Im a little surprised my doctor phoned me today to say that my Ferritin is too low and for me to take iron supplement every other day and retest in 6 months. She told me to get 320mg elemental?
What type should I buy?
Iron panel:
Hemoglobin: 13.8g/dl (11.5-15.4)
Iron: 76mcg/dl (37-145)
Iron binding cap: 328mcg/dl (228-428)
Iron saturated: 23.2% (15-50)
Iron binding unsaturated: 252mcg/dl (112-347)
Ferrintin: 24ng/ml (13-150)
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Batty1
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Good that your GP contacted you ! I have read here that a Grass Fed Beef Liver Capsule from Anazon has produced good results. They are a little expensive. Taking VitC aids absorption.
Check out posts and Replies from humanbean who has excellent knowledge on iron and more ...
Hemoglobin - This is well within range so you are not anaemic.
Iron - Optimal is 55% - 70% of the way through the range i.e. approx 96 - 112. Yours is substantially lower than that so it suggests you could benefit from more iron.
Iron Binding Capacity - Mid range so doesn't suggest you need more or less iron.
Iron Saturation - Optimal is 35% - 45% so yours is too low, suggesting you could do with more iron.
Unsaturated Iron Binding Capacity - I never know what to say about this...
Iron binding capacity measurements are used in the diagnosis and treatment of anaemias. Serum iron is carried by binding to the transport protein, Transferrin. The measurement of the maximum concentration of iron that Transferrin can bind is called the Total Iron Binding Capacity (TIBC). Normally, only about one third of the iron binding sites of Transferrin are occupied by Fe (III); therefore, serum has considerable reserve iron binding capacity. This is called the serum Unsaturated Iron Binding Capacity (UIBC). Total Iron Binding Capacity equals the Unsaturated Iron Binding Capacity plus serum iron: TIBC = UIBC + Serum Iron.
Ferritin - Most people feel best when this is mid-range i.e. approx 80 - 85 with the range you've been given. If symptoms of low iron persist then going a bit higher is possible. To raise ferritin you need more iron.
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In your shoes with these results I would want to increase my iron and ferritin levels.
my doctor phoned me today to say that my Ferritin is too low and for me to take iron supplement every other day and retest in 6 months. She told me to get 320mg elemental?
When I was very low in iron I was prescribed Ferrous Fumarate 210mg (FF210), one tablet three times a day. This totalled 207mg of elemental (i.e. pure) iron per day, and I found that tough to tolerate. [This dosing pattern appears to have been superseded now, and alternate day dosing is recommended instead.]
BUT!!! I don't think your doctor actually meant what he/she said.
I'll use Ferrous Fumarate as an example.
One tablet of FF210 contains (surprise, surprise!) 210mg of ferrous fumarate. But that is NOT the same as saying it contains 210mg of pure iron. In fact, one tablet of FF210 contains approx 69mg of pure iron. The rest of the weight of FF210 is made up of carbon, hydrogen and oxygen.
So, I think your doctor is suggesting that you take Ferrous Fumarate 325mg (FF325) or Ferrous Sulfate 325mg (FS325), once every other day. (I've never seen ferrous fumarate or ferrous sulfate sold in a dose of 320mg.) Since, according to the wiki link I gave above, ferrous fumarate is 32.87% pure iron, then FF325 contains approx 107mg of pure iron.
Personally, I found ferrous fumarate easier to tolerate than ferrous sulfate, but opinions do vary. Another option that is sometimes prescribed in the UK is ferrous gluconate which has approximately half the pure iron content of ferrous fumarate and ferrous sulfate. The higher the pure iron content of a supplement the harder it is for people to tolerate.
Advice on how to take iron supplements has changed in the UK in recent years. We used to be told that they must be taken on an empty stomach. But that was intolerable for lots of people, so now we are advised to take them with food.
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I've just looked at US Amazon, and ferrous fumarate at decent doses is not common. Most higher dose supplements are ferrous sulfate. I found this one on US Amazon but I can't see a way of buying just one box. You'd be best to try other sites I think.
There are other choices of iron supplements that are completely different to the iron salts I've mentioned above. Helvella wrote a very useful document on the subject of iron supplements of different types :
I've never taken ferritin or heme iron supplements - they are hard to find and extremely expensive in the UK and usually have to be imported from the USA. People who have taken them prefer them and find them more tolerable than ferrous fumarate or sulfate or gluconate. But I have no idea about doses or how fast they will raise iron.
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Referring to the "every other day" instruction from your GP... This is based on recent research that suggests this increases iron absorption. I am not aware that the research has been replicated. I hope somebody does this soon.
Note that the research was carried out on a fairly small number of women. From the lancet link above :
For study 1, 40 women were enrolled on Oct 15–29, 2015. 21 women were assigned to the consecutive-day group and 19 to the alternate-day group.
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take iron supplement every other day and retest in 6 months
I think taking iron supplements for six months before testing is too long to wait. If you absorb what you take well then you could end up with far too much iron and/or ferritin. I would want to test after 2 or 3 months.
Well, personally I wouldn't take it - too little iron for me, particularly if taken just once every other day.
Some years ago (before I knew anything about iron) I had diabolical levels of iron and ferritin and started buying supermarket iron tablets which had only slightly less iron in than gentle iron (which is iron/ferrous bisglycinate), but the difference was small. My levels of iron and ferritin were still going down even when I was taking 9 of them a day.
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