Oral Iron supplements, doing it wrong!

[WideBody]

Well, I got my full blood test back and after some analysis, I think I messed up.

I have been supplementing daily with 36 milligrams of ferrous bisglysinate. Here are my lab results that concern me.

Ferritin was 72! This is my lowest since my infusion in 2016. Eight weeks after my infusion I was 114. I do not want another infusion.

TSP was 41... That's ok.

POTASSIUM 3.8 --> 3.5-5.3 mmol/L

Interesting, I put 1 teaspoon of Potassium citrate in every water bottle. about 1,700mg of potassium citrate. I buy potassium citrate by the kilo .

CALCIUM 8.8 --> 8.6-10.3 mg/dL

I have been supplementing with calcium 250mg twice a day with my coffee. I tie it to the coffee so I remember.

PROTEIN, TOTAL 6.2 --> 6.1-8.1 g/dL

ALBUMIN 4.3 --> 3.6-5.1 g/dL

GLOBULIN 1.9 --> 1.9-3.7 g/dL (calc)

I need to eat more protein. I am a carboholic.

RED BLOOD CELL COUNT 4.23 ->> 4.20-5.80 Million/uL

HEMOGLOBIN 13.3 ->> 13.2-17.1 g/dL

HEMATOCRIT 40.2 ->> 38.5-50.0 %

OH NO, that's not good at all. Nobody wants to live on minimum wage and low energy. Yes, I am normal and in range, so the doctors would say. Everything is 'fine' or 'normal', right!

A month after starting liquid ferrous sulfate, I got my Hematocrit to 51%. I would have been flagged for doping in the Tour De France! 40 is low end for me.

Did anyone spot the problem? It took me awhile to figure it out?

36 milligrams of ferrous bisglysinate only contains 7.2 milligrams of elemental iron. It is no where near enough for me to keep my ferritin up. The recommendation is 65 milligrams of elemental iron. The RDA for iron is 8 milligrams.

This a very interesting study showing the safety of ferrous bisglycinate in pregnant women. They were giving pregnant women 120milligrams of ferrous bisglycinate! Please don't skip this study, it has some really good information.

ncbi.nlm.nih.gov/pmc/articl...

"One in particular, ferrous bisglycinate, has been demonstrated to have at least two-fold higher bioavailability and absorption compared to conventional iron salts, including ferrous sulfate and ferrous fumarate, while also resulting in improved oral tolerability during pregnancy."

"The role of ascorbic acid in iron homeostasis relates to its prolific ability to enhance enteric iron absorption. It is effective at restoring iron balance and imparts metabolic benefits, owing to its antioxidant and anti-inflammatory properties. Ascorbic acid alone over a two-month period has been definitively shown to correct IDA in supplemented subjects ."

Wow, I messed up and it shows! I feel it too. Before my test I predicted it I was going to be low on iron based on energy levels.

Addition note:

VITAMIN D,25-OH,TOTAL,IA 64 30-100 ng/mL

I take either 10000IU of Vitamin D a day if I have been outside. 20000iu a day if I am not outside.

It is harder for me to raise my Vitamin D then to raise my ferritin.

I intend to up my oral iron to 135milligrams a day (3 * 45milligrams) from 36milligrams. I will retest in about 6 months.

Cheers!

[SueJohnson]

I assume you know this but just in case you don't: Take your iron 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. Also antacids interfere with its absorption so should be taken at least 4 hours before the iron or at least 2 hours after. 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. If you take thyroid medicine don't take it within 4 hours. It takes several months for the iron tablets to slowly raise your ferritin. Normally you would ask for a new blood test after 3 months.

For your test: Stop taking any iron supplements including in a multivitamin 48 hours before the test, don't eat a heavy meat meal the night before and fast after midnight. Have your test in the morning before 9 am if possible.

[WideBody in reply to SueJohnson]

Did you see the study? I quoted

“The role of ascorbic acid in iron homeostasis relates to its prolific ability to enhance enteric iron absorption. It is effective at restoring iron balance and imparts metabolic benefits, owing to its antioxidant and anti-inflammatory properties. Ascorbic acid alone over a two-month period has been definitively shown to correct IDA in supplemented subjects .”

Ascorbic acid is Vitamin C.

[SueJohnson in reply to WideBody]

I didn't look at the study but I originally had vit C in my answer but then edited it to remove it since I looked back and saw your quote..

[bumblebee_tuna]

Isn't oral iron poorly absorbed, with or without vitamin C?

[WideBody in reply to bumblebee_tuna]

The study I linked to said a couple thing.

1) vitamin C alone has been shown to help restore iron balance.

2) ferrous bisglycinate, has been demonstrated to have at least two-fold higher bioavailability and absorption compared to conventional iron salts, including ferrous sulfate and ferrous fumarate, while also resulting in improved oral tolerability during pregnancy.

Ok, so I am not pregnant. I do think ferrous bisglysinate is a good source of iron. I wasn’t taking enough!

[SueJohnson in reply to bumblebee_tuna]

Vit C or some orange juice creates an acidic environment which helps iron be absorbed.

[DicCarlson]

Iron is a complex and confusing ingredient in human health, and a huge player in RLS. Lots of information here...

irondisorders.org/

They allude to a new "on the horizon" product - bioFe. Info here...

siderobio.com/the-product.html

[WideBody in reply to DicCarlson]

Thanks as always. Great site, I will parse it later today.

There is a BioFe for kids it contains Iron pyrophosphate (III) elemental? Whatever that is. It’s only available for children, very small doses. I wonder if there is a connection?

[DicCarlson in reply to WideBody]

You could try contacting them with a question about adult use and dosage. When I was a child (under 7 years) I remember having "growing pains" and being treated for iron deficient anemia. I never had RLS as an adult 'till my 60s.

[Baz33]

Why are we prescribed sulphate and not the other? I was told yesterday NOT to take the bisglyconate

[WideBody in reply to Baz33]

I can’t imagine why anyone would say to not take bisglysinate.

Ferrous sulfate is the most common and inexpensive form of iron supplement. It is well-absorbed by the body, but it can also cause gastrointestinal side effects such as constipation, nausea, and diarrhea.

Ferrous bisglycinate is a newer form of iron supplement that is chelated with the amino acid glycine. This makes it more gentle on the stomach and less likely to cause side effects. However, it is also more expensive than ferrous sulfate.

Which one is better?

In terms of efficacy, ferrous sulfate and ferrous bisglycinate are equally effective at treating iron deficiency anemia. However, ferrous bisglycinate may be a better choice for people who are prone to gastrointestinal side effects.

Some studies show found bisglysinate is better absorbed, like the one I posted.

[SueJohnson in reply to Baz33]

To clarify what WideBody said, bisglycinate is better absorbed which is why even though it has less elemental iron than ferrous sulfate it is roughly equal. More specifically 120 mg of ferrous bisglycinate contains 24 mg elemental iron) is as effective as ferrous sulfate 50 mg elemental iron.