FERRITIN LEVEL

[Josana13]

What should my Ferritin level be to help with RLS? Secondly, can anybody recommend an iron supplement. I am anemic. Thank you

[ChrisColumbus]

Do you know what your ferritin level is at present? You should have a full panel iron test to include serum ferritin and transferrin saturation (TSAT) numbers. It should take place in the morning, after fasting overnight (nothing other than water), having not taken iron supplements or multivitamins containing iron for 48 hours before.

You must then insist on getting the actual numbers: there's a very wide range of ferritin numbers that a doctor will call 'normal' and most don't know that RLS sufferers need higher levels.

Boosting serum ferritin to above 100 μg/L, ideally 200, helps a majority of RLS sufferers - but some of us naturally had levels well above this and still had RLS symptoms.

In my case other drugs (statins - but sedating antihistamines, most antidepressants etc can also trigger RLS) and diet (in my case too much sugar, too much caffeine, artificial sweeteners particularly aspartame - but we're all different) still caused RLS until I took magnesium and stopped/cut back on the above.

[ChrisColumbus]

On the basis of a consensus of RLS experts, it is recommended that all RLS patients with serum ferritin concentration of 75 μg/L or less and transferrin saturation below 45% should receive a trial of oral iron therapy......

A common oral iron regimen is 325 mg of ferrous sulfate - or 50-75 mg of ferrous bisglycinate (Gentle Iron) if you have difficulty tolerating iron - in combination with 100 to 200 mg of vitamin C with each dose to enhance absorption, once every second day. Iron is best absorbed on an empty stomach.

However, some can't even tolerate Gentle Iron: if your iron is low and you can't tolerate tablets (and/or want a faster result) an iron infusion would be best - but in some areas it's very difficult if not impossible to get an infusion unless you're actually diagnosed anaemic.

[SueJohnson]

Since you are still anemic, you should try and get another iron infusion like you had before. I assume you were tested after that and you are still anemic. If you haven't been tested recently you should. Since you had surgery recently if you were tested after your surgery your transferrin saturation is a better indicator of whether you need an infusion or iron supplements. So If it is below 20%, you definitely do.

Take iron supplements a few hours apart from your blood thinners to avoid interactions. Iron binds with blood thinners, potentially reducing the effectiveness.of the blood thinners and of the iron so your doctor should figure out the right balance.

If you can't get an infusion then as Chris said take 325 mg of ferrous sulfate or 50 mg to 75 mg 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 or iron infusion to slowly raise your ferritin. Ask for a new blood test after 8 weeks if you have an iron infusion or after 3 months if you are taking iron tablets.