Iron deficiency

[BigSue 1,320]

On 1/13/2021 at 2:40 AM, Pdub8112 said:

Have you asked about Iron injections?

No, I would rather not go that route if I don't have to. Fortunately, my iron levels are good now with the oral supplements I'm taking, so that shouldn't be necessary.

[catwoman7 10,844]

55 minutes ago, Darktowerdream said:

I think the Vitamins can be confusing, at least to me. I studied Holistic health and nutrition and I understand it but not when it comes to my own blood test results 🤣 I have taken whole foods based Vitamins since my gastric bypass surgery April 29th 2019. My Vitamin levels have done well. my previously very low Vitamin D even before surgery actually normalized. my Iron levels are within the normal range I try to get it from the whole foods based Vitamin and food even the gentle Iron supplement that claim no constipation cause severe Constipation and I have too much problems for that. what is extremely low is my Ferritin. I am not sure it correlates with iron deficiency or is as simple as iron supplements. I know my hormones must be whacked since I went into surgical menopause after having my last ovary removed due to endometriosis. as well as existing metabolic disorders. but my doctor and my surgeon just assume it is that simple to just take iron. but my levels stay the same. and of course say speak to the nutritionist. but I could not afford an appointment since its no longer covered I paid for a set amount of visits they wanted the same amount for one appointment that it cost for what I needed to have before my surgery and the post op visits. I have a endoscopy today. so Im a bit distracted.

Sorry I cant answer your question. It just seems to vary so much between each person.

Ferritin is stored iron - your "reserves" that your body grabs if your blood iron levels get too low. Usually when it drops below 30 or so they recommend infusions (although I know some people get them when it drops below 50, but not all doctors will authorize it at that level).

iron is one of the only levels that can be tough to bring up via supplements, but it does work for some people (did for me - my ferritin level once got fairly low - but it's fine now after I increased my iron supplement dosage a bit).

some people don't absorb iron well from capsules or tablets *at all*, even from the start, and they need to get occasional infusions to keep their levels up. A majority of us do fine on oral supplements, though.

[mae7365 372]

I was very anemic pre-bypass surgery (low serum Ferratin, Iron, hemoglobin and hematocrit). I later found out that anemia is one of the first signs of gastritis, esophagitis and GERD, which is why I had the bypass.

My doctor told me to take two 65 mg tables of Iron (Ferrous Sulfate) for 3 months then repeated my labs. After 3 months, my ferratin was normal, but total iron was high, so I went back to just one 65 mg tablet per day. That is what my surgeon recommended post bypass as well.

My surgeon does the first set of lab tests 5 months after surgery. I'm scheduled to get labs done in March, so I'm hoping to be in the "normal" range for all the Vitamins and minerals that he checks for to rule out malabsorption. From what I've read, very few RNY patients end up with malabsorption, as long as they take the recommended supplements - which for me is one Multivitamin, 2 calcium chews and on 65 mg iron pill. I get the B vitamins from the multivitamin, so I'm not taking any B-12 supplements.

[catwoman7 10,844]

1 hour ago, mae7365 said:

I was very anemic pre-bypass surgery (low serum Ferratin, Iron, hemoglobin and hematocrit). I later found out that anemia is one of the first signs of gastritis, esophagitis and GERD, which is why I had the bypass.

My doctor told me to take two 65 mg tables of Iron (Ferrous Sulfate) for 3 months then repeated my labs. After 3 months, my ferratin was normal, but total iron was high, so I went back to just one 65 mg tablet per day. That is what my surgeon recommended post bypass as well.

My surgeon does the first set of lab tests 5 months after surgery. I'm scheduled to get labs done in March, so I'm hoping to be in the "normal" range for all the Vitamins and minerals that he checks for to rule out malabsorption. From what I've read, very few RNY patients end up with malabsorption, as long as they take the recommended supplements - which for me is one Multivitamin, 2 calcium chews and on 65 mg iron pill. I get the B Vitamins from the multivitamin, so I'm not taking any B-12 supplements.

we don't have enough intrinsic factor to metabolize B12 that comes in a regular tablet, so if your level ends up getting too low, you'll most likely have to take it sublingually (a tablet that dissolves under your tongue) or via injection.

[mae7365 372]

2 hours ago, catwoman7 said:

we don't have enough intrinsic factor to metabolize B12 that comes in a regular tablet, so if your level ends up getting too low, you'll most likely have to take it sublingually (a tablet that dissolves under your tongue) or via injection.

Just checked that, and you're right. Either my chronic gastritis or gastrectomy can result in insufficient intrinsic factor. Thanks for the heads up. I'll get some sublingual B-12 tomorrow!!!!

[2Bsmaller18 435]

On 1/8/2021 at 11:47 AM, BigSue said:

I figured I'd post an update here in case anybody comes across this post wondering about the same thing.

