Need Otc Iron Without Intestinal Side Effects

[suzyq63]

My daughter was diagnosed with celiac in August. We caught it super early (we watched the numbers increase over the course of 2 years) so at her 3 month follow-up, all her numbers were back in the normal range. However, her anemia has not improved at all.

Her hgb was 10.1 in July, so she started taking Bifera (recommended by the gastro). At her follow-up her hgb was still 10.1. Her iron-binding capacity was 507 (range of ? - 400). I believe it was her ferritin that was 16 (range 50-170). All those other MCV, MCHC, etc. were all abnormal too. The primary care doctor said to eat red meat and she should be fine. We do eat red meat, not every day but we do eat it. I don't understand why her numbers won't come up. I'm wondering if there's a better iron supplement to use. From what I've read, heme iron is better absorbed by the body and many supplements contain non-heme (plant-based) iron. What do you use?

Paula

[kareng]

There are some tricks to taking iron that most doctors don't tell you. Iron is better absorbed if it is the only thing in your stomach. No food 1 hour before and 2 hours after. If you must have a little something, banana or apple is good. No calcium foods or grains with iron. I did this with some high dose iron and it helped get it back up.

This is from WebMD.com: (obviously a few of these items are not gluten-free)

Very good sources of heme iron, with 3.5 milligrams or more per serving, include:

3 ounces of beef or chicken liver

3 ounces of clams or mollusks

3 ounces of oysters

Good sources of heme iron, with 2.1 milligrams or more per serving, include:

3 ounces of cooked beef

3 ounces of canned sardines, canned in oil

3 ounces of cooked turkey

Other sources of heme iron, with 0.7 milligrams or more per serving, include:

3 ounces of chicken

3 ounces of halibut, haddock, perch, salmon, or tuna

3 ounces of ham

3 ounces of veal

Iron in plant foods such as lentils, beans, and spinach is nonheme iron. This is the form of iron added to iron-enriched and iron-fortified foods. Our bodies are less efficient at absorbing nonheme iron, but most dietary iron is nonheme iron.

Very good sources of nonheme iron, with 3.5 milligrams or more per serving, include:

Breakfast cereals enriched with iron

One cup of cooked beans

One-half cup of tofu

1 ounce of pumpkin, sesame, or squash seeds

Good sources of nonheme iron, with 2.1 milligrams or more per serving, include:

One-half cup of canned lima beans, red kidney beans, chickpeas, or split peas

One cup of dried apricots

One medium baked potato

One medium stalk of broccoli

One cup of cooked enriched egg noodles

One-fourth cup of wheat germ

Other sources of nonheme iron, with 0.7 milligrams or more, include:

1 ounce of peanuts, pecans, walnuts, pistachios, roasted almonds, roasted cashews, or sunflower seeds

One-half cup of dried seedless raisins, peaches, or prunes

One cup of spinach

One medium green pepper

One cup of pasta

One slice of bread, pumpernickel bagel, or bran muffin

One cup of rice

Also, a list I was given years ago said egg yolks and blueberries. You might want to look those up.

[Katie B]

Apparently Proferrin (recommended by Kdawg) is the most available source of iron from a supplement and doesn't cause side-effects for most people. Unfortunately, my system is super sensitive and I can't tolerate this so I've been eating clams, teff, spinach etc. to get it up to normal levels. Apparently, if you take a whole bunch of iron you only absorb a certain percentage of it at one time. I believe it can take quite a long time to correct levels and some people actually need injections but this is done in a hospital setting and after the doctors think it's necessary.

I would research the RDA and then research how much you can absorb at a time. I believe if you have Vitamin C at the same time as iron then it helps to absorb the iron. Also, if you use cast-iron cookware it will increase the amount of iron in your food.

[Skylark]

Three months is not that long if you've been watching her develop celiac disease for two years. The fall in antibodies means repair can start because her intestine is no longer under assault, not that everything is necessarily healed. I wonder if she is still malabsorbing to some degree? I would give it a few more months of eating eating plenty of dietary iron.

[Roda]

Slow Fe brand works for me.

[tarnalberry]

I used SlowFe with no problems. Taking it on an empty stomach is good, but it should be taken with vitamin C to improve absorption. Additionally, cooking in a cast iron pan (particularly acidic foods like tomatoes) can be a good source of iron too.

[suzyq63]

Thank you very much. We will definitely add in Vitamin C with the iron. I've started making sure she has some red meat every day. Our suppers are usually ground beef or chicken. I guess we'll keep using the Bifera for now since it contains mostly heme iron.

Thank you Skylark for pointing out that she is probably still healing. Because we did catch it so early, I assumed that "normal" numbers meant her intestines were "normal".

We'll give it a while longer and then ask the primary care dr. for a recheck.

Paula

[Tina B]

My daughter was diagnosed with celiac in August. We caught it super early (we watched the numbers increase over the course of 2 years) so at her 3 month follow-up, all her numbers were back in the normal range. However, her anemia has not improved at all.

