Iron

[Guest guest]

In a message dated 12/29/2003 10:22:04 PM Central Standard Time,

heaven20seven@... writes:

what does it mean if you have low iron?

it means your iron is low.. hehe whadaya mean exactly? symptoms of anemia

are tiredness, coldness, irritability. I was anemic when I first started

menstruating and after I had Olivia.

~Amy~

Mom to Caitlyn Mae born to heaven 3/26/98

Olivia Isabelle born on 9/18/03 9:50am~`5lbs 1.6oz~`18 " long and very strong!

Olivia, born 9/18/2003

[Guest guest]

what causes it? no protein? i dont eat meat...so im assuming thats why.

-

[Guest guest]

Low iron can lead to anemia. I'm not sure what else it

means.

Marcy

heaven20seven@... wrote:

> what does it mean if you have low iron?

>

>-

>

>

>

[Guest guest]

Low iron can result from inadequate iron intake (too little in diet,

or not absorbed by the intestinal tract) or from blood loss (like a

leaking stomach ulcer, or intestinal lesion.) The resulting

condition is referred to as iron deficiency anemia. Other types of

anemias include pernicious anemia (from lack of Vitamin B12) and

aplastic anemia (from many causes including infection, radiation

exposure, certain medications, or exposure to toxins.)

Symptoms of low iron include: fatigue, paleness of skin,

irritability, and increased heart rate.

It is important to find out the cause of the low iron.

Hope this helps.

Randall

> what does it mean if you have low iron?

>

> -

>

>

>

[Guest guest]

In a message dated 12/30/2003 3:04:49 AM Central Standard Time,

heaven20seven@... writes:

what causes it? no protein? i dont eat meat...so im assuming thats why.

Not eating meat doesn't make you have low iron. You could try eating foods

that have a lot of iron, though. Broccoli, brussel sprouts, spinach, iron

fortified cereals are just a few.

~Amy~

Mom to Caitlyn Mae born to heaven 3/26/98

Olivia Isabelle born on 9/18/03 9:50am~`5lbs 1.6oz~`18 " long and very strong!

Olivia, born 9/18/2003

[Guest guest]

While meat is a major source of iron, plant sources of iron include

peas, beans, nuts, dried fruits, leafy green vegetables (especially

spinach), and enriched grains. Other sources include seafood and

eggs.

Eating foods high in Vitamin C such as broccoli, tomatoes, greens,

potatoes, cantaloupe and citrus fruits, increase the absorption of

iron.

Zinc and high-dose calcium supplements compete with iron for

absorption, so should not be taken at mealtime.

Years ago some cultures had the practice of sticking iron nails in

an apple and then eating it a day later (after removing the nails!).

Iron was absorbed by the apple, and this practice prevented iron-

deficiency anemia!

Randall

> what causes it? no protein? i dont eat meat...so im assuming thats

why.

>

> -

[Guest guest]

sometimes it's difficult to chew and swallow some of the more iron-rich foods.

i make a lot of pureed veggies soups.

[Guest guest]

Or/and take a multiple vitamin with iron.

Re: iron

In a message dated 12/30/2003 3:04:49 AM Central Standard Time,

heaven20seven@... writes:

what causes it? no protein? i dont eat meat...so im assuming thats why.

Not eating meat doesn't make you have low iron. You could try eating foods

that have a lot of iron, though. Broccoli, brussel sprouts, spinach, iron

fortified cereals are just a few.

~Amy~

Mom to Caitlyn Mae born to heaven 3/26/98

Olivia Isabelle born on 9/18/03 9:50am~`5lbs 1.6oz~`18 " long and very

strong!

Olivia, born 9/18/2003

[Guest guest]

Darcie,

There are several different forms of iron whose absorption rates vary from between 0.5% to 25%. Liquid ferrous gluconate has the highest absorption rate of iron (17-25%), and is easily assimilated by the body. Iron in the form of a solid tablet has to be broken down before it can be absorbed, thus the absorption rate is lower when compared with a liquid supplement. Ferrous forms of iron are said to be superior to the ferric forms. Also, liquid ferrous gluconate does not cause constipation.

While ferrous gluconate is absorbed better, it also has the lowest percent iron per pill. Ferrous fumarate is 33% iron, ferrous sulfate is 20% iron, and ferrous gluconate is 11% iron. Somewhat of a catch 22.

