The above trial only tested with pure vitamin C. Substances like orange juice and other fruit juices are rich in polyphenols which can decrease iron absorption by as much as 90%. The worst offenders are black tea and coffee. These substances are probably ok, just don't drink them with meals or around the time you take your iron. nature.com/articles/s41598-...
Here's an interesting tidbit about insomnia (not RLS sleep deprivation) and anemia.
Anemia and Insomnia
Recent research studies have identified a specific gene associated with insomnia and anemia stemming from iron deficiency, as well as restless leg syndrome (RLS). Women have a higher risk of insomnia than men, so it’s not surprising to find that research shows women are at higher risk for iron-deficient anemia than men. Around 3 percent of all adult men in developed countries have iron-deficient anemia. In contrast, an estimated 20 percent of all women and 50 percent of pregnant women in developed countries have anemia due to iron deficiency.
A recent genome-wide analysis has revealed that the gene MEIS1 is linked with insomnia, which has also been implicated in restless leg syndrome and iron-deficiency anemia (IDA), the latter caused by a decrease in the oxygen transporter in the blood–hemoglobin (Hb). – Sleep Review Magazine
A larger Chinese medical study explored the links between iron-deficient anemia and insomnia over a period of six years. Among the study population, 4.3 percent had anemia and 15.2 percent reported having insomnia. Several important connections between the two conditions were identified:
•People who had previously had anemia had a higher prevalence of insomnia.
•Simply having anemia was associated with a 32 percent greater risk of developing insomnia in the future.
•Severe anemia was strongly linked to an increased risk for insomnia. Mild and moderate anemia also increases the risk of developing insomnia but to a lesser degree.
In an interesting twist, the research study showed that men with anemia were at greater risk for insomnia than women with anemia—perhaps due to basic hormonal differences. Women are already twice as likely as men to have insomnia and are also twice as likely to develop RLS.
Say what you want, the ferrous bisglycinate knocks me out, in addition to relieving the RLS. I've taken iron and then 3 hours later awakened on the living room thinking I just came in here to turn off the lights and having to clean up the drool. These days I take the iron much closer to bedtime so I'm in bed before the iron takes full affect and that hasn't happened lately. But if anemia = insomnia and our brains are generally anemic then wouldn't iron be the answer to our insomnia as well?
I certainly don't consider shooting you at all, at all! You have raised an interesting point and are always welcome to do so.The point I was making is that is at odds with what we put out on this site, but if that is found to he incorrect, then we are only too happy to update our fact bank??
And I definitely see some of our specialist advisers bristling!
Hi Madlegs. I like the learning/debate process, but not in a war zone. I feel like this past week (or two or three) has been particularly bad and you guys have been doing triage. I post when I have that holy sh-t moment. In this case the moment was when I read how much polyphenols (which I always associated with tea) in things like even orange juice might be interfering with iron absorption and here we are advising a little OJ with iron.
Thanks for the tip about vitamin C. It's worth relooking at this. I believe the original idea was that acid aids iron absorption, so vit C, (ascorbic acid) or folic acid can help absorption.
It's also advised that antacids especially proton pump or H2 inhibitors can inhibit iron absorption.
Interesting connections between anaemia, insomnia and RLS. Links to the studies would help so that members could read them and make their own interpretation of what they say.
It's well established that anaemia or even iron deficiency without anaemia is associated with RLS.
As I've understood your previous writings you appear to claim that
1) taking oral iron will IMMEDIATELY relieve RLS symptoms
2) taking iron has an IMMEDIATE sedative effect.
Perhaps I've misunderstood you.
There is no previous evidence to support these claims and the studies you refer to now do not appear to support these claims either.
Again I may have misunderstood, but you further seem to claim that iron needs to be taken every day.
However, if RLS symptoms and sleep are immediately affected by serum iron levels then it seems logical to assume that it's best to ensure as much iral iron is absorbed as possible. If less is absorbed, even serum levels will be lower.
In which case the evidence is that the amount of iron is INCREASED by taking it bi-daily. This is because hepcidin limits iron absorption from up to 24 to 72 hours.
As I say I have have misunderstood what your claims are. In which case I apologise. Otherwise I have yet to see any evidence to support your claims.
