Advice on Iron Supplements Please

[Shad0w2]

My GP has agreed that I should have a blood test to check my iron levels but in the meantime has suggested that I should take an iron supplement 2-3 times a day. Based on previous advice seen on this forum, this seems excessive so I am thinking that I will just take gentle iron once a day as shown on the container. I would appreciate any advice on this please.

[WideBody]

If you are planning on getting a blood test for iron DO NOT supplement until after the test! It will absolutely without question skew the results.

[RKM7 in reply to WideBody]

Yes, I never knew I shouldn’t supplement prior to the blood test(makes sense!). I’ve read on RLS.org to avoid supplementing for 2 days prior to the lab draw. On this forum some have even suggested 5days or more. I also didn’t know that we should fast the night before the blood draw and preferably have the test in the morning for best results. Not sure why.

I have a full iron panel soon so I plan to follow this advice.

[Shad0w2 in reply to RKM7]

Than you for your advice, I will also make a point of checking about fasting before the blood test.

[Shad0w2 in reply to WideBody]

Thank you, that’s good advice, I will wait until after my blood test.

[Hidden]

Also you shouldn’t take iron supplements until you get your blood results you MIGHT not need to take iron depending on what your results say

[Shad0w2 in reply to Hidden]

Thank you. I have to wait 2-3 weeks before I get the test so I think the GP was hoping that the iron supplements might bring some short term relief in the meantime. However I think I will now wait until after the test

[Elffindoe]

A few things Drs don't tell you.

Iron metabolism changes over a 24 hour cycle. Better then to have an early morning test.

Also better to take the tablets in the evening and at least two hours after eating.

The tests should be for serum iron, transferrin saturation, (TSAT), ferritin and haemoglobin.

If iron and TSAT are low you have iron deficiency. If your haemoglobin is also low then you have anaemia. Either way you need iron therapy.

NOTE if you do have blood deficiency then iron therapy will have no effect on your RLS. It's necessary that the deficiency is corrected first.

If your GP says all tests are normal, then you need to know the exact result for ferritin.

Recommendations state -

If ferritin is less than 75 then statt an oral iron supplement.

If it's between 76 and 100 you may need an IV infusion.

The aim is to raise ferritin to at least 100. It is accepted that 50% of RLS sufferers can benefit from this level. Ideally 200 plus would be better.

It is widely accepted that iron is absorbed better in an acid environment. Taking vitamin C (ascorbic acid) or folic acid at the same time may thetefore help.

In addition taking an antacid or magnesium at the same time should be avoided. Leave a 2 hour gap.

Note proton pump and H2 inhibitor antacids can prevent iron absorption at any time.

Recent research shows that a low dose iron is better absorbed, e.g. gentle iron.

Taking iron only once every OTHER day can also increase absorption by 50%.

Taking iron daily reduces absorption, several times a day even more so.

Because of the way in which iron works for RLS do not expect iron to be effective immediately.

For most people it can take months for it to work. So if it doesn't work within days or a few weeks, KEEP taking it. Ask for a repeat ferritin test after 6 months.

A tip for you which I've found immensely useful. I have a LOT of blood tests!

All UK GPs are supposed to provide you with online access to your GP record, including blood results. I have been doing this for years. This way I can read the results for myself usually the NEXT DAY.

I got fed up of phoning for results and being told one of my results particularly was "OK" or " normal" when in fact it was never normal!

I've also found out lots of other things they've never told me and other things that have been wrong!

Try it!

[Shad0w2 in reply to Elffindoe]

Thank you so much for this, so much information which is really helpful. I am just about to phone the surgery to arrange my blood test appointment and will now ensure that it is for the morning. I do appreciate all the trouble you have taken to provide this amount of detail.