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RE: Testing iron

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On Fri, 27 Jan 2012 21:34:03 -0800 (PST), you wrote:

>

>I've heard that you should stop taking iron supplements 5 days before you do

the

>iron tests (serum, % sat, ferritin, TIBC). I can't understand why. Anybody

>else heard of this?

If you don't stop iron for at least 5 days you end up with a result

skewed by the supplement you were taking and think it's better than it

is

Nick

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That makes sense. But, what if you want to know how well the supplement is working, so you can figure out if you need to adjust your dose. Wouldn't you want to test while you are taking your current level of supplement? After all, you wouldn't be taking a supplement if your iron was at normal levels to begin with. And, if it goes up to normal levels while you are on the supplement, it is certainly going to go back down when you stop them. So, it seems to me that if you stop taking the supplement, all you are going to learn is that you need the supplement. If you stayed on the supplement, you would learn two things that you wouldn't learn if you

stopped:1 - if your numbers are high, that you should lower your supplement2 - if your numbers are low, you need to supplement more.What's wrong with this logic? Marge

If you don't stop iron for at least 5 days you end up with a result

skewed by the supplement you were taking and think it's better than it

is

Nick

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Hi Marge

Supplements of minerals and vitamins are needed when our levels

fall very low to build them up. Once they have been built up to a good level,

you ensure that you eat foods that are rich in iron to keep your level up where

it should be. After 2 to 3 months of being on a specific supplement you should

get your blood tested to see if it is working. Normally, you can tell by your

state of health whether it is working or not, because most people start to feel

so much better.

Because one nutrient is low and needs to be boosted doesn't mean

that if you stop, it is always going to go low again. It depends what caused

your low levels in the first place.

Luv - Sheila

So,

it seems to me that if you stop taking the supplement, all you are going to

learn is that you need the supplement. If

you stayed on the supplement, you would learn two things that you wouldn't

learn if you stopped:

1

- if your numbers are high, that you should lower your supplement

2

- if your numbers are low, you need to supplement more.

What's

wrong with this logic?

Marge

If you don't stop iron for at least 5 days you end up with a result

skewed by the supplement you were taking and think it's better than it

is

Nick

No

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On Sat, 28 Jan 2012 09:32:07 -0800 (PST), you wrote:

>So, it seems to me that if you stop taking the supplement, all you are going to

>learn is that you need the supplement. If you stayed on the supplement, you

>would learn two things that you wouldn't learn if you stopped:

>

>1 - if your numbers are high, that you should lower your supplement

>2 - if your numbers are low, you need to supplement more.

>

>What's wrong with this logic?

Iron levels move VERY slowly, it can take months to build levels up so

if you stop for a week you are not going to lose much of what you have

built up

Nick

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So, you're saying that stopping iron won't have much of an impact on your iron levels. If your iron levels won't change much if you stop taking iron for 5 days before testing, what's the point of stopping? Aren't you just going to confuse the issue?I'm sorry, but this answer says to me that stopping iron for 5 days before testing doesn't make sense. Marge

Iron levels move VERY slowly, it can take months to build levels up so

if you stop for a week you are not going to lose much of what you have

built up

Nick

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On Sat, 28 Jan 2012 21:07:41 -0800 (PST), you wrote:

>So, you're saying that stopping iron won't have much of an impact on your iron

>levels. If your iron levels won't change much if you stop taking iron for 5

>days before testing, what's the point of stopping? Aren't you just going to

>confuse the issue?

>

>I'm sorry, but this answer says to me that stopping iron for 5 days before

>testing doesn't make sense.

I am saying that stopping taking iron 5 days before will not have a

significant effect on the amount of useable and stored iron you have

It can have a large effect on the amount of iron that is measured on

the lab tests though and labs while still supplementing, especially if

you are taking a lot of iron, can be skewed in the direction of making

you think all is OK

If you are supplementing at a low rate it makes much less difference

If the labs read low while supplementing then you are definately low

I am taking 200mg of iron a day in split doses with Vit C and my

levels are coming up very slowly.