Needs to be taken every night you have RLS. Hey, if you only get RLS once a month, and you're not iron deficient then take it once a month. That's if iron has an immediate effect for you. Rarely does it have an immediate effect for someone augmenting on the DAs or at least no discernible one. Then I've told people, including recently Nick the Turk, to carry on taking the iron every other night. Listen my friend, I believe I was the first one to post about hepcidin on this site, as well as the original NIH article that discussed the fact that due to hepcidin, taking iron every other day (no where did they mention night) was the best regimen for raising iron levels in IDA. This was probably about 8 or 9 years ago. Gonna look for that post now that I think about it.
Speaking of night, don't you think it best to take iron first thing in the morning when our stomachs are really empty, not so much as a trace of that dinnertime tiramisu as there might be at bedtime and also when hepcidin is lowest? Plus, iron is thought of as being an energizing substance, rightly or wrongly so. Do you ever wonder why Dr. Earley suddenly started to tell his patients to take iron at night in addition to on an empty stomach? Could he be realizing that some of his patients receive some immediate benefit to their RLS from that iron?
Just in the last month there were two separate women (one in tears it seemed) who came on here and described how they were taking iron at night (not sure whether nightly or every other or three times a day) and were feeling great and went for their annual physical and the doctor told them their iron was in the 200s and to stop taking the iron and they were all proud and then within a day or two of stopping their RLS came roaring back. I know one woman called her doctor and he advised against taking anymore iron so she came crying on here. Most of us told her to continue taking the iron despite the doctor's advice. You on the other hand tried to convince her that what she was experiencing was not possible. That her ferritin couldn't drop much in two days such that it would make a difference. You tried to convince her that she was doing something that was triggering her RLS. In the meantime she went back on the iron and was fine.
Like that person said 20 years ago on that blog I read "there's just something about that free-floating iron at night that seems to help the RLS."
Elfin, all me, below. Wow, I was the most unpopular girl in class, I mean this site, back in the day, when terror reigned. If you think I care about "evidence" over helping people you got another thing coming baby. I'll say it again, iron has an immediate effect for all the people on here who have stated so. It is not all in their head. It is not placebo. And I so don't care if it's not mentioned in the Merck's Manual.healthunlocked.com/rlsuk/po...
Just some further feedback on what the linked article says.
It does say that one study has shown no increase in iron absorption due to taking vitamin C. So it may not be necessary to take the vitamin C.
However, it also mentions at least one study that shows the opposite.
Hence, whether you take the vitamin C seems to be a matter of personal choice.
The article also says iron should only be taken every other day.
As regards the anaemia - insomnia connection. Assuming that anaemia can cause insomnia (I can believe that).
Hence, logically if you have both insomnia and anaemia then the anaemia may be causing the anaemia. Therefore correcting the anaemia may improve the insomnia.
However anaemia is not immediately corrected by a single dose of iron, it takes a course. This gradually improves anaemia so will gradually improve the insomnia.
What if somebody has insomnia but not anaemia?
In this case taking iron will not improve the insomnia, because the insomnia is caused by something else.
Anaemia is not a term you can apply to the brain, this is nonsense.
Nutrients such as iron which get into the brain do so by crossing the blood brain barrier, i.e. leaving the blood and entering the Cerebro Spinal Fluid (CSF).
The literal meaning of "anaemia" applies only to blood, not CSF and refers to reduced "oxygen carrying capacity". (OCC). There are many forms of anaemia. Iron deficiency is only one of them.
If Red Blood Cells, (RBCs) whose function is to carry carry oxygen lack iron in the haemoglobin molecule, they are unable to carry as much oxygen. Over large (macrocytic) RBCs, as in B12 anaemia can reduce OCC. A reduced number of RBCs as in haemorrhage or sickle cell anaemia will reduce OCC.
To cut a long story short, there are no RBCs in CSF so no such thing as brain anaemia. The regulation of iron levels in the blood, is separate from the regulation of iron in the brain.
Your reaction to taking iron and it knocking you out in an apparent extreme way sounds a little scary. I would be worried about this. I can see why you might be trying to find an explanation for it. It doesn't sound a positive thing.
Perhaps you need to see a doctor. This may he a reaction to an excipient in the tablets you're taking.
To continue what Effindoe says the article says "Data appears to be mixed when it comes to the benefits of taking vitamin C with iron to support absorption." By the way I was told when taking iron with Vitamin C that it stopped the discomfort some people had when taking iron.
Term of art which I cannot take credit for. Read that term “anemic brain” over a decade ago. I call RLS “the Beast” but made that one up myself. Neither meant to be taken literally. The “iron at night” thing as you know was not my discovery. I just delved into it more than the person who said on the blog that “there’s just something about that free floating iron at night that seems to help.” I did a very deep dive. I found it gripping and compelling. If I had a dollar for every hour spent researching I would be on my own island right now sipping Pina Coladas with an iron chaser.