To figure out elemental iron per tablet, multiply the weight of the pill by the percentage of iron in the preparation. For example, ferrous sulfate is a typical prescription iron supplement at 325 mg. Ferrous sulfate is 20% iron. 325mg X 0.20 = 65 mg iron.

At our practice, I used to recommend ferrous fumarate, but still found some people were deficient. Now, we recommend amino iron, which is a chelated form and is highly absorbable. Amino iron is not recommended for people without malabsorptive issues because it can build up in the titssues and get to toxic levels.

Kate Alie, M.S., R.D., L.D.

Iron

Hi all,In following the listerve messages over time, I noticed multiplerecommendations for iron:Ferrous sulfateFerrous gluconateFerrous fumarateEtc.Can anybody justisfy the benefit of one over the other and what the standarddose is (for menstruating women)?ThanksDarcie***********************************************Darcie Ellyne, MS, RD, BC-ADM, CDEPalo Alto Medical Foundation795 El Camino RealPalo Alto, CA 94301***********************************************Phone: 650-853-4998 Fax: 650-853-4842email: ellyned@...

[Guest guest]

> ok ive been taking iron pills for 3 days and they are making my

> tummy hurt and stopping me up. any advice?? my eating has

decreased

> which means not enough protein. uh oh!! help help!!

>

> vicki

Take a different type of iron. It's actually a very common reaction

to Iron.

The form of Iron that I take is Iron Fumarate(266mg)...but you can't

go by me because I just doesn't plug me up or upset my tummy.

there is also perscription Niferex

or Trinsicon ferrocon

Ferritin

Iron amino Acid Chelate

I've seen this recommended: (though I know nothing personally about

it)

http://www.vitacost.com/store/products/productdescription.cfm?

SKUNumber=033984012509

The point is....try a different type of iron. Also remember to take

Iron apart from your calcium...Take the iron with a vit. C or small

cup of juice (you need an acidic base to absorb iron) Do not take

iron with anything that decreases the acid in your stomach like

tums...

Jo

[Guest guest]

> > ok ive been taking iron pills for 3 days and they are making my

> > tummy hurt and stopping me up. any advice?? my eating has

>********************************

the iron im taking is 45mg. bottle says its 316% of RDA. i'll see

what else is out there or i may just take 1/2 a pill. thanks jo

vicki

[Guest guest]

In a message dated 1/22/2004 1:41:02 AM Central Standard Time,

lghthousegrl@... writes:

> ok ive been taking iron pills for 3 days and they are making my

> tummy hurt and stopping me up. any advice?? my eating has decreased

> which means not enough protein. uh oh!! help help!!

>

> vicki

>

Viki,

My advice is to take the iron with food...I know they say and empty

stomach but if you can't take it the other way, eating with food is better than

none. Also surfak or another brand of stook softner will help with the stopped

up feeling. Kind of keep things moving. I took some sennacot which is

anatural vegtable laxative and had complained that the iron hadn't stopped me up

but

between the low carb atkins with Tom and the iron....I was doing a little at a

time. The laxative worked wonders and I dropped 4 lbs....LOL. (I was full of

Sh** )

in Alabama

1982(age 17)-VBG(433lbs down to 270)

1996 RNY revision from VBG (343lbs down to 299)

Dec 2003- (377.5 now 259.4 down 118.1lbs THANKS TO DR. K!!!!!!!!!!!.

Mel's AOL home page

http://hometown.aol.com/mdl1031/myhomepage/profile.html

[Guest guest]

In a message dated 1/22/2004 1:41:02 AM Central Standard Time,

lghthousegrl@... writes:

> ok ive been taking iron pills for 3 days and they are making my

> tummy hurt and stopping me up. any advice?? my eating has decreased

> which means not enough protein. uh oh!! help help!!

>

> vicki

>

Viki,

My advice is to take the iron with food...I know they say and empty

stomach but if you can't take it the other way, eating with food is better than

none. Also surfak or another brand of stook softner will help with the stopped

up feeling. Kind of keep things moving. I took some sennacot which is

anatural vegtable laxative and had complained that the iron hadn't stopped me up

but

between the low carb atkins with Tom and the iron....I was doing a little at a

time. The laxative worked wonders and I dropped 4 lbs....LOL. (I was full of

Sh** )

in Alabama

1982(age 17)-VBG(433lbs down to 270)

1996 RNY revision from VBG (343lbs down to 299)

Dec 2003- (377.5 now 259.4 down 118.1lbs THANKS TO DR. K!!!!!!!!!!!.