Nick

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Sheila - I can understand this for something like the adrenal system where you

can heal on supplements and then you wean off the supplement. But, I don't

understand it with iron, especially because you take four tests. Couldn't

stopping iron have a different affect on each test? Plus, why five days? Why

not 12 hours or two weeks?

This is really bugging me. If nobody can explain this to me, I'm going to learn

as much as I can about iron and disorders of iron metabolism and see if I can

figure this out for myself.

Marge

________________________________

From: Sheila <sheila@...>

thyroid treatment

Sent: Sat, January 28, 2012 11:02:05 AM

Subject: RE: Testing iron

Hi Marge

Supplements of minerals and vitamins are needed when our levels fall very low to

build them up. Once they have been built up to a good level, you ensure that you

eat foods that are rich in iron to keep your level up where it should be. After

2 to 3 months of being on a specific supplement you should get your blood tested

_______________________________

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Nick - Thanks for going deeper on your explanation. I think I need a lot of

pieces of the puzzle to understand this.

Let me see if I understand your explanation in relationship to the common iron

tests. Four tests are recommended - ferritin, serum iron, TIBC and %

saturation (a calculation, thus not a direct blood test)

So, stopping iron will not have a significant effect on ferritin, because that

is stored (storage) iron. It will, also, not have a significant effect on what

you call useable iron - I assume you mean serum iron? But, it will have a large

effect on the lab tests for ferritin and serum iron? What about TIBC, an

indirect measure of transferrin.

I can easily see why you would want to stop iron for at least 12 hours prior to

testing because you are looking for a " normal " level not spiked by recent doses.

If I took the tests 12 hours fasting and and the results looked okay, I would

keep supplementing at the same levels. Is there a problem with this? Is the

answer different if you're supplementing at high or low rates?

Marge

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On Sun, 29 Jan 2012 14:35:41 -0800 (PST), you wrote:

>Nick - Thanks for going deeper on your explanation. I think I need a lot of

>pieces of the puzzle to understand this.

I'll try my best, working from experience of others who have seen a

lot of iron labs over the years, 5 days is what is found to work

empirically.

>

>Let me see if I understand your explanation in relationship to the common iron

>tests. Four tests are recommended - ferritin, serum iron, TIBC and %

>saturation (a calculation, thus not a direct blood test)

>

>So, stopping iron will not have a significant effect on ferritin, because that

>is stored (storage) iron. It will, also, not have a significant effect on what

>you call useable iron - I assume you mean serum iron?

I think you'll find that there is a significant skew to both of those

based on what I've heard. People test after a day without iron and

decide they are OK, drop the iron down and find they are low soon

after.

> But, it will have a large

>effect on the lab tests for ferritin and serum iron? What about TIBC, an

>indirect measure of transferrin.

>

The binding capacities tell you how much iron your body can take

without overloading it, If the binding capacity is low, near the

bottom of the range, then you can't safely take much iron

>I can easily see why you would want to stop iron for at least 12 hours prior to

>testing because you are looking for a " normal " level not spiked by recent

doses.

>

>

>If I took the tests 12 hours fasting and and the results looked okay, I would

>keep supplementing at the same levels. Is there a problem with this? Is the

>answer different if you're supplementing at high or low rates?

The answer is different on maintenance doses and " build up doses "

If you are just taking 20mg a day then labs on that are reasonable.

If, like me, you are taking 200mg a day to try and build up from a

severe lack or iron then a 5 day withdrawal is a minimum to get

accurate results.

Iron is a vicious circle with hypo people, if you are hypo it's hard

to hang onto iron, without iron you can't utilise thyroid hormone and

can often get nasty intolerance results when you take it.

If your GP is funding the testing you could gather some data for us

all, have labs while still on iron and then stop iron and have another

set of labs 5 days later, post the differences for us all to see, I

for one would be interested.

