Too much iron and vitamins : Hi, Two weeks ago I... - Thyroid UK

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Too much iron and vitamins

Imps1234 profile image
25 Replies

Hi,

Two weeks ago I was given ferrous fumarate 305mg to take 3 times a day, since I have hypothyroidism and my iron levels were low. I have been taking them for two weeks now. I was also given Fluoxetine 20mg and have been taking those for 11 days for depression. Two days ago I bought Vitamin D 10ug tablets from the local pharmacy, as well as multivitamins and skin, hair and nail tablets. Overall I'm taking 7 tablets a day. I read the labels of all of them and I feel like I might be taking too much iron. I was just wondering if anyone knew whether there was any risk to taking all of these tablets. I don't want to do any harm to my body, I just want to get better.

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Imps1234
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greygoose profile image
greygoose

You won't get any iron out of the multivits, because iron is supposed to be taken just by itself (except for vit C). But you won't get much else out of them, either because they contain iron, and the iron nullifies most things. Multivits are just a big money-making con for the manufacturers.

But, impossible to say if you're taking too much ferrous fumarate because you don't say what your iron level was. Did you also have your vit D tested? How about B12 and folate? Most of us take more than seven tablets a day to build up our nutrients. It not the number of tablets that counts, but what's in them. :)

Imps1234 profile image
Imps1234 in reply to greygoose

My doctor said it was at a 4.7, when it should be at 4.2.

greygoose profile image
greygoose in reply to Imps1234

What, the ferritin? I think you'd be dead if it was 4.7. Ferritin levels usually go up to 150/200, something like that. Lower level about 15. But, if it was 4.7 and it should be 4.2, then that would be high, not low.

Don't you ever ask for a print-out of your results? If you live in the UK, it is your legal right to have one, under the 1998 Data Protection Act. I think you ought to go and ask for one. You need to know exactly what was tested, and exactly what the results were, and keep records for yourself.

Imps1234 profile image
Imps1234 in reply to greygoose

I do have a copy. It says that serum ferritin is at 4ug/L. Serum TSH level is at 4.7mU/L and Plasma fasting glucose level is at 4.4mmo/L.

greygoose profile image
greygoose in reply to Imps1234

Wow! that is very, very low ferritin! I'm surprised your doctor hasn't given you iron infusions. So, no, I think you'd have to take a lot of iron to take too much! It should be at least mid-range.

Your doctor is totally, utterly wrong about the TSH! When you are on thyroid hormone replacement, your TSH should be one or under. 4.2 is hypo. You're hypo as soon as your TSH hits 3.

Is that all he did? Just those three tests?

Imps1234 profile image
Imps1234 in reply to greygoose

There are a bunch of results on the paper. I'll post them here:

Serum TS4 - 17.5

SERUM sodium- 139

Serum Potassium - 4.2

Serum Urea - 4.2

Serum Creatinine - 78

Serum Chloride - 100

GFR calculated abbreviatedo MDRD - 80

Liver function tests:

Serum Total Protein - 79

Serum Albumin - 49

Serum total bilirubin - 7

Serum alkaline phosphatase - 60

Serum ALT - 14

Serum cholesterol- 4.9

And there are a lot more. Another page full of results.

humanbean profile image
humanbean in reply to Imps1234

Do you have a result for vitamin D? This often looks something like

Serum 25-HO vit D3 level

on your results.

And what about vitamin B12 and folate? Any sign of those?

Imps1234 profile image
Imps1234 in reply to humanbean

I've just checked and there isn't any results for those 3.

greygoose profile image
greygoose in reply to Imps1234

Serum TS4? Are you sure that's not FT4? If so, do you have a range for it?

Imps1234 profile image
Imps1234 in reply to greygoose

Sorry I meant:

Serum free T4 level - 17.5pmol/L.

And the range is 10.50 - 24.50pmol/L.

