iron digestibility

[glucel]

Just about 2nd anniversary gluten-free and latest blood test showed <1. The good news was verification no microscopic blood in urine which had been present for yrs. Also I have regained much of the weight but still down about 10 pounds 160 vs 170. I think villi recovery still has long way to go. Heavy fatigue in afternoon and usually need quick nap. The problem seems to be red blood cells have been trending down and finally went out of range to low side by couple points. The doc has not looked at iron for last few yrs and will get that done soon. I remember yrs ago it was always to the high end of range but ferritin was always ok so doc never questioned. Now I'm thinking maybe I had beginning gluten problems back then that screwed up iron digestibility and even then needed nap but of course pretty difficult at work. I am going back to see my gi doc to see if he has any suggestion. I should add that I had triple bypass 3 yrs ago and do aerobics 5 x weekly. Any suggestions on how to assimilate iron or anything else appreciated.

 

[Aretaeus Cappadocia]

Congratulations on your progress!

Blood iron was a serious issue for my celiac child around the time they were diagnosed. Supplements were not sufficient and a series of (I think 5) infusions were prescribed. It worked as a "catch up" and blood iron has been normal since then (with supplements). Might be what you need to get a reset.

[glucel]

Thanks very much. Did your child have to see a specialist for the infusions or done at hospital?

[Aretaeus Cappadocia]

Child was an adult so they scheduled. Was seeing a lot of docs at that time. Could have been general practitioner or a specialist. However I went along for the infusions. It was really easy. Outpatient infusion unit at the local Kaiser medical center. Make an appointment, walk in, comfy chairs, juice boxes - they really put some effort in to reduce the stress of it. If I remember correctly it took about an hour each time.

[glucel]

Thanks will definitely check it out.

[knitty kitty]

@glucel,

Thiamine deficiency usually goes along with iron deficiency.  The iron can't be utilized to make more red blood cells without Thiamine.  

Thiamine provides energy from the foods we eat.  The body has higher metabolic demands for Thiamine when healing (after an illness or after surgery), if one is an athlete, works out frequently, is an outdoor laborer, and after emotional and mental stress.  Cardiovascular health problems can be a result of Thiamine deficiency.  

Unintended weight gain (or loss) can be a symptom of Thiamine deficiency.  The body stores more calories as fat in Thiamine insufficiency.  

Heavy Fatigue is another symptom of Thiamine insufficiency.

Ask for an Erythrocyte Transketolace Activity Assay to check Thiamine level.  

Keep in mind that gluten free foods are rarely enriched or fortified with vitamins and minerals like gluten containing foods.  Since you may not be getting sufficient B vitamins like Thiamine, talk to your doctor or dietician about taking a B Complex supplement as well as extra Thiamine to correct the deficiency.  

[glucel]

hey knitty, I have taken b complex for yrs and recently upgraded to quatrofolic so holding out hope for benefits there. The complex has 25 mg thiamin and then take another 100 mg with lunch. My memory is not great anymore and realized after original post that I took a vit b test on your recommendation, btw, back in 2024. Everything was in range except that doc forgot to incl thiamin and I never did follow up. Also iron, ferritin and binding all in mid range and make my dilemma even more confusing. As I said I crash around 2 pm and then at 5 become very hungry and have to force myself to stop eating at some point.

[knitty kitty]

@glucel,

Please check the ingredients label on your B Complex.  Many B Complexes contain Thiamine Mononitrate, a form of thiamine that is not very usable in the human body.  Only thirty percent is able to be absorbed, and even less than that is able to be utilized by the body.  Thiamine Mononitrate is a shelf-stable form of thiamine, meaning it won't break down when exposed to light, heat and over long time periods, like sitting on a shelf waiting to be sold in a store.  Thiamine Mononitrate from the diet needs Thiamine already in the body to break it down into a useable form of thiamine.  A Catch-22 there.  

Thiamine Hydrochloride is a better form.  Benfotiamine and Thiamine TTFD are also excellent forms of thiamine to take.  They help with healing the digestive system and neurological issues.

The amount of vitamins in the blood can reflect nutrients absorbed from meals in the previous twenty-four to forty-eight hours, including vitamin supplements.  You should be off vitamin supplements for two months before having blood tests for vitamin levels.  

