PSA: Are you female? Are you a vegetarian? Is your performance suffering? CHECK YOUR FERRITIN!!!

[redeemed2000]

@pastorgs woah. similar experience with a doctor--i had "no detectable Ferritin" and iron pills weren't helping. i couldn't walk very far without getting dizzy and out of breath and i was extremely irritable. i asked the doctor [my regular PCP was on maternity leave] about an infusion and she schooled me on how it would be a waste of resources and is dangerous.

i was miserable, but then in dawned on me that perhaps the pills weren't being absorbed--so i tried liquid iron--a month in, I am feeling so much better!

a side note, when i finally got in to see a hematologist [five month wait! yay rural medicine] my ferritin had risen to 15 after three weeks of liquid iron and she still thought that it would be useful to get an infusion--i declined because i'm a wimp, don't like needles and the liquid stuff seemed to be working.

it gets me so mad when doctors dismiss really legitimate health stuff. grrr.

 

[dawn16]

@redeemed2000 Where did you find liquid iron? I’ve been using pills and it’s working very slowly. Perhaps liquid would work better.

 

[christicrusader]

@dawn16 I am taking Floradix(liquid supplement, as I can't swallow pills). You can get it at health food stores/grocers or online. And be sure to take vitamin C with your supplements to boost absorption.

 

[kingston]

@redeemed2000 It seems to be a common thing when women come in that doctors assume it’s just all in their head and not an actual problem...

 

[vlo]

@dawn16 Wow...what a terrible doctor!

 

[fideminillalux]

@vlo I always get constipated when I take iron supplements. Any recommendations about how to avoid this side effect?

 

[dawn16]

@fideminillalux When I was working as an RD we got this question a lot -- a lot of medications cause constipation, especially opioid pain killers. We'd usually get the doc to prescribe stool softeners, but with a motivated patient who wanted to try to keep it natural there are three things that help: movement, fiber, fluids.

So for fiber, no "whites" (no white flour, no white rice). Eat whole fruit with peel (for fruit with edible peel), and lots of veg. And be careful with fiber supplements because usually they're mostly soluble fiber, which ferments but doesn't speed transit times. So you'll just add bloating and gas to your constipation. Insoluble fibers speed things along, and that's what you want (or a good balance of the two).

For fluids -- just drink more water. Especially if you're getting more fiber

For movement -- go for runs in the morning or do some sort of vigorous cardio. Exercise stimulates large contractions in your intestines, which also gets things moving. In fact if you're used to getting lots of exercise and you stop, constipation and bloating is pretty common as a result, so definitely don't combine taking a constipation-inducing medication with reducing exercise.

 

[matheushorta]

@fideminillalux There are slow-release supplements, which are supposed to be more gentle on your system. So make sure yours says something to that effect. I also make sure to take mine with food, and I also take it every-other day or so. I figure some is better than none. It's still not perfect, but at least I'm taking it.

 

[ifightforgood]

@matheushorta There is actually some research to indicate that taking it every other day is better than taking it more often. Your body downregulates iron absorbtion after a dose of iron supplements and it takes 24-48 hours for your absorbtion to go back to normal.

 

[dawn16]

@matheushorta Yeah and, I posted above about it, but I'd heard there are some doctors looking into reducing iron supplement doses since iron absorption slows when we consume too much at one time -- which paradoxically makes high supplementation less effective. Might be worthwhile to look it up or ask your dr about it.

 

[jesussa]

@fideminillalux You can try cooking with cast iron! I’ll see if I can find the studies on it. Also, they make a little cast iron fish that you boil in water or broth that will give you the daily amount needed. It’s called lucky iron fish.
https://universityhealthnews.com/da...ron-cookware-as-an-iron-deficiency-treatment/

 

[hollersnhills]

@fideminillalux I mentioned Gaia liquid iron supplement in another comment here, and I never experienced constipation on the pill supplement I was taking before so I can't speak from direct experience but when I bought it at whole foods the employee told me this was known to not cause constipation

 

[ttyler]

@hollersnhills Most liquid iron supplements are “gentle” because they have extremely low iron concentrations, like 10mg/10mL suggested serving for the Gaia product. Side effects are typically from unabsorbed iron, so if you never even approach absorption capacity, then no, no side effects. But also, slow ferritin rebound and lots and lots of product.

 

[hollersnhills]

@ttyler Interesting, I didn’t know that. Do you have one you recommend?

 

[ttyler]

@hollersnhills There’s absolutely nothing wrong with Floradix or the Gaia liquid, if they’re working for someone. I like the heme iron products myself, as an omnivore, but for mild-to-moderately iron-deficient vegetarians, I generally recommend iron carbonyl or iron bisglycinate—both of which are commonly marketed to patients who’ve had bariatric surgery—along with a vitamin C supplement, which improves absorption. (I’m a pharmacist.)

 

[kaylakristinag]

@ttyler Thanks, pharmacists are awesome. I just found out I have a ferritin of 10. I have an autonomic disorder and suspect it's exacerbating my symptoms. The liquid iron I'm taking (amino acid chelate) is expensive but it's the only one I've tried that doesn't cause constipation. My doctor said let's try that first and recheck in month. Are the iron carbonyl and iron bisglycinate constipating?

 

[ttyler]

@kaylakristinag Iron bisglycinate is actually a chelate (with a form of the amino acid glycine), so you might try switching over to an equivalent-dose bisglycinate chewable or tablet from your liquid.

Any iron supplement can be constipating or not; it depends how much you’re taking—it’s the unabsorbed iron that gives you the side effects. The small intestines generally can transport out around 50ish mg of iron daily, so the ferrous sulfate 325s will max out most people. If you’ve been anemic for a while, your body may have unregulated the number of transporters that can absorb iron and you may not have side effects from higher doses. I took the FeSO4 325s for a while as a teenager, and actually had zero constipation because I was that iron-deficient.

 

[kaylakristinag]

@ttyler Oh wow, OK. Thanks! That's very interesting and good to know about the unabsorbed iron. Maybe I have not yet hit my max. I'm not anemic as I understand it, just very low in ferritin. I'm not exactly sure what that means in medical terms!

 

[ttyler]

@kaylakristinag Low serum ferritin (

 

[kaylakristinag]

@ttyler Haha I try to swing that way! Thanks I'll read it.

I've also read that lower ferritin is associated with POTS which is what I have. While I don't think it's the whole problem, some patients have felt a little better when they brought up their ferritin to 50+. I think my local lab says 19 + is normal which is at odds with the literature.

Thanks for writing to me, you've been so helpful.