Sammeds1992 profile image
Sammeds1992 in reply to greygoose

I'm all fairness my Ferritin level is 6 I feel awful and still the gp won't provide me with a transfusion 12 years I've had this iron tablet for 6-12 months then I come off and it drops again and then the same cycle :( I try extremely hard to get iron into me through my diet but nope :(

greygoose profile image
greygoose in reply to Sammeds1992

Sammeds, no one is going to read this thread, now. It's 4 months old. If you have a question about iron, start a new thread. :)

humanbean profile image
humanbean in reply to Sammeds1992

Lots of people cannot hold on to iron and have to take it all the time. You take one dose for increasing iron and ferritin levels, then a lower dose for maintaining it when you get to optimal. There is no point in stopping the pills, becoming deficient, improving levels, then stopping again. Constantly dropping to deficient levels is pointless.

Assuming you live in the UK you may not be aware of it but prescription-strength iron supplements of the type that GPs prescribe can be bought without a prescription either online or in pharmacies at the pharmacist's discretion. If a pharmacist refuses to sell, just go to another pharmacy. I was always able to buy decent strength iron supplements from Tesco pharmacies and Lloyds pharmacies.

It will take a long time to raise such deficient ferritin levels. It took me nearly two years, some people take even longer.

What kind of iron tablets are you taking, and at what dose? You may not be taking enough.

humanbean profile image
humanbean

How are you coping with that dose of ferrous fumarate? It is a very high dose and a lot of people don't tolerate iron very well. Each of your capsules contains 100mg of pure iron, so you are taking about 300mg of pure iron per day. Are you taking tablets called Galfer capsules? They contain ferrous fumarate 305mg and sound like what you are taking.

The Patient Information Leaflet for Galfer capsules says that the appropriate dose for iron deficiency is one capsule twice a day :

medicines.org.uk/emc/PIL.25...

The BNF (British National Formulary) which is the info your doctor relies on to know what they can prescribe, suggests that the maximum dose of pure (elemental) iron to be taken per day for the treatment of iron deficiency should be about 100mg - 200mg per day.

evidence.nhs.uk/formulary/b...

You might want to reduce your dose of capsules to one, twice a day. If you aren't already doing so, it is a good idea to take vitamin C with iron supplements. The normal suggested dose is 500mg - 1000mg vitamin C with each dose of iron. It has two effects - vitamin C helps the body to absorb iron. Also, vitamin C can cause diarrhoea in high doses. If you adjust the vitamin C dose to your needs you can avoid the problem of constipation caused by the iron, which makes people feel a lot more comfortable.

If you don't tolerate the ferrous fumarate at all there are other options. You might find this document helpful, written by one of the admins, helvella :

Link : dl.dropboxusercontent.com/u...

Imps1234 I've just added the above link - sorry I forgot to do it earlier.

If you eat meat then a once weekly or twice weekly helping of liver will help to raise your iron. If you don't like liver it can be cut up or minced up and cooked in other meaty dishes to try and disguise it.

Regarding your vitamin D, a dose of 10ug is very low indeed, and probably won't make much of a dent in a deficiency. Do you know whether or not you are deficient in vitamin D?

You will find most people on this forum refer to vitamin D in units other than ug. Most of us use iU instead. 10ug is equivalent to 400 iU of vitamin D. In the event of a deficiency many of us need to take anything from 2000 iU - 10,000 iU per day of vitamin D3.

Imps1234 profile image
Imps1234 in reply to humanbean

I live in the UK and there is barely any sun at the moment so I think taking Vitamin D will help with any deficiency. I've been taking 3 iron tablets; the box they are in says ferrous fumarate 305mg on it. They are in capsules which are half green and half red. The first few days I had an upset stomach, but since then it's been fine.

humanbean profile image
humanbean in reply to Imps1234

Yes, I agree that taking vitamin D will help with any deficiency, but I doubt your dose is anywhere near high enough to have much effect.

I had moderate levels of vitamin D, not really bad, but they weren't optimal either. I started taking 1000 iU vitamin D per day, and my levels actually dropped.

In order to improve my levels I needed a minimum of 3000 iU per day, and to maintain them I needed 2000 iU per day.