Blood tests are not accurate measurements for B vitamins.  The amount of vitamins circulating in the blood are not equal to the amount of vitamins stored inside cells where the vitamins are actually used.  You can have "normal" amounts in the blood, but this doesn't mean they are being absorbed and utilized within cells that are low in  Thiamine.  Thiamine provides the energy so a cell can do its job, whether it's a muscle cell contracting, a brain cell sending nerve impulses to your big toe, or a pancreas cell making insulin.

You can have "normal" blood levels of vitamins, but organs and tissues can suffer from localized deficiency.  The brain can order stored thiamine to be released from organs and tissues so that the brain and heart can have sufficient amounts needed to keep functioning.  High dose Thiamine is now routinely given to patients suffering from cardiovascular events, like heart attacks and strokes (localized thiamine deficiencies), because thiamine is safe and nontoxic even in high doses.  

In thiamine deficiency, high doses of Thiamine Hydrochloride are needed to flood the body's system and move into cells.  It's becoming more widely practiced to take 500 mg Thiamine Hydrochloride in the doctor's office and look for health improvement.  Some have improvement within an hour, some have improvement after several days.  High dose Thiamine (500 mg x 3 daily) should be continued for several weeks.  Doses can be reduced as health improvement stabilizes over several months.  

Fatigue to the point of needing a nap and a ravenous appetite are both symptoms of Thiamine deficiency.  When the body does not get sufficient thiamine, the brain tells the body to keep eating until it gets more thiamine.  Thiamine deficiency can cause both a ravenous appetite or no appetite at all (anorexia).  Symptoms can mysteriously wax and wane depending on how much thiamine is absorbed from the diet.  A twenty percent increase in dietary thiamine causes an eighty percent increase in brain function, so you feel better.  Good sources of Thiamine are meats.  Next time you get ravenous, try eating meat and see how that affects you. 

If you are eating a diet high in carbohydrates (if more than half of your plate is carbohydrates), you need to take more thiamine.  It takes more thiamine to turn excess carbs into energy.  For every extra 1000 calories of carbs, you need 500 mg of Thiamine.  If the body doesn't have plenty of Thiamine, the body stores excess carbs as fat, often in the abdomen.

Quatrofolic is Folate Vitamin B 9.  Taking Folate can mask a B12 Deficiency which in turn can in turn can affect anemia.  Taking more Folate is not going to improve a Thiamine deficiency.  

Thiamine is needed to make red blood cells.  Red blood cells need thiamine to hold Oxygen in place while circulating to various organs and tissues.  Without oxygen, the body switches from aerobic metabolism to anaerobic metabolism which causes hypoxia.  Hypoxia drives inflammation.  Hypoxia results in fatigue.  Thiamine deficiency induced hypoxia can be reversed by taking Thiamine.  This lowers inflammation and promotes healing.  

Please let me know what kind of Thiamine is in the B Complex that you are taking and the form of thiamine you take at lunch.  125 mg is not sufficient to correct a Thiamine deficiency.  

[Aretaeus Cappadocia]

6 hours ago, glucel said:

hey knitty, I have taken b complex for yrs and recently upgraded to quatrofolic so holding out hope for benefits there. The complex has 25 mg thiamin and then take another 100 mg with lunch. My memory is not great anymore and realized after original post that I took a vit b test on your recommendation, btw, back in 2024. Everything was in range except that doc forgot to incl thiamin and I never did follow up. Also iron, ferritin and binding all in mid range and make my dilemma even more confusing. As I said I crash around 2 pm and then at 5 become very hungry and have to force myself to stop eating at some point.

I'm not certain if I understood your post precisely. The iron infusion I mentioned before probably would not be useful if your "iron, ferritin and binding all in mid range". With normal iron, ferritin and ferritin binding but low red blood cell count, it seems like it is worthwhile reviewing/supplementing your B vitamins like @knitty kitty is suggesting. However, at the same time I would also talk to your Dr about what other conditions could lead to this situation. Internal bleeding (probably less likely if it's been going on for a long time and iron is still normal), cancer, chronic kidney disease, other autoimmune diseases, etc. One potential cause that is unlikely, because it is a rare condition, would be autoimmune hemolytic anemia (AIHA), where your immune system starts targeting your red blood cells. I think it's unlikely you have that, but I mention it because you already have a celiac diagnosis, which is also an autoimmune disease. People with one autoimmune disease tend to be at increased risk for other autoimmune diseases.

