So glad to have found this wonderful forum! I am a 74 year female who recently started taking pregabalin for RLS. I just got back my ferritin level and it is 12. I will order some iron and would like to know how many mg is a good dose. Also, I started taking niacin 500mg daily for my cholesterol. Niacin will cause insulin resistance for about 6 months, and I was going to take berberine to counteract that as it has been shown to decrease insulin and HbA1c. My lab 2 weeks ago showed my HbA1c to has
increased to a pre-diabetic level, 5.9. I just learned that berberine can decrease iron 😒 so I did not start. Apparently it decreases the absorption. My question is, do you know if I can take the berberine if I take it hours apart from the iron? Thanks for your responses.
Written by
glorious-granny
To view profiles and participate in discussions please or .
Welcome to the forum. You will find lots of help, support and understanding here.
If you take blood thinners, iron binds with blood thinners, potentially reducing the effectiveness.of the blood thinners and of the iron so check with your doctor. Otherwise, take 325 mg of ferrous sulfate which contains 65 mg of elemental iron, the normal amount used to increase ones ferritin, or 50 mg to 75 mg (which is elemental iron) of iron bisglycinate with 100 mg of vitamin C or some orange juice since that helps its absorption. Ferrous sulfate is fine for most people, but if you have problems with constipation, iron bisglycinate is better. 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. 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. Ask for a new blood test after 3 months or after 8 weeks if you have an iron infusion.
Take your iron at night and your berberine in the morning and that will help.
Better yet if you can get an iron infusion it will more quickly raise your ferritin and wait several days - perhaps a week -before starting your berberine.
What about taking lactoferrin for better iron absortion? ( I also just made a general post about this - not sure if it went to the RLS community so I am writing to you her about it.)
You might want to consider taking something else for your cholesterol. Triglide (Fenofibrate, Fibricor, Lipantil, Lipofen, Supralip) and Bezafibrate (Bezalip) which are not statins which seem safe. You might want to discuss these with your doctor. A more difficult way to reduce cholesterol is to go vegan. My husband lowered his cholesterol from 221 to 131 this way.
Since you take pregabalin you should be closely monitored as it can raise the bad LDL and lower the good HDL.
Meanwhile some things that can make RLS symptoms worse for some people are alcohol, nicotine, caffeine, sugar, artificial sweeteners, carbs, foods high in sodium(salt), foods that cause inflammation, ice cream, eating late at night, oestrogen (estrogen) including HRT, dehydration, MSG, collagen supplements, electrolyte imbalance, melatonin, stress and vigorous exercise. Some things that help some people include caffeine, moderate exercise, weighted blankets, compression socks, elastic bandages, masturbation, magnesium glycinate, fennel, low oxalate diet, selenium, 5 minute shower alternating 20 seconds cold water with 10 seconds hot water finishing with hot water for another couple of minutes, hot baths, distractions, CBD, applying a topical magnesium lotion or spray, doing a magnesium salts soak, vitamins B1, B3, B6, B12, D3, K2, if deficient, and potassium and copper if deficient, massage including using a massage gun, vibration devices like therapulse, using a standing desk, listening to music, meditation and yoga. Keep a food diary to see if any food make your RLS worse.
Many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute.
Thanks so much for all your invaluable information. Other medical problems are Ehlers Danlos Syndrome, IBS, mild CAD, HTN, hypothyroidism . I had Hashimotos during pregnancy, but after tx it resolved and have no antibodies.
I am taking pantoprazole, a PPI, which I know decrease iron absorption. Also taking atenolol, lubiprostone (generic amitiza for chronic constipation), bupropion, vitamin D3 5000 units, vitamin k2, cetrizine prn, occasionally trazadone for sleep (but at times it makes my RLS crazy), diazepam prn muscle spasms (from my EDS), levothyroxine 50 mcg(I think I need to go up on this), nasalcort spray. Also taking citrus bergamot and berberine, I use topical mg cream at night which helps sometimes.
My doc prescribed the pregabalin 50mg prn, said not to use it every night to avoid side effects. Kind of crazy, I know, but at least she prescribed it, as originally she suggested ropinarole and I knew from your info not to take it. I can take more if I like, and although I know it is not supposed to be used as a prn, I find my RLS is bad 3 or 4 nights a week and if I can get to sleep fast, it usually does not wake me up. I do have trouble with insomnia. The pregabalin really helps me sleep. I have occasionally taken 2 caps when the RLS was bad. I know I can go up but Im afraid to reach a high level that eventually won't work any longer.
On the pregabalin your dose is low. The normal starting dose is 75 mg unless you are susceptible to falls in which case it is 50 mg. And as I mentioned the usual effective dose is 200 to 300 mg. I am 83 and take the equivalent of 250 mg.
I wouldn't worry about increasing it since you can go up to 600 mg. If it works as it seems to be doing for you, it will continue to work at the amount that works for you and although you may have to increase it to continue having it work it will be many years before that happens and it would only need to be increased by 25 mg, so that's not a problem.
However you do need to take it every night. You may be able to get away with only taking it this way now but if you increase it as you should so that you don't need to worry about having to get to sleep really fast especially since you suffer from insomnia and find the pregabalin helps you sleep you will suffer from withdrawal effects if you don't take it every night.
As far as side effects taking it every other night isn't the way to avoid them. If you have any they usually are mild and will go away in a few weeks. Print out and give or show your doctor part of the Mayo Updated Algorithm that discusses pregabalin. If he refuses to read it and to give you the amount of pregabalin to completely control your symptoms, you may need to either ask him/her to refer you to a neurologist or get a new doctor which is easy in the US compared to the UK. If so ask the neurologist or new doctor if they follow the Mayo Algorithm. If you nee the name of a doctor let me know the city and state you live in and I may be able to give you the name of a good one.
