Anemia and iron intolerance?

[lyra]

I just found out last month that I''m anemic. I''m 47 and not in menopause yet. The doctor put me on iron pills (Euro-fer), and I found that they gave me extreme adverse reactions. The gas and bloating was horrendous, and constipation was incredible. I couldn''t empty my bladder at times, the pain was so great that just sitting was horrible. I took metamucil 3 times a day, lots of water and added colace at the end just trying to get some relief. Nothing helped and I was bedridden a lot of the time. I did my second blood test, thought I was through with it, and the doctor said to keep taking the iron!

I explained that I just couldn''t tolerate the pills and he said I was on one of the mildest ones. ??? Has anyone had this problem? I know it is an issue for pregnant women too. Did you find a supplement that would work more gently? I''m desperate at this point. My stomach is still upset these days, almost a week after stopping the iron. Any advice appreciated.

 

[KimberlyH]

Lyra, I am anemic, but have it under control. When first dx'ed I tried taking iron and had a very difficult time with it. The pills gave me horrific stomach cramps and constipation. I stopped taking them and altered my diet to include lots of high protien foods and that evened things out for me. I take a prenatal with 28 mg of iron in it and I don't struggle with stomaching that, nor has it caused extreme constipation.

 

[Pandora II]

Having spent months having to take 600mg a DAY of the stuff I sympathise! Bleugh... but then my iron levels were around 7.5 at the time (normal being around 13 and 10 being the lowest you could go without treatment) and went down as low as 6 following a major postpartum haemorrhage at which point I had 5 blood transfusions. Then had to take supplements for the next 2.5 months.

Tips for increasing your iron levels:

Taking them with orange juice with increase the absorbtion and so should mean you need less supplementary iron.
Increase consumption of iron rich foods
Try various brands - some are better than others
You could try the shots, but they do have a nasty side-effect of staining your skin.

 

[lyra]

I was on 600mg/day like you Pandora. I cannot absorb enough through food for some reason. I''ll try the orange juice thing once I get the name of the new supplement. I would love to just do an injection if it didn''t have side effects with my digestion, but it hasn''t been suggested. Is it a once a week thing, daily, or how often?

 

[dragonfly411]

Lyra - I am off and on anemic. I would definitely suggest lots and lots of water, but you can also find foods that help you to absorb iron better, and you might try eating lots of iron rich foods too, such as spinach, kale, red meats, etc. The iron pills stink, b/c of those same side effects. Just make sure you are getting TONS of fluids.

 

[kama_s]

If you''re drinking orange juice with your iron supplements, make sure it''s not Calcium enriched. Ca inhibits the absorption of Fe. Alternatively, you can take Vitamin C supplements along with your Fe. I''ve been anemic since birth, and I have a very flimsy stomach. Ferrous gluconate works best for me. I know several people who have severe side effects with Fe Fumarate (Euro-fer) and I''ve suggested they switch to gluconate and it works much better for them. Also, take your supplements at night before you go to bed.

 

[Pandora II]

Date: 9/8/2009 4:06:23 PM
Author: kama_s
If you''re drinking orange juice with your iron supplements, make sure it''s not Calcium enriched. Ca inhibits the absorption of Fe. Alternatively, you can take Vitamin C supplements along with your Fe. I''ve been anemic since birth, and I have a very flimsy stomach. Ferrous gluconate works best for me. I know several people who have severe side effects with Fe Fumarate (Euro-fer) and I''ve suggested they switch to gluconate and it works much better for them. Also, take your supplements at night before you go to bed.

I''ve found Ferrous Sulphate to be better than some of the others.

Ditto the taking at bedtime - makes you feel less icky for definite.

Kama_s, you don''t have spherocytosis by any chance? Just ask as my DH has this and has been anaemic since birth.

 

[kama_s]

Date: 9/8/2009 5:26:26 PM
Author: Pandora II

Date: 9/8/2009 4:06:23 PM
Author: kama_s
If you''re drinking orange juice with your iron supplements, make sure it''s not Calcium enriched. Ca inhibits the absorption of Fe. Alternatively, you can take Vitamin C supplements along with your Fe. I''ve been anemic since birth, and I have a very flimsy stomach. Ferrous gluconate works best for me. I know several people who have severe side effects with Fe Fumarate (Euro-fer) and I''ve suggested they switch to gluconate and it works much better for them. Also, take your supplements at night before you go to bed.

I''ve found Ferrous Sulphate to be better than some of the others.

Ditto the taking at bedtime - makes you feel less icky for definite.