I took my endocrinologist's advice and started taking additional Iron. I now take a multivitamin with 45 mg of ferrous fumarate, plus a chelated Iron supplement with 36 mg of iron, for a total of 81 mg of iron per day. I just got my 6-month bloodwork, and everything is great, so I think I'm taking the right dosage of iron (at least for now). I have no idea whether the chelated iron makes a difference, but it's certainly not hurting.

Thanks for the update. I had blood test done multiple 3 times over the first 18 months and switched doctors. The new surgeon tested my ferratin level and it was low. He wants me to take 2 iron (65mg) per day in addition to my multi Vitamin that has 45 mg. He said to work up to 4 iron pills a day!! Now I saw the video but it's 6 year sold re. taking chelated iron. I am going to switch to that and then have labs taken again.

[2Bsmaller18 435]

On 1/14/2021 at 11:41 AM, catwoman7 said:

Ferritin is stored Iron - your "reserves" that your body grabs if your blood iron levels get too low. Usually when it drops below 30 or so they recommend infusions (although I know some people get them when it drops below 50, but not all doctors will authorize it at that level).

iron is one of the only levels that can be tough to bring up via supplements, but it does work for some people (did for me - my ferritin level once got fairly low - but it's fine now after I increased my iron supplement dosage a bit).

some people don't absorb iron well from capsules or tablets *at all*, even from the start, and they need to get occasional infusions to keep their levels up. A majority of us do fine on oral supplements, though.

So I saw a new surgeon that is closer to my home. he saw my blood tests with iron levle and hemoglobin levels in the normal range but he had me take a blood test for ferratin level. the lab test says normal is 11-307 but the surgeon said he likes to see his patient in the 50-100 range. I tested at 10.6!

Is this the same test that in your experience people are getting infusions? He wanted me to start taking 2 iron pills a day and work up to 4. I think they are 65mg each in addition to my bariatric multivitamin has 45 mg. I am only taking 2 a day since the Constipation side effects. It's been 2 months now and I am supposed to go in to have the ferritin level rechecked.

I think I am goin to start taking the chelated iron and see if that is easier to digest and helps my number.

Ugh such conflicting info.

How often did you retest? How long did it take to go up?

[catwoman7 10,844]

13 minutes ago, 2Bsmaller18 said:

So I saw a new surgeon that is closer to my home. he saw my blood tests with Iron levle and hemoglobin levels in the normal range but he had me take a blood test for ferratin level. the lab test says normal is 11-307 but the surgeon said he likes to see his patient in the 50-100 range. I tested at 10.6!

Is this the same test that in your experience people are getting infusions? He wanted me to start taking 2 iron pills a day and work up to 4. I think they are 65mg each in addition to my bariatric Multivitamin has 45 mg. I am only taking 2 a day since the constipation side effects. It's been 2 months now and I am supposed to go in to have the ferritin level rechecked.

I think I am goin to start taking the chelated iron and see if that is easier to digest and helps my number.

Ugh such conflicting info.

How often did you retest? How long did it take to go up?

10 is really low - and yes, a lot of surgeons will refer you for an infusion when it drops below about 20. A few will even recommend an infusion when it's below 50. Ferritin is one of the few levels that can be difficult to bring up when it's that low without an infusion, although some people have done it (I managed to bring mine up with oral supplements, but it was never as low as yours - I think it was around 30).

when mine was low, they also had me increase my oral supplements. Then they retested two or three months later, and it was fine.

[Darktowerdream 419]

51 minutes ago, catwoman7 said:

10 is really low - and yes, a lot of surgeons will refer you for an infusion when it drops below about 20. A few will even recommend an infusion when it's below 50. Ferritin is one of the few levels that can be difficult to bring up when it's that low without an infusion, although some people have done it (I managed to bring mine up with oral supplements, but it was never as low as yours - I think it was around 30).

when mine was low, they also had me increase my oral supplements. Then they retested two or three months later, and it was fine.

I find it confusing too as my Ferritin has consistently been 6 even when my Iron has been within normal range. Its hard for my digestive system to handle Iron supplements because of diverticulosis, and some unknown issue causing narrowing of the colon (and inflammation) even small amounts of iron constipate terribly, The only time my Ferritin when up a bit was when I had blood transfusion for surgery. I took a "non constipating" iron supplement lets just say it didnt live up to its claim. not sure how people do it. Or if theres possibly another cause of low ferritin unrelated to gastric bypass thats coincidental that compounds the issue.

[Changes4Life 8]

Thank you for sharing about the chelated Iron supplement. I will try this!! I'm always so anemic and my ferritin and iron stores remain low even after my last infusion. I was also thinking about trying the iron Patches, but I don't know anyone else who uses them and I'm a little hesitant.