Iron and vitamin B12 deficiency
 

Just heard back around blood work that I had done yesterday because my hemoglobin count was low in blood work I had done the previous week. I have to start taking iron and vitamin B12 supplements. I hope my tummy can handle it. Maybe this is why I have been so tired. I will be retested in 3 months. I guess I need to eat more spinach. I rarely eat red meat. I need to do some research on what other foods have iron in them.

There are many.

http://www.redcrossblood.org/learn-a...ron-rich-foods

Funny I just replied to Fatigue post that B12 & Iron are a great start.
B12 does absolutely nothing to my stomach, Iron supps constipate unless it's "slow fe". Have spinich with the orals. I've tried that combo. Seemed to help strength.

No wonder you have been so tired.

Just a hint, take your iron supplement with some sort of vitamin C. It will help the iron "bind" to blood cells.

I don't take B12 supplements so I have no suggestion there as to whether or not it will upset your digestive system. I used to take it years ago and never had trouble, but that was before all my digestive issues started.

Spinach is a great superfood! I love it. Since I can no longer eat lettuce, spinach has been a good replacement. I also eat at for dinner, at breakfast in my eggs, or in sandwiches.

Fortified cereals have both iron and B12 as well as other vitamins and minerals in them. Check the labels on them when you go to the store.

Eggs are a good source of both as well. Combine them with spinach and you're doing great.

Hang in there and let us know how you are doing.:hug::hug:

A spinach omelete ...yummmmm!!

B12 does not typically upset the GI tract. The amount in each tablet is quite minute. It is not even absorbed very well, so you should take it on an empty stomach, and choose the activated form called methylcobalamin or methylB12 for short.

Iron is a different thing altogether. Iron really should be supervised by a doctor. How long to take it, how much, etc. Taking iron when you don't need it, can lead to toxicity as it is stored in organs and over time poisons them. Iron is not well absorbed, and much remains in the GI tract and comes out in the stool. The body does not want to easily absorb it, because it of its potential toxicity. You should have bloods tests done to show when your anemia has improved enough to cut back on it finally.

Exactly. Too much Iron can be toxic.

I was told by pcp to take both with food -- at different meals. The directions of the B12 bottle say the same. I am taking 1000 mcg. I am not sure how much iron she prescribed. I am going to pick up the prescription today if the thunderstorms ever let up. I am scheduled to have blood work again in three months.

Do not take B12 with food.... I don't care who told you otherwise, as they are not well informed.

Drugs in microgram quantities like levothyroxine, and digoxin and other things are not well or absorbed at all in the presence of food. This has been well documented, but not for supplements yet. It could be 50 more years of waiting and failing.

B12 is absorbed two ways. 1) with intrinsic factor which is designed to grab small 1-4mcg amounts of B12 out of protein you eat. If this fails, and intrinsic factor will not be secreted in low acid environments or when damaged by autoimmune attack, the only way B12 can be absorbed is passively in the small intestine instead. Food absorbs it like sponge and keeps it from getting absorbed. 2) passive absorption of B12 was not believed until very recently... in some studies. But many doctors don't read those.

People very low in B12 --- if you have your test results, please post here. Very low test results, really should have 5 mg of methylcobalamin daily on an empty stomach. Borderline low patients can probably get by with 1mg of this daily.
B12 is the only B I know of at this time that has special requirements. Most other vitamins can be taken with food.

My B12 thread:
http://neurotalk.psychcentral.com/thread85103.html
You will see from the medical sites and medical studies, on that thread that this is not a simple situation. Trust me, empty stomach for B12. Best taken alone, for that reason. B-complexes with B12 in them, the B's can upset the stomach.
So they are typically taken with food. Methyl B12 alone only costs pennies a day and is not a hardship.

Iron on the other hand can cause significant upset stomachs and constipation. That is because most is not absorbed because the body limits iron absorption because of its toxicity.

When people are low in B12 it is because of a PROBLEM with it. I assume people with problems most likely have low acid or intrinsic failure or they wouldn't be low. Long term vegans get low because of diet. Some drugs deplete B12, also. But since B12 has no upper limit of safety and is easily tolerated and very inexpensive, you don't need to worry about like you should for other types of supplements.

When I saw my first neuro, my B12 levels were quite low. I was directed to take 1000 mg of B12 once daily. They've been normal for years now. I take it an hour before lunch...seems to have done the trick, which I was happy about because otherwise I was told I'd have to go on injections.

I don't have the test results yet. They just called me on the phone. I imagine I will get the lab results in the mail in a few days. I will look for methyl B12 when I go pick up the iron. The bottle I have just says B-12. I have been on prilosec and now nexium for many years. I have tried to get off of them but I experience constant nausea without taking the meds.

Methyl type is not common in stores yet. Yours is probably cyano form. I hope it is not "timed release" because that form is useless. It is not absorbed well from a tablet that does not release it all at once. This is because passive absorption is
dependent on concentration. That whole idea is rather absurd.
Most online places have methylcobalamin very commonly now.
Puritan's Pride, iherb.com, Swanson's, etc etc.

So please read your label.

I take my 1000mcg B12 with "soon as I get up" meds.
1000mcg B12, 2000iu D, 40mg Baclofen, 200mg Ibuprofen, 2mg Prazosin.
16oz of 1 or 2% milk's what I wash it down with for past few yrs. My B level's a tad above high, D is 85.