In addition to your RBC issue, you might want to ask your Dr to take a look at your blood glucose levels. The daily crash followed by intense hunger sounds similar to a low blood glucose problem (hypoglycemia). 

[Aretaeus Cappadocia]

.... and right after posting my comment, I saw this relevant post. Below the primary article are a few other articles on related topics.

 

[knitty kitty]

Thiamine helps iron function in cells.  Thiamine also helps with glucose intolerance (pre-diabetic state) and can prevent diabetes.  Thiamine improves blood pressure and cardiovascular diseases.

Interesting Reading:

Thiamine (Vitamin B1)—An Essential Health Regulator

https://pmc.ncbi.nlm.nih.gov/articles/PMC12251314/

The Association Between Vitamin B1 Deficiency and Anemia Among Elderly Patients at a Rural Hospital in Japan: A Cross-Sectional Study

https://pubmed.ncbi.nlm.nih.gov/38021762/

The Iron Deficiency Response of Corynebacterium glutamicum and a Link to Thiamine Biosynthesis

https://pmc.ncbi.nlm.nih.gov/articles/PMC7205493/

Association of vitamin B1 with cardiovascular diseases, all-cause and cardiovascular mortality in US adults

https://pmc.ncbi.nlm.nih.gov/articles/PMC10502219/

Edited yesterday at 09:04 PM by knitty kitty
Typo correction

[glucel]

16 hours ago, knitty kitty said:

@glucel,

Please check the ingredients label on your B Complex.  Many B Complexes contain Thiamine Mononitrate, a form of thiamine that is not very usable in the human body.  Only thirty percent is able to be absorbed, and even less than that is able to be utilized by the body.  Thiamine Mononitrate is a shelf-stable form of thiamine, meaning it won't break down when exposed to light, heat and over long time periods, like sitting on a shelf waiting to be sold in a store.  Thiamine Mononitrate from the diet needs Thiamine already in the body to break it down into a useable form of thiamine.  A Catch-22 there.  

Thiamine Hydrochloride is a better form.  Benfotiamine and Thiamine TTFD are also excellent forms of thiamine to take.  They help with healing the digestive system and neurological issues.

The amount of vitamins in the blood can reflect nutrients absorbed from meals in the previous twenty-four to forty-eight hours, including vitamin supplements.  You should be off vitamin supplements for two months before having blood tests for vitamin levels.  

Blood tests are not accurate measurements for B vitamins.  The amount of vitamins circulating in the blood are not equal to the amount of vitamins stored inside cells where the vitamins are actually used.  You can have "normal" amounts in the blood, but this doesn't mean they are being absorbed and utilized within cells that are low in  Thiamine.  Thiamine provides the energy so a cell can do its job, whether it's a muscle cell contracting, a brain cell sending nerve impulses to your big toe, or a pancreas cell making insulin.

You can have "normal" blood levels of vitamins, but organs and tissues can suffer from localized deficiency.  The brain can order stored thiamine to be released from organs and tissues so that the brain and heart can have sufficient amounts needed to keep functioning.  High dose Thiamine is now routinely given to patients suffering from cardiovascular events, like heart attacks and strokes (localized thiamine deficiencies), because thiamine is safe and nontoxic even in high doses.  

In thiamine deficiency, high doses of Thiamine Hydrochloride are needed to flood the body's system and move into cells.  It's becoming more widely practiced to take 500 mg Thiamine Hydrochloride in the doctor's office and look for health improvement.  Some have improvement within an hour, some have improvement after several days.  High dose Thiamine (500 mg x 3 daily) should be continued for several weeks.  Doses can be reduced as health improvement stabilizes over several months.  

Fatigue to the point of needing a nap and a ravenous appetite are both symptoms of Thiamine deficiency.  When the body does not get sufficient thiamine, the brain tells the body to keep eating until it gets more thiamine.  Thiamine deficiency can cause both a ravenous appetite or no appetite at all (anorexia).  Symptoms can mysteriously wax and wane depending on how much thiamine is absorbed from the diet.  A twenty percent increase in dietary thiamine causes an eighty percent increase in brain function, so you feel better.  Good sources of Thiamine are meats.  Next time you get ravenous, try eating meat and see how that affects you. 

