Ferrous Fumerate and pre-existing Reflux

[Hellio]

Any tips on how to take ferrous ferritin when you are already prone to reflux (for which I take a PPI)? My guts have just about put up with FF since December, and it has greatly improved my RLS, but increasingly given I take it at night it’s caused bad reflux and I had a massive flare recently during which I had to stop taking the iron supplement altogether. It’s not recommended to take antacids close to a dose which leaves me really stuck. I will go back to half a dose that is 500 mg to start again - and will have with my dinner each night - once this has calmed down as I don’t want my iron levels to drop too much. I’m just wondering how sustainable taking this supplement is as I really don’t want to get an ulcer. I’m waiting for an appointment with my RLS doctor, to advise on this . It’s a shame because I have found this very helpful, although not a complete cure.

My ferritin is now around 150. Once you have achieved your goal of 200 do you have to continue taking the same large dose of FF every night or do you take a lower dose to just keep it at that level? I don’t want it to keep going up and up and up indefinitely, presumably. I can’t find my latest transferrin measurement which is also important, but it wasn’t quite up to the target.

Many thanks in advance.

[SueJohnson]

BetterYou Iron oral spray delivers 5mg of highly bioavailable iron directly into the bloodstream, bypassing the digestive system however you need 65 mg. A better option would be to get an iron infusion.

What antacid are you taking? Many will make RLS worse.

If you continue with the tablets you are right that antacids should be taken at least 4 hours before or 2 hours after. However since you are having problems with that you can take them together. They limit absorption but you could take 2 tablets to counter that. Take your iron tables with 100 mg of vitamin C or some orange juice since that helps its absorption. Take it every other day preferably at night at least 1 hour before a meal or coffee or tea and at least 2 hours after a meal or coffee or tea since iron is absorbed better on an empty stomach and the tannins in coffee and tea limit absorption. If you take magnesium, calcium or zinc, even in a multivitamin, take them at least 2 hours apart since they interfere with the absorption of iron. Don't take your iron tablets before or after exercise since inflammation peaks after a workout. Don't take tumeric as it can interfere with the absorption of iron or at least take it in the morning if you take your iron at night.

As mentioned you can take them every other day as that is the normal advice. If you want to take them every day be sure they are 24 hours apart.

No you don't have to continue it at that dose. You could stop and then have it checked at 6 months to see if it has gone down.

If the above doesn't work. Take the iron with some food.

You say 500 mg. Check the bottle and see how much elemental iron it has. 65 mg is the normal dose. So cut the pills down to get this amount.

[Jumpey in reply to SueJohnson]

Orange juice and ascorbic acid tablets cannot be taken by people who suffer from relux.Far too acidic and dangerous.

[Hellio in reply to Jumpey]

I quite agree, not to mention my pesky blood sugar! Thanks.

[SueJohnson in reply to Jumpey]

You're absolutely right. I knew that but missed it. Sorry.

[SueJohnson]

Instead of a PPI which can make RLS worse, take Gaviscon Extra Strength tablets which are safe for RLS. Discuss this with your doctor.

[Hellio in reply to SueJohnson]

Thanks, a lot to digest (sorry) there. Will adjust dosage when I get back to it. I took vitamin C tablets with the FF having noticed after three months of nightly orange juice, which I normally avoid, my blood sugar had shot up. I had planned to discuss infusions with my specialist when he finally gets back to me.

I remain grateful for the iron protocol though it ebbs and flows somewhat in efficacy as it changed my life without horrid drugs, none of which agree with me.

[Munroist]

Iron bisglycinate is often well tolerated and easier on the stomach as far as I’m aware, hence the trade name “gentle iron”. You can get it from Holland and Barrett and I successfully raised my ferritin from 70 to 170 µg/L using it over a year. I have never tried ferrous fumarate so I don’t personally know how they compare though. I have absolutely no stomach issues with Iron bisglycinate

[Hellio in reply to Munroist]

Thanks for that, it sounds promising. I read the research article about the iron protocol and the recommended dose was exactly what my specialist suggested: 600 mg (!) of ferrous fumerate nightly with orange juice or vit c tablets. It did the job but with various worsening gastric consequences. So as Sue says, once it’s up time to ease off a little. I’m glad you raised your ferritin that way.

[Amrob]

Is it ferrous fumarate in particular that helps you? There are alternatives to iron supplements such as dessicated beef liver in capsule form. Many people find this helpful in getting iron levels up quite quickly. Also, in relation to Sue's comment, be aware that antacids and PPIs are not the samething. The former neutralises stomach acid, the latter reduces the production of stomach acid.

[Hellio in reply to Amrob]

Yes, this is apparently the clinically preferred version for a swift and effective increase in ferritin and transferrin levels, at a high dose. Thanks for the tip however.

[SueJohnson in reply to Hellio]

I agree with Amrob. You want to take heme iron which doesn't require Vit C. It can also be taken with food. The beef liver is one form of heme iron.

[AHG123]

I thought ferritin level of 100 was what you were meant to aim at?

[Hellio]

From where I am It keeps changing frankly, the literature suggests 150, but somewhere else (here?) I read 200 is ideal. I started at around 70, which is probably average. Just as important is your transferrin result - sorry I can’t recall what that should be, but I’m not there yet.

[SueJohnson in reply to Hellio]

You want your transferrin saturation to be between 20 and 45.