Her hgb was 10.1 in July, so she started taking Bifera (recommended by the gastro). At her follow-up her hgb was still 10.1. Her iron-binding capacity was 507 (range of ? - 400). I believe it was her ferritin that was 16 (range 50-170). All those other MCV, MCHC, etc. were all abnormal too. The primary care doctor said to eat red meat and she should be fine. We do eat red meat, not every day but we do eat it. I don't understand why her numbers won't come up. I'm wondering if there's a better iron supplement to use. From what I've read, heme iron is better absorbed by the body and many supplements contain non-heme (plant-based) iron. What do you use?

Paula

vitamin C improves iron absorption. My doc had me take it with OJ way back 20 years ago when i was diagnosed.

[trents]

Has your daughter been checked for pernicious anemia?

[sam0910]

I use Gentle Iron (Iron Bisglycinate). The brand is Solgar. It is specially formulated to be non-constipating and non-irritating to your stomach, and also easily absorbed. I bought mine at Market of Choice-I'm not sure if you have that store wherever you are. I just found out I'm celiac two months ago, and my Iron levels have already gone up since then : ) And I also take it with Chewable Vitamin C supplements from Trader Joe's.

[ElseB]

I take FeraMax and haven't had any side effects. I'm in Canada, and not sure if its available elsewhere....

[suzyq63]

Thank you. I bought Vit. C yesterday to go with the iron supplement. We'll also switch the time she takes her iron to between supper and bedtime so that her stomach should be pretty empty. She also has Type 1 diabetes so depending on blood sugar, it can be difficult to find a time she has an empty stomach. Maybe we should add in an additional iron supplement but only take it every other day to see if we can give her a boost.

Paula

[Gutsy Girl]

Cooking in a cast iron pan can also help. Whatever pans/pots you cook with...the metals in those pans and pots end up in your food to some degree, so cast iron can be really helpful for this. Of course, with a cast iron pan some people don't use detergent so be very careful about cc issues if it's always been YOUR pan.

I tolerate iron supplements some days better than others. Never quite know how it's going to "hit me". Introduced more red meat and eggs into my diet along with leafy greens to increase Fe, but ended up getting high cholesterol!! So....not sure what to do about that. My GI dog looked at me with big eyes and said, "3 months ago your cholesterol levels were GREAT, and now they're awful! What happened?! What goodies have you been eating?!" Surprised, I answered, "What goodies? I'm Celiac - I don't eat good tasting stuff!" He said, "Well you ate it so you should know!" *Shrug.* I wasn't eating THAT much. But...............

[mommida]

I second the idea of testing for pernicious anemia. There is a connection to Celiac. There are some other auto-immune diseases that anemia is a primary symptom.

I can tolerate slow Fe sometimes. I even have a hard time eating any iron rich foods.

[SaraKat]

I take Feosol with no problems.

[WheatChef]

Vit-C helps absorption of non-heme based iron only. It has no effects on your absorption of heme based iron, but isn't the worst thing to supplement with anyways.

[laura4669]

I take sublingual B-12 (along with other things already mentioned on this thread) to help with anemia.

[suzyq63]

Thank you.

Alison's MCV, MCHC, etc. are all low, which means she has microcytic anemia. B-12 deficiency and pernicious anemia are macrocytic anemias, if I remember correctly. The only number that is high is her iron binding capacity.

She has been eating more red meat and taking her Vit. C. After the new year, I'll take her back to get checked again. Unfortunately, autoimmune diseases (or possible autoimmune diseases) seem to be causing problems for the females in my family. RA has become a possibility for my older daughter.

Hopefully, Alison's iron will have improved by January.

Paula

[rosetapper23]

You might ask the doctor to test your daughter's manganese level--if she's deficient in manganese, her body cannot utilize iron and iron anemia is the result.

Also, with a ferritin level of 10, I'm shocked that the doctor has not prescribed intravenous iron infusions. It is very important to maintain adequate iron levels because they affect her cell oxygenation level. If your daughter's doctor agrees to intravenous iron infusions, she will receive them once a week for four weeks. Her iron level will climb quickly after the first infusion, and she should start feeling better immediately. There is NO reason to continue oral iron if she cannot absorb it! Some doctors simply do not seem to grasp this important concept. After your daughter's gut has healed and she's able to maintain a good ferritin level, she can stop getting iron infusions. Until then, there is no reason why she needs to suffer, since intravenous iron is available. By the way, your daughter's doctor may be unaware of the availability of iron infusions, so you may have to do some research on it and present the information to him. I suffered from low ferritin levels for many years before someone on this forum mentioned intravenous iron, and, lo and behold, my doctor had never heard of it. He called the hospital's Infusion Center and learned that it was the most common treatment given at the center!

[beefree11]

Milk and milk products, not only affect iron absorption, but can cause internal bleeding in infants.

(I didnt know this!!)

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