Kama_s, you don''t have spherocytosis by any chance? Just ask as my DH has this and has been anaemic since birth.

Hey Pandora,

I used to take Sulphate as well, later switched to gluconate. I think my tolerability to suphate reduced as I grew older! (P.S.: I love how you spell it with a ''ph'' as well - people look at me weird here in NA when I spell it with a ''ph'' instead of an ''f''!).

I don''t have spherocytosis. I actually have a genetic disorder where my body isn''t able to convert and store iron in the body. So I have to continuusly replenish with supplements since absorption from food is not nearly enough. It''s been in the family for generations *sigh*

 

[lyra]

I appreciate everyone''s responses, thank you. I''m really feeling frustrated about this whole issue. The doctor has not given me a diagnosis for why I''m anemic. He just assumes it is because of heavy periods, which I don''t always have. I want more of an answer, but with him, pretty much everything boils down to needing some invasive test. He''s always pushing for endoscopy. Next will be colonoscopy. He''s the most pokey proddy doctor I''ve ever had. (I don''t like it, I have an aversion to testing).

Anyway, I waited at home all day for his office to get back to me with the name of the next iron supplement to try and they didn''t call back. Grr.

The euro-fer is ferrous sulphate.

So I should take it with orange juice for better absorption, but that won''t help with the other gastro-intestinal issues? I had been drinking lots. I did everything I could to minimize symptoms. I''m supposed to take 2 pills a day, with meals. Could I possibly take them both at bedtime? That''s 600mg/day in one shot. Perhaps it *is* better to split it so I wouldn''t get it all in one dose like that. So at bedtime, and when else, to minimize the side effects? I wish I didn''t have to take it at all. Sounds like there are only a couple of versions to try and I''ll probably have the same problems. I''ll try talking with the pharmacist tomorrow if she can spare the time.

 

[LtlFirecracker]

I just want to say as bad as the pills are the injections are far worse....trust me on this one.

And as far as why you are anemic, if you are not happy with what your doctor is doing, you should not feel bad to request a second opinion from a specialist. There are simple blood tests to determine that it is truly iron deficient anemia, so at least make sure those are done.

Oh and a colonoscopy should be done in everyone at the age of 50 to screen for colon cancer, so you doctor is not being unreasonable in that regard. It took 2 years to convince my Dad to get that test and when he finally got it they found some pre-cancerous polyps, he is now a believer and goes whenever they tell him too. My BFs grandmother refused to get it and she just died from colon cancer. I know it is not a fun test, but it is really worth doing when your doctor says it is time to.

I am sorry this is so rough, I know iron is not a fun med to take. Hopefully you don''t need to be on it longer than a few months.

 

[Pandora II]

Just wanted to flag up the dangers of iron supplements and young children...

It''s one of the leading causes of death and the leading cause of poisoning, People think that because it''s a supplement rather than a medicine that they are harmless whereas they are extremely dangerous in young children and babies and the fatal dose is quite low. So, lock ''em up!

 

[LtlFirecracker]

Date: 9/9/2009 4:55:55 AM
Author: Pandora II
Just wanted to flag up the dangers of iron supplements and young children...


It''s one of the leading causes of death and the leading cause of poisoning, People think that because it''s a supplement rather than a medicine that they are harmless whereas they are extremely dangerous in young children and babies and the fatal dose is quite low. So, lock ''em up!

You mean if a toddler gets a hold of mom''s iron??? Yes that is a problem.

We don''t routinely give babies iron supplements per say, but if they are formula fed they should be on a formula with iron. If they are breast fed, we recommend starting iron rich/fortified foods at 6 months. If I need to supplement, I always do iron studies to prove it is an iron deficiency anemia and than give 2-6 mg/kg of elemental iron a day - a much lower dose than those adult pills!

Too much iron is not a good thing and can cause iron overload. We actually used to give iron to all the NICU babies, but have stopped that practice. That is because if they were transfused, their iron stores are high, and the anemia is not because of low iron. So now we check their iron stores first, and only give iron if they are low.

 

[Pandora II]

Sorry, yes I mean if they accidentally get hold of them.

My SIL caught our mutual niece (2) and nephew (4) playing with a bottle of their mother''s iron tablets (she''s pg) and they''d got the top off and the little girl was holding a fist full of them. My SIL couldn''t get them to tell the truth over whether they had taken any or not.

When she told the parents, they just laughed and said so what, they''re only vitamins...

 

[lyra]

The doc''s office has sent me to go find some Triserex, which nets zero results on google, and I did have her spell it for me.

I''ll visit the pharmacist and see what the next step is then.

