Iron supplement

[Blueskyyy]

Hi all

My most recent iron’s level is 10 range (4.1 - 24 ).

How much iron in mg per day should I take ?

I bought tablets that contain iron, vitamin c and folate.

I think one tablet contains 14 mg iron, is that enough?

Btw, I have hashimoto.

[SeasideSusie Remembering]

Are you talking about serum iron or ferritin?

Have you had an iron panel done? And full blood count? These will tell you if you have anaemia.

If it's just ferritin that you need to raise then eating iron rich foods (liver, liver pate, black pudding, etc) will can help.

Iron is complicated and nobody here is really qualified to advise you on whether you should take iron tablets or how much. It depends on many things.

As you have Hashi's, what are your other nutrient levels - B12, folate, Vit D?

[greygoose in reply to SeasideSusie]

Just out of curiosity, Susie, who does know about iron? GPs don't seem to. Does one need to see a hematologist?

[SeasideSusie Remembering in reply to greygoose]

I agree that GPs generally don't seem to know much (that's my experience of when my ferritin was low). One would hope that a hematologist would but getting referred to one - well goodness knows how you'd get that, referrals to anyone seem to be avoided as much as possible here in the UK.

I've had FBC done quite a few times in recent years but I have done my own iron deficiency check with Medichecks. If that was off I'd be taking the result to my GP.

[greygoose in reply to SeasideSusie]

Thank you.

There isn't any other sort of specialist that would know about that sort of thing?

[SeasideSusie Remembering in reply to greygoose]

Gastroenterologist maybe, they would look for problems with the digestive system - absorption or blood loss but I expect your levels would have to be pretty dire to be referred. I just despair at the whole system of looking at each symptom and treating them individually but not looking at the whole picture, there's no joining of the dots, no real doctoring any more, there doesn't seem to be much "care" any more, I find it all very depressing. And trying to get a referral for any problems .......... well that's another subject

[greygoose in reply to SeasideSusie]

Yes, I agree with you. It's dire. At least, here in France, we don't need a referral to see a specialist. We just pick our specialist and make an appointment. They would prefer you to have a letter from your doctor, but if you don't, too bad.

[Angel_of_the_North in reply to SeasideSusie]

I was referred to gastroenterology with just bottom of range ferritin

[SeasideSusie Remembering in reply to Angel_of_the_North]

Wow! Do you have a very on the ball GP?

[Angel_of_the_North in reply to SeasideSusie]

No, I would say they (never see the same one twice) were completely useless. They tap away on the keyboard and refer you to someone else at the drop of a hat. But they never prescribe or actually do anything to make you better, just pass the buck.

[SeasideSusie Remembering in reply to Angel_of_the_North]

Oh, a different ploy. Your surgery is "CBA, pass 'em on to someone else" and mine is "If we ignore them long enough they'll just die and we don't have to bother". Crikey, what a wonderful health service we have here!

[DIYqueen in reply to SeasideSusie]

Interesting. I have found the opposite to be true. Apart from thyroid meds (which my GP is trying to treat to protocols and I have to have regular debates with her) she is very quick to refer me. In last 12 months:

I had pain in right side/shoulder blade - referred straightaway for ultrasound. Found gallstones and referred for urgent surgery.

I had trouble with severe constipation/so difficulty eating/difficulty swallowing - referred to gastro same day! then had endoscopy (both ends) - though no link to possible thyroid lump??? All clear apart from small hiatus hernia and one polyp.

I had trouble with shaking (plus other parkinson symptoms) - referred to neuro to test for Parkinsons and had a DaT scan. All clear.

I had trouble falling over - referred to falls clinic who referred me to cardio to test for black outs due to arrhythmias. I now have a 'gadget' in my chest to measure for this, not found.

6 years ago I had some MH issues, referred within days to psych. Still supported regularly.

For 8 months this year I was seeing all four about once a month ie about one a week. Exhausting and VERY confusing to my hypo-fog brain!!

Now gone to GP with severe joint/muscle pain (+ others), tests ordered and she plans to have telephone call with rheumatologist to see if I need a referral! I just put my head in my hands! Can't fault her for being pro-active, but no joining of dots!

[SeasideSusie Remembering in reply to DIYqueen]

Well it's good to hear that some doctors care.