If you are eating a diet high in carbohydrates (if more than half of your plate is carbohydrates), you need to take more thiamine.  It takes more thiamine to turn excess carbs into energy.  For every extra 1000 calories of carbs, you need 500 mg of Thiamine.  If the body doesn't have plenty of Thiamine, the body stores excess carbs as fat, often in the abdomen.

Quatrofolic is Folate Vitamin B 9.  Taking Folate can mask a B12 Deficiency which in turn can in turn can affect anemia.  Taking more Folate is not going to improve a Thiamine deficiency.  

Thiamine is needed to make red blood cells.  Red blood cells need thiamine to hold Oxygen in place while circulating to various organs and tissues.  Without oxygen, the body switches from aerobic metabolism to anaerobic metabolism which causes hypoxia.  Hypoxia drives inflammation.  Hypoxia results in fatigue.  Thiamine deficiency induced hypoxia can be reversed by taking Thiamine.  This lowers inflammation and promotes healing.  

Please let me know what kind of Thiamine is in the B Complex that you are taking and the form of thiamine you take at lunch.  125 mg is not sufficient to correct a Thiamine deficiency.  

Great info, thanks. Luckily I am taking thiamin hcl 100mg at lunch and the 25 mg in morning b complex is made up of hcl and cocarboxlase. 

I have read many of your writings about thiamin and understand/believe that the body gets rid of the excess. One thing that a gluten-free diet has done for me is no microscopic blood in urine after a lifetime of it, at least so far, but in other aspects my kidneys not so good. My kidneys have never been completely healthy and as an old guy have only gotten worse. My brother is on dialysis so I am more than concerned about excessive thiamin affect on the kidneys. It would be great to check with a dr about this but most of the time they have no interest in anything but drugs. So yes I would love to load up on b1 but it was actually a big decision for me to add 100 mg at noon time a few months ago.

Normally my so called bigger meal, or at least where meat is consumed is at mid day. I eat way too much bread and cereals at night and usually stay away from meat as I try to limit cholesterol, although I do sneak a hard boiled egg in there. Maybe a half a hamburger or something like that could help curb the appetite.

[knitty kitty]

@glucel,

Yes, most doctors prefer to prescribe pharmaceuticals than delve into vitamins because they aren't educated about the health impact vitamins and minerals can make in medical school.

Thiamine, especially Benfotiamine, has been shown to be protective to the kidneys.  Benfotiamine improves kidney function!  Especially in people on dialysis.  

Thiamine and Benfotiamine are safe and nontoxic even in high doses! 

PLEASE Read!

Prevention of Incipient Diabetic Nephropathy by High-Dose Thiamine and Benfotiamine 

https://diabetesjournals.org/diabetes/article-abstract/52/8/2110/13835/

Benfotiamine Protects against Peritoneal and Kidney Damage in Peritoneal Dialysis

https://pmc.ncbi.nlm.nih.gov/articles/PMC3083313/

Prevention of incipient diabetic nephropathy by high-dose thiamine and benfotiamine

https://pubmed.ncbi.nlm.nih.gov/12882930/

If more than half your plate is carbohydrates, you need more Thiamine!  High carbohydrate diets induce thiamine because as the carbohydrate load us increased, an increased amount of thiamine is needed to process them. 

I have been taking high dose thiamine as thiamine hcl and Benfotiamine for over ten years.  I have not had any bad experiences with it.   I no longer have any symptoms that reflect type two diabetes.  

Doctors can't profit from prescribing vitamins because they can't be patented.  They profit from pharmaceuticals and medical procedures necessitated by health conditions that could be remedied, or at least improved, with essential vitamins and minerals!  

Don't fear thiamine!  Do discuss the benefits with your doctor.  Ask if you can take 300 mg Benfotiamine in his office under medical supervision if you're nervous.  Most people have improved health within a short period of time.  You've already seen improvement with low dose thiamine hcl.  Jump in with both feet!  

Edited 1 hour ago by knitty kitty
Typo correction