More on Iron - Apparently the Albion Company (the maker of Ferrochel - aka Gentle Iron, Ferrous Bisglycinate Chelate) has been sold or merged with Balchem. I have read in many places previous (can't find it currently) that Vitamin C is not required for this type of iron supplement.
From Supplements review "Buffered upper GI absorption promoter - This patent (U.S. Patent 20130209577) covers the integration of Ferrochel with malic acid and another weak acid or base buffer to lower the pH of the small intestine, thereby improving absorption or bioavailability of Ferrochel."
Not to be left out - many, many breakfast cereals have a generous amount of fortified minerals including iron. I thought it was just Cream of Wheat, but many others have 10mg + of iron (not a small amount).
Yes, yes, yes and one more yes. I too have read that ferrous bisglycinate is so broken down (down to amino acids) that it's questionable if hepcidin can prevent it's ingress. Dare I say it also stands a better chance of crossing the blood brain barrier? Hmmm, a buffer??? To change the PH of the small intestine?? Next life I want to be a bio-chemist. No comprendo. Sounds like whistling in the wind, but then again I'm a goldfish when it comes biochemistry.
Thank you so much for the lively debate. I was one of those proud people when I first got my ferritin to 200, the nurse said it was too high and I stopped supplements. Granted I was supplementing in the morning with my coffee. It had no affect on my RLS.
I agree with you that iron is the number one thing for my RLS. I try to maintain a ferritin of 200 which is quite difficult. Not that getting to 200 is hard, even 300 is relatively easy for me. But keeping it consistent is tough.
Do you ever test your iron stores? How frequently? Where are you at?
BTW, I have read several studies on iron and athletes. I do take my iron in the morning before a 200 or 300km ride. Does it help? I have no idea, I still hurt everywhere.
Whaaat? Morning??? Not night? You must have your RLS well under control, you little athlete you. Who in "late middle age" doesn't hurt all over. I have an annual iron panel. Over the years ferritin has ranged from 50 to 100. You know me, I'm not a believer in getting my ferritin way up. Iron is my candy and my drug. I no more want my iron stores way high than I want my sugar way high. It's a heavy metal, tightly regulated by the human body. I would prefer to not have to take that nightly iron to be honest, but I guess you gotta pick your poison. I gotta get my tush on my bike. The weather has been very nice here in Chicago lately. 300km? 18 miles everyday? No wonder your RLS is better.
LonePine, we should take this to a PM. Where in Chicago do you live? I lived at 405 N. Wabash for several years, I worked in the "Diamond Building" (150 N. Michigan) for 15 years! I road my bike on the lake front everyday, except weekends 18 miles each way. Bought my first house in Naperville.
Yes, I monitor my ferritin, it does make a difference. I have been on Mt. Hood with a Ferritin of 30 and I couldn't breathe or talk. I have also been up Mt. Hood with a ferritin of 200, it was a walk in the park.
There is a limit, for me that is 200 above it I saw no benefit. Trying to maintain 200 is tough, I am either 75 points too high or 50 too low. I don't stress too much, but I do want to maintain it.
I would be interested in comparing notes with you. I am in a similar situation. Iron is my drug, I am dependent on pregabalin. I have been taking Vitamin D, Taurine and homemade kefir with some success. My sleep tracker shows me doing better overall, but my sleep is still inconsistent.
Not sure what the weather is like there, but I am doing a club ride today, only 50 miles but at least I am getting out.
Ouuu lalala, Oregon!!! What a big move from Chicago. I’ve grown a tap root I’m afraid. You’re kidding about the “only” 50 miles, right. All the people I know in “late middle age” would be dropping like flies. Probably carrying us off the trail on stretchers. You have a damn nice life there. What did you do on good old Wabash Ave?
My dear retired allergist once said if you’re gonna cheat on a diet then enjoy and don’t worry about it because the worry is worse than the calories. If the Pregabalin is working then take it and don’t worry about it. Same with the iron. What’s in a number anyways? 200 versus 230 versus 175. Don’t make yourself crazy.
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Iron article
Hepcidin as biomarker for RLS - study
Ever wonder why Vitamin D helps some of us and why the incidence of RLS is much lower in the tropics and higher in cloudy England?
For those seeking rest from RLS