I may even try and get my GP to run them on me for me since he now

knows I've been self treating and is supporting me in it.

Nick

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Yippee, I think you clarified my point of confusion. I've been on a maintenance dose of 65mg elemental for four years and my iron levels are okay. If I stopped for 5 days, chances are good that all I would learn is that I need to supplement. But for you on 200mg, when you stop for 5 days, you would be getting a new baseline. Once you get to where you want to go, you would then lower your dose to maintenance? And, you would test while supplementing to tweak your dosage? Marge

The answer is different on maintenance doses and "build up doses"

If you are just taking 20mg a day then labs on that are reasonable.

If, like me, you are taking 200mg a day to try and build up from a

severe lack or iron then a 5 day withdrawal is a minimum to get

accurate results.

If your GP is funding the testing you could gather some data for us

all, have labs while still on iron and then stop iron and have another

set of labs 5 days later, post the differences for us all to see, I

for one would be interested.

I may even try and get my GP to run them on me for me since he now

knows I've been self treating and is supporting me in it.

Nick

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Hi Marge

I was talking about any

minerals/vitamin supplements. It is advised that before having any blood taken

to test your iron levels that you fast for at least 12 hours before the test is

done. Check out http://www.americanhs.org/faq.htm. There's some interesting information here.

" A

simple series of blood tests which can be performed by any doctor or lab can

indicate iron levels. They must be proper iron measures: Total Iron Binding

Capacity (TIBC) together with Serum Iron. Divide TIBC into Serum Iron to get

the percentage of transferrin saturation. It is important that the serum

ferritin is also performed at the same time and it should be done, if possible,

while fasting.

Refrain from

iron pills for a week prior to the tests.

Hope this

helps, but read the information in that web site.

Luv - sheila

Sheila - I can understand this for something

like the adrenal system where you

can heal on supplements and then you wean off the supplement. But, I don't

understand it with iron, especially because you take four tests. Couldn't

stopping iron have a different affect on each test? Plus, why five days? Why

not 12 hours or two weeks?

This is really bugging me. If nobody can explain this to me, I'm going to learn

as much as I can about iron and disorders of iron metabolism and see if I can

figure this out for myself.

Marge

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Sheila - many thanks for telling me about this web site. In addition to surfing the site, I found where you got the quote. AHS recommends HealthCheck for testing. In the description of their Ferritin test HealthCheck says, "For a complete picture of iron overload, other tests - such as total iron binding capacity (TIBC) and hereditary hemochromatosis DNA screening - may be required. Prepare to fast 12 hours before taking this test to ensure the most accurate data."I called HealthCheck (I'm in the US) and they do not require more than 12 hours fasting for iron supplements before iron testing.Here's what I now think. If you are testing for high iron, maybe it makes sense to stop taking iron pills for however long your body needs to get it out of your system (if you have high iron, why would you be

taking iron supplements?). However, if you are taking iron pills, you already know you have low iron, and stopping iron for 5 or 7 days may defeat the object of the testing, which is to determine how the supplement is doing at raising your iron levels. Stopping for 12 hours would eliminate spikes from the supplement. Supplementing, of course, does not answer the question of why you have low iron in the first place. MargeI was talking about any

minerals/vitamin supplements. It is advised that before having any blood taken

to test your iron levels that you fast for at least 12 hours before the test is

done. Check out http://www.americanhs.org/faq.htm. There's some interesting information here. "A

simple series of blood tests which can be performed by any doctor or lab can

indicate iron levels. They must be proper iron measures: Total Iron Binding

Capacity (TIBC) together with Serum Iron. Divide TIBC into Serum Iron to get

the percentage of transferrin saturation. It is important that the serum

ferritin is also performed at the same time and it should be done, if possible,

while fasting. Refrain from

iron pills for a week prior to the tests. Hope this

helps, but read the information in that web site. Luv - sheila

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