1) I have lung disease with 2 colonised infections that can flare up. Went to GP with obvious signs (to me) of infection. She added a steroid inhaler to my other 2 non-steroid inhalers, instructions to go back in a month. Went back, feeling worse, told to continue with steroid inhaler, go back in a month. 3 follow ups in 3 months, feeling worse then ever and asked to be referred to a lung consultant. GP refused saying she'd give me a gym referral - not on prescription so I had to pay for 32 sessions which did nothing for me. I ended up paying privately to see consultant who diagnosed flare up of one of the colonised infections, prescription for the correct antibiotic and transferred me to NHS list so I now see him on the NHS but not routinely, only if I have some problem and the Nurse Practioner thinks I need to see him (I don't bother with the doctor any more about my lungs).

2) Several episodes of tachycardia, ended up in A&E, 24 hour heart monitor, referral to cardiology done by Nurse Practioner, no appointment granted, further episodes, 2 week heart monitor, another referral done by Nurse Practioner, no appointment granted, echocardiogram, another episode, another referral done by Nurse Practioner, no appointment granted.

3) Son experiencing chest pain, ECG and referral to cardiology made by Nurse Practioner. Nurse Practioner arranged 24 hour heart monitor. Urgent phone call - did he loose consciousness while wearing heart monitor, come in for another ECG. Told there were gaps in heart trace where no heart activity showing. GP said heart monitor must be faulty. Didn't suggest arranging another heart monitor. No cardiology appointment forthcoming.

I could go on, unfortunately.

Just seems to be the luck of the draw or maybe it's just the Welsh NHS.

[DIYqueen in reply to SeasideSusie]

Oh dear! So sorry. What is a colonised infection compared to an ordinary one?

Number 3) !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[SeasideSusie Remembering in reply to DIYqueen]

A colonised infection is when the bacteria is present in your body (in my case in my lungs) and there are no signs or symptoms, it just lurks there. Then every so often something kick starts them into action and you get full symptoms of an infection and you need treatment.

[DIYqueen in reply to SeasideSusie]

Goodness! I naively thought that treatment eg antibiotics got rid of all infection. I know they jigger up the gut, but I have (on the rare occasion) immediately included more probiotics to rebalance. I didn't know some can 'hide'.

[SeasideSusie Remembering in reply to DIYqueen]

In my case I have COPD (narrowing of the airways) but further down in the bottom of my lungs I have Bronchiectasis - widening of the airways - which currently shows two pockets of this widening and muck collects (some people need to clear their lungs daily like Cystic Fibrosis patients have to). The bacteria is most likely lurking in these pockets just waiting for my immune system to have a bad day! Like many Bronchiectasis patients I am on maintenance antibiotics which is quite successful - 1 specific type of antibiotic tablet 3 times a week. It's quite successful and helps many patients reduce their flare ups to virtually nil or very few.

[DIYqueen in reply to SeasideSusie]

That's excellent. Glad to hear it, though sorry about the COPD. My mum had that. Not easy.

[Blueskyyy in reply to SeasideSusie]

i mean ferritin, and my MCH is 1.67 ( 1.65 - 2.07 fmol)

[SeasideSusie Remembering in reply to Blueskyyy]

So your ferritin is 10 range (4.1 - 24 ) which is 29.6% through range. Low ferritin can suggest iron deficiency anaemia.

Your MCH is very low in range. Low MCH shows that the red blood cells don't have enough haemoglobin. Haemoglobin is an iron rich protein and low haemoglobin can cause anaemia symptoms.

And if your B12 is low with low haemoglobin then that may indicate Pernicious Anaemia.

So a full blood count and an iron panel will show if you have any form of anaemia.

This is why just treating a low ferritin level with iron tablets isn't a good idea, as I said, iron is complicated, you need the full picture.

[Blueskyyy in reply to SeasideSusie]

What should I do then ?

I am not only taking iron, i take B12, folate and iron..: not enough ?

[SeasideSusie Remembering in reply to Blueskyyy]

Have you had a full blood count and iron panel?

What are your results for Vit D, B12, folate and ferritin.

[Blueskyyy in reply to SeasideSusie]

Ferritin 10.

I didn’t test Folate and b12 yet

[SeasideSusie Remembering in reply to Blueskyyy]

There really isn't anything else I can say. You really need those other tests. You really shouldn't be taking supplements unless you have tested and know your levels to see if you need to supplement and, if so, at what dose.

[Angel_of_the_North]

To get the same amount of iron as the NHS would prescribe you'd need between 9 and 13 of those a day