My vitamin D requirements are actually quite modest compared to many on this forum. Most people take a lot more than me. This is why I'm dubious about your dose of 400 iU per day doing any good.

Imps1234 profile image
Imps1234 in reply to humanbean

I think that kind of dose can only be prescribed by the doctor. My brother had to take them a year ago, so he went to the pharmacy to buy it, but they wouldn't give it to him without a prescription.

humanbean profile image
humanbean in reply to Imps1234

You can buy high dose vitamin D from Amazon with no difficulty at all. :)

Imps1234 profile image
Imps1234 in reply to humanbean

Really? Well I'll go check know that out right now. Thank you. 😊

bluebug profile image
bluebug in reply to Imps1234

I've brought 10,000IU, 5,000IU and 2,500IU supplements from two of my local independent pharmacies. I've brought similar from Amazon and online pharmacies.(The 10,000IU were for other people.)

A GP at my practice agreed that I should take 5,000IU to get my number up to optimal range of 75.

I'm in London and due to the number of people who are deficient independent pharmacies know that they can sell these high doses as many GPs tell patients to buy their own supplements if the patient is not severely deficient.

humanbean profile image
humanbean

I notice you've started fluoxetine (Prozac) recently. Depression is a symptom of both nutrient deficiencies and untreated or under-treated thyroid problems. If you manage to fix those problems you probably won't need the anti-depressants at all.

bluebug profile image
bluebug

To be told to take 3 x 305mg of iron per day you must have iron deficiency anaemia. If you need to take that much then your GP should have referred you to a haematologist, as the only people I know on such high doses have seen a haematologist first.

The normal ferrous fumerate or ferrous sulphate tablets people are told to take tend to be around 210mg out of which 65-72mg is the elemental iron. So in fact you end up taking about 195-216 mg of elemental iron a day. Out of which you absorb anything from 20-33% of it.

Anyway for more informed help from other posters an you please post:

1. Your haemoglobin or haemoglobin estimate result (they are the same thing),

2. Your ferritin result with units AND ranges.

3. Your vitamin D result or Serum 25-OH vit D3 result WITH units.

4. Your vitamin B12 result WITH units AND range

5. Your folate result WITH range.

The results you have posted so far apart from your TSH and T4 are just liver and kidney function tests, and aren't useful on their own in working out if you have nutrient deficiencies.

Imps1234 profile image
Imps1234 in reply to bluebug

I dont have any results for Folate, B12 or Vitamin D. I don't think I was tested for those.

But the ones I do have are these:

Serum Ferritin - 4ug/L, in range 10.00 - 160.00ug/L

Haemoglobin estimation - 80ug/L, in range 120.00 - 150.00g/L

bluebug profile image
bluebug in reply to Imps1234

You do have iron deficiency anaemia but as stated by humanbean in detail your prescription is not standard.

You should go back to the GP with the tablets in their packaging and confirm the dosage. If the GP asks why show them the patient information leaflet and simply state you are confused to why you are taking more than stated.

If the GP doesn't explain why you need a non-standard protocol or is rude, then make sure you don't see that GP in the practice again or change practices.

Due to your low ferritin level as well you are going to be on the iron tablets for a few months after your haemoglobin level gets to 120g/L. Lots of GPs do not alter prescribed doseages and this is when problems can occur.

bluebug profile image
bluebug

I just realised no-one has explained to you why we are concerned with the information on your iron supplements you have stated.

There are people who can easily end up with iron overload, haemochromatosis, if they are prescribed supplements.

Some people have an inherited haemochromatosis but unless they have a close relative who knows they have this they are unlikely to know they are at risk and if they are lucky be tested for it.

Even if you don't have an inherited form, there are some GPs who see a low ferritin level and prescribe too much iron leading to haemochromatosis. There have been a few posters on here who have reported this.

Initial symptoms tend to be that of low iron levels e.g. fatigue, hair loss, weakness plus others like brown patches on the skin and joint pain.

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