I don''t mind doing the tests if I have to, I just don''t like doing them.

No young kids in this household, so no worries about my meds right now. I know that childproof lids are not at all childproof. When my daughter was 3 she opened a prescription med bottle that was stored what we considered at the time way out of reach. It was a bad experience for us, although she was fine. It''s exactly as you said too--she thought since mommy takes these pills, they are okay like candy or something. Of course, at the same time she grabbed a jar of vaseline and smeared it all over my bed and her head, it was quite the scene at the hospital believe me. She was out of my sight "napping" for all of 15 minutes, with her older sister nearby. Older sister had chickenpox at the time. It was a mess, and I''ve never felt like more of a failure as a mom in my life. Luckily it was not serious. She is now 19 and just started college.

 

[kama_s]

Date: 9/9/2009 2:07:04 PM
Author: lyra
The doc's office has sent me to go find some Triserex, which nets zero results on google, and I did have her spell it for me.

I think it must be Triferexx

Date: 9/8/2009 10:50:06 PM
Author: lyra

So I should take it with orange juice for better absorption, but that won't help with the other gastro-intestinal issues?

Take it with Vitamin C supplements if you find it hard to take it with orange juice. Vitamin C increases absorption of iron.

Date: 9/8/2009 10:50:06 PM
Author: lyra

The euro-fer is ferrous sulphate.

Oops, my bad. In Canada, Euro-fer is the generic version of Palafer, which is ferrous fumarate. I looked it up on drugdex and it's ferrous sulphate in the US.

 

[partgypsy]

Like Kama said there are different formulations of iron, so try a different formulation if the first doesn''t work. I am also prone to anemia, had to do the 600 mg a day and it didn''t affect me at all (I think my body was craving it!) , but when my husband had to be on a similar regimen could hardly tolerate it.

The main thing; If you can''t tolerate the higher doses go to a lower dose you can tolerate. Your body can only absorb so much iron in one sitting; it''s better to cut down than stop taking it in frustration. Some people find taking extra fiber, liquids, also taking doculax can be helpful.


Suggestions: 1) have meals with orange juice 2) include iron rich foods in diet (favorites: liverwurst, seafood, dried fruit, grape nuts, make sweets with blackstrap molasses) 3) use a cast iron skillet for cooking.

And finally, yes if chronically anemic it''s worth it to investigate what might be making you anemic, because being chronically anemic sucks. I found out I had a condition that was making my periods even worse than my usual heavy self. Since I had that taken care of and went back on the pill feel 100% better.

 

[lyra]

Haha, you were right Kama, it is TRIFERREX. I had to go to the pharmacy, where they told me it was available OTC at $90/bottle. Argh!

So then I had to phone my doc's office, give them the DIN # and have the doc phone in a prescription hoping my drug plan would cover it instead, which it does. Yay. I've read that this formulation "should" give less problems, so we'll see.

I am diabetic, so some things are an issue, like the orange juice, and some sources of iron like nuts and beans. All have a tendency to raise my blood glucose too high, but I can and do work these things in, just takes some planning. Except for the orange juice. I'll just have to hope that it works okay. Usually I avoid fruit juice completely. I'll pick one without calcium and will also try to make sure I don't drink milk too close to the dosage. I believe it is just one 150mg tablet a day, so I'll try it at bedtime then.

Thanks for all the help! I hope this one works out better. I am in Canada, and I couldn't tell whether euro-fer was fumarate or sulphate btw. I usually only get generics as that is what my drug plan covers.

ETA: oops, didn't see the advice about Vitamin C supplement instead of orange juice. Yes, that would work much better for me, thanks!

 

[LtlFirecracker]

I think the vit C supplements are the best idea for you. OJ with Calcium is not a great idea because Ca interferes with iron adsorption.

Pandora, the face you put up is my reaction to those parents. Not all vitamins are harmless when taken outside of their normal dosing range. I love the curious nature of toddlers, but have spent many nights up dealing with the effects of those "pills that got left out." I think I am going to be a paranoid mom when it comes to that stuff.

 

[Deelight]

I am iron deficient on and off all the time the red cross suggested to me when I was iron deficent and couldn''t donate to drink orange juice when I eat and to drink loads of milo (good thing milo tastes AWESOME)

I hope you find something that works for you

 

[lyra]

Well, I took the first dose (150mg) last night with about 4 oz of orange juice (no calcium, pure), and so far no side effects. I''ll do one dose for a few days then work up to two doses as per my instructions. I felt sick the very first time I started the Euro-fer, and I can stand to have some discomfort, but so far so good with Triferrex.