Mel's AOL home page

http://hometown.aol.com/mdl1031/myhomepage/profile.html

[Guest guest]

> > ok ive been taking iron pills for 3 days and they are making my

> > tummy hurt and stopping me up. any advice?? my eating has

> decreased

> > which means not enough protein. uh oh!! help help!!

> >

> > vicki

>

Hey Vicki:

This what I do. Don't know how it works; but, it does.

I eat 1/4 piece of bread, so not taking on empty stomach, & take it

about an hour before bedtime. I also take a couple of Rolaids to

follow the taking of the iron.

Hopefully this may work for you.

Until next time,

Theresa Harper

Yuba City, CA

Surgery: 03/14/02

Start weight: 252

Current: 145

[Guest guest]

> > ok ive been taking iron pills for 3 days and they are making my

> > tummy hurt and stopping me up. any advice?? my eating has

> decreased

> > which means not enough protein. uh oh!! help help!!

> >

> > vicki

>

Hey Vicki:

This what I do. Don't know how it works; but, it does.

I eat 1/4 piece of bread, so not taking on empty stomach, & take it

about an hour before bedtime. I also take a couple of Rolaids to

follow the taking of the iron.

Hopefully this may work for you.

Until next time,

Theresa Harper

Yuba City, CA

Surgery: 03/14/02

Start weight: 252

Current: 145

[Guest guest]

I also take a couple of Rolaids to

> follow the taking of the iron.

> Theresa Harper

=========================

Theresa....Taking Tums, rolaids....at the same time as Iron is not a

good idea. Iron needs an acidic environment for absorption and

Tums/rolaids...neutralizes the acid. That is why we need to take

iron with a little bit of orange juice or at least vit. C. This was

discussed at the last support meeting on Iron. I can't remember for

sure but I think Dr. K said to wait at least 30-60 min. after Iron

before you take tums....

Jo

[Guest guest]

In a message dated 1/30/2004 11:15:29 PM Central Standard Time,

hevnbound1@... writes:

Is this iron infusion thing a real common thing amongst DSer's? I've

never heard of this in the RNY world, but have heard of several

people having to have this done on this and other DS lists. What's

up with that? Does the problem get better or are the infusions for

life?

Hugs,

Laurie in WI

DS Revision 8/12/04

Dr. Ara Keshishian

195 days to go!!

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

!!!!!!!!!!

Nope. I started having problems with it after my RNY(HGB of 8 was the lowest

in 1999). It has reared it's ugly head this winter. I have always had trouble

absorbing iron and have had severe B12 defeciencies. So I am a problem child

from way before the DS revision. I also know of 3 RNYers who have to have

periodic IV iron infusions. I thought I was alone in the DS world with the iron

stuff until tonight. I was so excited that I was having an almost normal H & H

that it floored me when I saw the lab values.

in Bama

VBG 1982 (lost from 433lbs to 270's)

VBG to RNY1996 revision(Lost from 343 to 299)

RNY to DS revision Dec 2002 -down 118 lbs so far (377.7 to 259.4 and still

going

Homepage address- http://hometown.aol.com/mdl1031/myhomepage/profile.html

Many thanks to Dr. K willing to take on a 3rd timer....LOL

[Guest guest]

In a message dated 1/31/2004 12:06:50 AM Central Standard Time,

mjs93311@... writes:

Laurie,

I would think it would be more common among the RGB patients,

actually, due to the total bypass of the duodenum. Or maybe my buzz

has me forgetting where iron is absorbed and if so, sorry.

Marta

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

That and the majority of B12 is absorbed in the duodenum and now it never

touches food. One thing I do know are the EVILS of the RNY....LOL....Evil I

tell

you!

in Bama

VBG 1982 (lost from 433lbs to 270's)

VBG to RNY1996 revision(Lost from 343 to 299)

RNY to DS revision Dec 2002 -down 118 lbs so far (377.7 to 259.4 and still

going

Homepage address- http://hometown.aol.com/mdl1031/myhomepage/profile.html

Many thanks to Dr. K willing to take on a 3rd timer....LOL

[Guest guest]

Laurie,

I would think it would be more common among the RGB patients,

actually, due to the total bypass of the duodenum. Or maybe my buzz

has me forgetting where iron is absorbed and if so, sorry.

