestion.  Always take with water/liquid and with a meal otherwise you can google how to best take it (so this thread response don't get (way, way, too long).. .but here is a nice online article that is a nice overview of it/why this is. . .and how you can (self test often) to confirm this hypothesis.

https://drjockers.com/5-ways-test-stomach-acid-levels/

I hope this is helpful but it is not medical advice.

Again I hope you will research this more and “Consider what I say; and the Lord give thee understanding in all things”  2 Timothy 2: 7

Posterboy by the grace of God,

[joe3530]

Fascinating information and theories in here. I wonder if this is what’s causing me persistent fatigue. 

Low iron was the first thing I noticed that started me guessing I had celiac especially when I had all these GI symptoms not resolving for a few months. 

I was however able to fix my iron levels before going gluten-free. However I think it’s because I caught it early.  

Since gluten-free (around week 3-4, currently at week 7) my energy has dropped tremendously. I wonder if my iron has gone down and if I should retest it. I do eat a good amount of high iron foods naturally (eggs daily/steak/ground beef weekly)

[Posterboy]

4 hours ago, joe3530 said:

Fascinating information and theories in here. I wonder if this is what’s causing me persistent fatigue. 

Low iron was the first thing I noticed that started me guessing I had celiac especially when I had all these GI symptoms not resolving for a few months. 

I was however able to fix my iron levels before going gluten-free. However I think it’s because I caught it early.  

Since gluten-free (around week 3-4, currently at week 7) my energy has dropped tremendously. I wonder if my iron has gone down and if I should retest it. I do eat a good amount of high iron foods naturally (eggs daily/steak/ground beef weekly)

Joe3530,

If you are having persistent fatigue ie. etc aka CFS symptom's etc. then try some Magnesium Glycinate or Magnesium Citrate.

Ennis_tx and I sware by it. . .the body can't make energy with out it

Here is a study of how low Magnesium Red blood cell levels can lead to CFS symptom's.

Most don't test low for Magnesium because of the test the doctor's perform are not very good at "whole body/cell" levels only measuring the blood levels . . .and the majority of the magnesium 90+ percent is in our cells.

Here is a couple article about low Magnesium levels in CFS/ME.  entitled "Red blood cell magnesium and chronic fatigue syndrome" and "The Epstein-Barr Virus, Magnesium and ME/CFS Connection" respectively

https://www.sciencedirect.com/science/article/pii/014067369191371Z

http://simmaronresearch.com/2015/08/epstein-barr-virus-the-magnesium-connection/

I hope this is helpful but it is not medical advice.

“Consider what I say; and the Lord give thee understanding in all things” 

2 Timothy 2: 7

if you want to learn more about magnesium there are great threads on celiac.com about it...both Ennis_tx and I talk about it constantly. ...it really works when you find the right form.  just search for Magnesium and a good thread will come up.

Posterboy by the Grace of God,

[Posterboy]

joe3530,

I took the liberty of looking up a good Magnesium thread for you.

It is one of the last active threads about Magnesium and has a lot of good information in it about what form is best to take. .. and which blood tests give you the best test results concerning your whole/body "cell" levels and and not just your blood levels which tend to be low for normal ranges. . .according to Dr. Carolyn Dean.

https://www.celiac.com/forums/topic/123376-magnesium/?tab=comments#comment-999856

Here is Dr. Dean's thought about which test's are best to test for your true Magnesium levels.

https://drcarolyndean.com/2015/10/why-test-for-magnesium/

Just taking it and showing improvement in your energy, fatigue, sleep quality and muscle cramps in Magnesium Glycinate or Magnesium Citrate with meals is usually enough to self confirm that your low in Magnesium ...but most people want an "official" diagnosis . ..which most doctor's test don't show low for it (Magnesium) ...according to Dr. Dean.. .and why she recommends the RBC blood test for Magnesium levels.

But I should warn you she did write a book about it and her website is selling (you) things ...but she says that is really not necessary to confirm a Magnesium deficiency ...where she says quoting "Don’t forget what I said in the first sentence, you don’t necessarily need a magnesium blood test. And, even if your test looks good but you still have magnesium deficiency symptoms, go by how you feel, not the test.'" and I feel better and my energy is better when I take Magnesium Glycinate or Magnesium Citrate with meals.

I hope this is helpful but it is not medical advice.

Posterboy,