Atenolol is a beta blocker which make RLS worse for most. Some medicines that are safe for high blood pressure are propranolol (Inderal, Hemangeol, InnoPran) a beta blocker that may help RLS, Isosorbide Mononitrate (Monoket, Imdur) which is not a beta blocker nor calcium channel blocker. Other possibilities are: Clonidine (Catapres) an Alpha-2-Agonist used to treat high blood pressure which may help RLS and which also treats insomnia, tenex (Guanfacine, Intuniv), prazosin (Minipress) an alpha-adrenergic blocker that is also useful in managing sleep-related problems caused by PTSD and Tadalafil a vasodilator that in one study completely eliminated RLS. Clonidine can actually help RLS. Discuss these with your doctor. And then there is reducing salt by 1 teaspoon a day nih.gov/news-events/nih-res....
Otherwise everything you are taking is OK. Although as you mentioned your PPI will will interfere with the iron absorption so all the more reason to get an iron infusion if you can.
Hi Sue, I requested a cholesterol test having noted what you mentioned in your reply to Glorious granny as I have been taking Pregabalin for some time - this is the response from my GP. “regarding your pregabalin and cholesterol monitoring. I can confirm that this is not an issue that is indicated in the BNF and we would not require to monitor your cholesterol as a result of using this drug so you can continue to take this appropriately without the monitoring you suggest”
Please could you let me know if you believe that this information is incorrect? Thanks.
How much pregabalin are you taking? Does i control your RLS? According to the Mayo Clinic Updated Algorithm on RLS: "Most RLS patients require 200 to 300 mg of pregabalin."
Check out the Mayo Clinic Updated Algorithm on RLS which will tell you everything you want to know including about its treatment and refer your doctor to it if needed as many doctors do not know much about RLS or are not uptodate on it at Https://mayoclinicproceedings.org/a...
FYI - I have been taking Berberine for awhile for cholesterol lowering and just found a "better absorbed" but of course more expensive version. It's called BerbVis developed by Indena. It's in a product by Solaray called Prosorb Berberine. I take it every other day with regular Berbine on the day off.
My severe RLS was brought under control with Iron supplements - ferrous bisglycinate. Many sleep issues remain. I originally took Berberine to control SIBO (Small Intestinal Bacterial Overgrowth), which is linked to RLS in some studies. I used the herbal treatment which included berberine to control SIBO.
Thanks..I will certainly check out this brand. Has it had any impact on your iron levels? When I was looking into this, a lot of people on several threads in reddit reported it markedly decreased their iron levels. I really want to continue taking it for its positive affect on insulin resistance.
It could have an effect on iron levels as it is touted in some studies as a treatment for excess iron (iron overload). I'm not sure what the consequences of taking it if your iron levels are very low. I have had no effect on my iron levels in recent months with the new supplement and I took the usual supplement for perhaps a year before that.
I will...except from all I read, it is supposed to be taken 2-3x day because it has a short half life. But once a day is better than none...I will take the brand that DicCarlson recommends for better absorption.
DicCarlson, I just read the links you posted re: SIBO. Results were amazing , that all the people they tested so far had SIBO, albeit only 7 people. You said you took berberine to control it. Was that the only things you did or was there some other treatments you followed? Still have the same question to you about berberine and decreased iron, but it sounds as though that did not decrease your iron. I wonder if more people with RLS should be tested for SIBO and if the RLS centers and specialists do this?
Let me modify my answer on iron - sometime I answer too quickly Since your ferritin is so low take two tablets of 325 mg of ferrous sulfate or 75 mg to 100 mg of iron bisglycinate if you can't get an iron infusion.
Thanks, Sue. I will check out those meds. I was taking atenolol, and have been for years, because of arrythmias that occur with tachycardia at times so I will see which meds seems to be also good for that, although my heart has been better since I stopped drinking alcohol. I like my doc, and she is right on with some things, like not pushing statins on me, ordering any labs I want and being open to all I suggest. She is a good doc, but knows squat about RLS. I live in Maryland near Baltimore, and I know you mentioned one doctor who you said may not be taking patients at this time. I forgot his name? I did check his website at that time and it did not mention he was not, so I could call and see. Any other docs or neurologists that you can recommend in the DC, Maryland or Virginia area would be great. Medicare won't pay for infusions unless oral meds have been shown to be ineffective, or basically you have some god awful condition, so I will try the iron bisglycinate with vitamin C. I am so glad to have found this group and you, and am hopeful that the iron will help. I think I have had low iron for quite awhile because my MCH has been down for some time and doc did not pick this up...I did and requested the labs. (And also read all you said about iron and had never been tested.)
I very much appreciate all your knowledge and advice.
Johns Hopkins is a Quality Care Center, one of only 12 in the world and have the best experts on RLS and follow the Mayo Algorithm. This is probably what I mentioned.
If you can, get an IV iron infusion. With a ferritin of 12, you probably have nothing in your brain. You need a big boost. I don't know enough about how it will affect your other medical conditions to comment further but know it helped me turn the corner on my RLS. Good luck!
Thanks...I will try, but Medicare will not pay unless oral meds have not helped to raise it or you are bleeding out or have some kind of serious affliction. It seems as though it costs anywhere from $400-$4000, and at the moment I can't afford that. I will definitely check it out though and appreciate your input.
I couldn’t get my iron levels up quickly after a year of trying on iron supplements. I found grass fed blood capsules and with 3 months my ferritin went up to 165 from 14. My doctor and myself were shocked.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Iron
Brain iron vs Blood iron
Iron 
Gabapentin/Iron Doses