Marta

[Guest guest]

Laurie,

I would think it would be more common among the RGB patients,

actually, due to the total bypass of the duodenum. Or maybe my buzz

has me forgetting where iron is absorbed and if so, sorry.

Marta

[Guest guest]

Stacey,

Do you have any idea what % of your patients need IV iron? I am seeing about

1% of compliant patients who cannot keep iron level normal following a

proximal gastric bypass. Cannot explain why, questionably on basis of

intrinsic bowel defect in small % of patients. All were female but not

having excessive periods or other blood loss.

Re: iron

> ,

> From my understanding, ferratin levels are the first indicator of

> a 'stage I' iron deficiency where all Fe studies are normal except

> for transferrin (<20 at this stage). As the Fe deficiency progresses,

> other labs will then decrease, serum Fe, % saturation etc. That is

> based on a clinical reference called UpTODate that our hospital uses.

> I'll try and email you the reference! I am very confused by Fe

> levels done post-op, sometimes the surgeon does a full Fe studies,

> sometimes iron (but as above only serum Fe doesn't show early

> deficiency). Of note, we have a fair number of patients starting at 6

> months post-op who are presenting for IV Iron b/c they are not

> absorbing their oral iron (and yes, are compliant pt's). Hope this

> helps!

> Stacey Frost, RD

>

>

>

>

>

>

>

>

[Guest guest]

,

From my understanding, ferratin levels are the first indicator of

a 'stage I' iron deficiency where all Fe studies are normal except

for transferrin (<20 at this stage). As the Fe deficiency progresses,

other labs will then decrease, serum Fe, % saturation etc. That is

based on a clinical reference called UpTODate that our hospital uses.

I'll try and email you the reference! I am very confused by Fe

levels done post-op, sometimes the surgeon does a full Fe studies,

sometimes iron (but as above only serum Fe doesn't show early

deficiency). Of note, we have a fair number of patients starting at 6

months post-op who are presenting for IV Iron b/c they are not

absorbing their oral iron (and yes, are compliant pt's). Hope this

helps!

Stacey Frost, RD

[Guest guest]

Stacey,

Thanks for the info., happy to see you are keeping good records. I worry

more about the long term ramifications of Ca than iron since we pick up the

low iron but we don't really know how to follow calcium, see previous

discussions on this site. The lost to follow-up, or no follow-up is going to

get worse before it gets better especially with the " standards " for the

Centers of Excellence suggesting that phone calls or post-card constitue

adequate follow-up. Even the most committed programs lose 20% of patients by

2 years post-op. The solution is mandated follow-up for a least five years,

but this won't happen through ASBS. For our recommendations refer back to

Barter's comments earlier on the site. Let me know if you can't locate

and I will repeat.

Thanks,

Re: iron

> ,

> Our hospital's oncologist/hematologist provides the iron injections,

> not the bariatric surgeon. I have managed to locate ~6 patients, all

> female (out of ~250 total patients) earliest 5 months post-op and

> latest 4 years so about 2-3% of our population. Lowest Ferratin I

> have seen is 2. The majority of these patients are reportedly

> compliant with their supplements. Now that is not even considering

> those who are lost to f/u, which if anyone has read Brolin et al's

> articles on Iron/B12/MVI supplementation, there is a HUGE loss to f/u

> ( if i recall correctly only 8 followed up after 5 years)!!

> Initially, we supplement everyone with at least 325mg Fe daily (65mg

> elemental) and I boost menstruating women and those with history of

> anemia to bid 325mg Fe.

>

> Ironically,in the last 2 weeks,I have received numerous referrals for

> patients who had their surgery at different clinics who fail to

> follow-up with ANYONE post-operatively and now they show up at my

> doorstep malnourished, iron deficient (and who knows what else

> deficient). I am most concerned about this group of patients....how

> can we prevent this? I attempt to be realistic with each patient

> regarding eating styles/food preferences and supplements. I would

> rather have them taking 2 children's chewable's than nothing.

>

> , I want to say how interesting and wonderful it is to have your

> thoughts and experiences in this group! Would you be willing to

> share, if you already haven't, what supplements you order after

> surgery and when/what labs you order? I would like some 'substance'

> when I approach our surgeon about follow-up issues.

