Pernicious Anaemia Society
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Continuing iron issues

Thank you everyone that gave me advice re. my iron level results. I have now been prescribed ferrous fumarate but reading the details it says don't take if you have b12 PA. The doctor knows I gave PA and said this is what i should take. She also said take with orange or grapefruit to help with digestion even though I told her my mouth and tongue ulcer badly even with one mouth full of orange juice. I can't even eat a small tomato. She just told me take it for 2 months and then go back to see a doctor. Does anyone know why you shouldn't take them if you have PA?

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Wow that's a new one on me as I've been taking 1 – Iron Ferrous Fumerate 210mg tablet every day for more years than I can remember and I've had P.A. for 45 years

Advice before taking -

Some medical conditions may interact with ferrous fumarate. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

"If you have hemolytic anemia, pernicious anemia, or other types of anemia, or if you have a condition that may cause anemia (eg, sickle cell disease, glucose-6-phosphate dehydrogenase [G6PD] deficiency)"

I'm still "clivealive" at 75 so I'm guessing my doses are not causing me much harm.

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I agree with clivealive. I also take this supplement and did not know the warning for PA. I am still anemic after 6 months of supplements though so maybe there's an issue with absorption?

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LauraJF - suggestion about orange juice is because you need vitamin C in order to be able to absorb iron - so if you have problems with acidic foods then you could try something else that has vitamin C in it - and you could speak to a pharmacist to see what they suggest.

Not heard warning on ferrous fumarate and PA - again - suggest that you ask the pharmacist who dispensed it - which is basically what Clive advises. It may be to do with use of the word anaemia and a risk that someone with PA will take ferrous fumarate when they aren't iron deficient - and you can overdose on iron - but that is pure speculation on my part

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You don't necessarily need Vit C to absorb iron.

Iron will only dissolve when in solution. It dissolves better in acidic environments, which is why people with absorption problems due to low stomach acid will have problems absorbing iron.

Another good way of getting the iron into solution is via chelation. Ascorbic acid (Vit C) and citric acid are both cheating agents which will help iron dissolve (they have minimal effect on the acidity of the stomach). That is why it is recommended to take iron sulfate with orange juice.

Fumaric acid is another chelation agent. So iron fumarate is already chelated and should need any help from ascorbic and citric acids. The same applies to iron bisglycinate.


I to have low iron levels with PA I have been told by my doc to take iron tablets for 3 months. Also told to cut down on tea and drink more herbal teas as normal tea takes away all the iron in your food if drunk with your meal.wait at least 1 hr after eating

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