Edit- I take B100 with "after lunch" meds so maybe that's why it bother stomach.

Picked up the prescription for iron -- ferrous sulfate 325 mg -- one per day. I am confused because the directions say to take it on an empty stomach before or 2-3 hours after a meal with 8 ounces of water. It also says if this upsets your stomach take with crackers, bread, or small meal. I told the pharmacist I was concerned about getting sick and she suggested that I take it with a meal and if it does not bother me then to try it the next time an hour before eating. she said that my dose was a relatively low one and that some people have to take it three times per day.

I think I will wait until tomorrow to start. I am going to a movie and out to dinner later and do not want to get sick.

The elemental amount of iron in 325mg ferrous sulfate is
about 60mg. When reading labels, on OTC iron, the elemental is always listed. This is for poison control.

Most minerals have an elemental value, and a total weight value.
Here is a good monograph with detailed explanations.
Basically not all the iron in a tablet taken by mouth will be absorbed. This is true for almost all minerals. Calcium for example without D is only 20-25% absorbed per pill.
http://ods.od.nih.gov/factsheets/iro...hProfessional/

Very few people can tolerate iron on an empty stomach. Iron is best absorbed with ACID also...and the stomach secretes MORE acid with food present than on empty.

Heme & nonheme iron was a good lesson learned from article mrsD posted link to above. Thank you.

Took the iron supplement with lunch yesterday. Became very nauseated last night with stomach cramps. Nausea and cramps continuing this morning. Taking a sick day; called and left a message for my doctor.

Iron supplements can be bad for you..... Try eating more Iron rich foods..:) I love Pate de foie gras (goose liver and the highest in iron)

http://www.healthaliciousness.com/ar...es-of-iron.php

Ferronyl iron is sometimes easier on the stomach.

Here is one example:
http://www.drugstore.com/products/pr...AID=1146754258

This is OTC, no rx needed.

this type also is easier on the stomach:
http://www.drugstore.com/bifera-iron...lets/qxp221306

also called Ferrex-150
http://www.amazon.com/FERREX-150-CAP.../dp/B000GG15UM

I could not handle the first iron pills I was prescribed so then I tried to increase levels through diet for two months. That did not work. So I started taking slow release iron. My doctor told me to take it two hours before or three hours after eating, but the directions on the box said take it with a meal. I tried it once on an empty stomach and ended up with horrible nausea. So then I started taking it at lunch time. Pharmacist told me that most people could not tolerate taking it without food. I experienced some nausea and constipation but I could handle it.

That is, I could handle it unitl a few days ago. On Sunday evening I expereinced a nasty irriitable bowel attack and ended up in the bathroom for two hours with constant spasms/ pain and vomiting. So I skipped the med on Monday and took it again yesterday. This moening I woke up to some mild nausea and ate some toast. Now I am miserable again. Called the doctor. I just cannot take iron orally.

Sorry Barb, that is too bad, but maybe your body is rejecting it because it doesn't need it?? My hemoglobin read low all my life. I was off and on iron supplements but finally told myself it just wasn't worth it, so went off the Extra iron.

B12 is another one that can upset your system if you take too much. I was taking 5000mcg per day and have reduced it to 1000mcg...much better.

I hope you can work it out and feel better soon. :hug:

I am taking 1000 mg of B12. It does not seem to bother me.

Hi Barb,

I can't tolerate iron very well either. I was iron deficient and was falling asleep all the time, my hair was falling out, my heart rate was rapid, my lips were always sore and chapped! I thought the fatigue was from MS but once I got my iron stores up it was remarkable how much better I felt. I no longer needed naps, no longer dragging.

But I had to take a liquid iron supplement which does not constipate and is easy on the stomach. Its called Floradix. The problem is that it is very expensive and is usually found in places like Whole Foods. There is a great discount online supplement store called iHerb. I buy everything there--products are already discounted and then if you buy regularly you get more discount. So I buy 5-6 bottles of the liquid iron at a time.

http://www.iherb.com/m/Flora-Floradi...0-ml/3005?at=0

I think the link above is for the alcohol free, yeast free, etc. like I said it was the only thing that got my iron up. Iron build up is slow too. But after a couple of months I was a totally different person!

Good luck! Speaking of which, I need to go take some now.

Was just given a referral to a hematologist. Nurse said they would most likely order an iv infusion.

I am low in B12 and take weekly injections (I give them to myself). I also have a slightly low RBC 3.2, hemoglobin is 11, hematocrit 33; however my ferritin is only 10.
No one has ever told me to take iron. I am alway sooo tired, my hair is falling out and mouth is burning and sore....but I thought that was from the MS and low B12; but maybe the low iron has something to do with it too??

Have an appointment with the hematologist on Thursday. Will report back.

I saw the hematologist this afternoon. I really like him. I have to go in next Wednesday for an iron infusion. It will take 7 hours:eek:.. Otherwise I could have spread it over 4 to 5 different appointments with each appointment taking about 90 minutes. I just chose to get it done in one apointment. I guess the main concern is with my ferritin level which is a 7. B12 had improved since taking the oral supplement.