>

> Everyone else, thanks for all the great ideas, I am learning so much

> from you all! Could you share how you approach the topic of

> supplements with me, do you provide an 'acceptable' list?

>

> Thanks,

> Stacey Frost, RD

>

>

>

>

>

>

[Guest guest]

,

Our hospital's oncologist/hematologist provides the iron injections,

not the bariatric surgeon. I have managed to locate ~6 patients, all

female (out of ~250 total patients) earliest 5 months post-op and

latest 4 years so about 2-3% of our population. Lowest Ferratin I

have seen is 2. The majority of these patients are reportedly

compliant with their supplements. Now that is not even considering

those who are lost to f/u, which if anyone has read Brolin et al's

articles on Iron/B12/MVI supplementation, there is a HUGE loss to f/u

( if i recall correctly only 8 followed up after 5 years)!!

Initially, we supplement everyone with at least 325mg Fe daily (65mg

elemental) and I boost menstruating women and those with history of

anemia to bid 325mg Fe.

Ironically,in the last 2 weeks,I have received numerous referrals for

patients who had their surgery at different clinics who fail to

follow-up with ANYONE post-operatively and now they show up at my

doorstep malnourished, iron deficient (and who knows what else

deficient). I am most concerned about this group of patients....how

can we prevent this? I attempt to be realistic with each patient

regarding eating styles/food preferences and supplements. I would

rather have them taking 2 children's chewable's than nothing.

, I want to say how interesting and wonderful it is to have your

thoughts and experiences in this group! Would you be willing to

share, if you already haven't, what supplements you order after

surgery and when/what labs you order? I would like some 'substance'

when I approach our surgeon about follow-up issues.

Everyone else, thanks for all the great ideas, I am learning so much

from you all! Could you share how you approach the topic of

supplements with me, do you provide an 'acceptable' list?

Thanks,

Stacey Frost, RD

[Guest guest]

Our office uses amino iron (as iron amino acid chelate) 18 mg per day. We have found that amino iron has a far superior absorption rate compared to even ferrous fumarate. Amino iron cannot be purchased over-the-counter, but we do order ours through Laboratories. This additional iron is recommended in addition to a prenatal for pre-menopausal women and those who are anemic.

Kate Alie, M.S., R.D., L.D. Director of Nutrition Services Medabolix 600 Way

Northgate Business Park

ton, WV 25311 (304) 347-4313 (304) 347-4316 (fax)>From: "froststa99" <sfrost@...> >Reply- > >Subject: Re: iron >Date: Wed, 21 Jul 2004 13:50:00 -0000 > >, >Our hospital's oncologist/hematologist provides the iron injections, >not the bariatric surgeon. I have managed to locate ~6 patients, all >female (out of ~250 total patients) earliest 5 months post-op and >latest 4 years so about 2-3% of our population. Lowest Ferratin I >have seen is 2. The majority of these patients are reportedly >compliant with their supplements. Now that is not even considering >those who are lost to f/u, which if anyone has read Brolin et al's >articles on Iron/B12/MVI supplementation, there is a HUGE loss to f/u >( if i recall correctly only 8 followed up after 5 years)!! >Initially, we supplement everyone with at least 325mg Fe daily (65mg >elemental) and I boost menstruating women and those with history of >anemia to bid 325mg Fe. > >Ironically,in the last 2 weeks,I have received numerous referrals for >patients who had their surgery at different clinics who fail to >follow-up with ANYONE post-operatively and now they show up at my >doorstep malnourished, iron deficient (and who knows what else >deficient). I am most concerned about this group of patients....how >can we prevent this? I attempt to be realistic with each patient >regarding eating styles/food preferences and supplements. I would >rather have them taking 2 children's chewable's than nothing. > >, I want to say how interesting and wonderful it is to have your >thoughts and experiences in this group! Would you be willing to >share, if you already haven't, what supplements you order after >surgery and when/what labs you order? I would like some 'substance' >when I approach our surgeon about follow-up issues. > >Everyone else, thanks for all the great ideas, I am learning so much >from you all! Could you share how you approach the topic of >supplements with me, do you provide an 'acceptable' list? > >Thanks, >Stacey Frost, RD > Don’t just search. Find. Check out the new MSN Search!