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Crohn's and iron absorption

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Crohn's Disease
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Posted 4/14/2008 6:17 PM (GMT 0)
I was wondering if having inflammation from Crohn's in the intestines can affect how well your body absorbs iron from food. My iron was severely low recently and I've slowly been getting it back up by taking an iron supplement daily. I also started back up on Pentasa. I ate plenty of iron-rich food before, but it didn't seem to be getting absorbed. Where exactly in the intestines is it absorbed? I know B12 is around the terminal ileum, etc, but don't know about Fe. Have you had anemia from Crohn's?
Posted 4/14/2008 6:29 PM (GMT 0)
Yes. It's quite common to have low iron or B12 due to absorption difficulties due to crohn's. I have anemia and low B12 due to my crohn's. Iron is primarily absorbed in the duodenum and upper jejunum.
Posted 4/14/2008 6:42 PM (GMT 0)
All year I've been suffering from massive fatigue - and this was more than just being tired from going to the bathroom all the time (I'm in a flare). I knew this was something else. Out of the blue, my GI requests that I go have my iron levels checked. Mine were really low, too. Since then, I've been on an iron supplement which has helped a great deal with the fatigue I was having.

I don't know much, though, about absorption...I thought all nutrients were absorbed in the small intestine... ???
Posted 4/14/2008 6:48 PM (GMT 0)
Our year and a half journey to figure out why my son was anemic is what ultimately led to his CD diagnosis. We saw 4 different doctors--one who was a hematology specialist--all of whom said "just normal iron deficiency anemia". They explained it away by saying he was growing so fast (which he wasn't, his growth had drastically slowed) that his iron intake wasn't keeping up with his activity/growth level. I knew better because we always have taken nutrition very seriously.

During that year and a half he was taking 650 mg of ferrous sulfate a day and his anemia was not improving. Later it was explained to us that this was due to the inflammation in his intestines impeding iron uptake. As for where *exactly* this uptake occurs, even hematology specialists will tell you they don't know precisely. The specialist explained to me there is a WHOLE LOT they don't understand about where, how and from what sources the body best absorbs iron. They *do* know, though, that inflammation will most definitely impede uptake. Decrease inflammation and iron will absorb. It takes time, though, so be patient.

Make sure you are taking additional vitamin C while you are taking iron supplements. It is thought to facilitate iron absorption.
Posted 4/14/2008 6:54 PM (GMT 0)
I find that iron supplements just kill my stomach, even the SlowFe's. This is unfortunate for me...
Posted 4/14/2008 9:30 PM (GMT 0)
my low blood count lead them to test me for crohns, my blood level was only a 6 and my ferritin level was at 4....I went on iron and pentasa but my level only went up to 8 and stood there a year before I switched doctors and he also put me on entocort now I finally reached 10. Iron never really bothered my stomach, I take chromagen tablets. I hate the feeling of being tired all the time. Hope you feel better.

Posted 4/15/2008 1:03 AM (GMT 0)
After 3 bowel resections (1st being a right hemicolectomy) my iron levels were non existent. My hemotologist told me I could take iron supplements forever, and it would not help me as I wasn't absorbing them. Therefore, now I have iron infusions. When my hemoglobin gets just under 100 I need an infusion. It takes 2 weeks to make red blood cells, but then I feel better. Hope this helps.
Posted 7/4/2012 3:35 AM (GMT 0)
If you are still curious Iron is typically absorbed in the duodenum, or the first portion of the small intestines. However the causes of the deficiency in patients with Crohn's are more complicated than malabsorption.
Posted 7/4/2012 4:34 AM (GMT 0)
For at least a decade before my diagnosis, I was borderline anemic. After my resection, that situation continued. Oral iron not only really upset my stomach, but it didn't work at all. I finally had a bone marrow test (not as painful as I expected), which determined that I had zero stored iron in my bone marrow. Worried about the possibility of anaphylactic shock, my hematologist decided to split the recommended iron infusion into sixteen weekly installments, instead of one mega-installment. So I went in once a week and sat among the chemotherapy patients (a good reminder that lots of people face worse situations than I do--and handle them with impressive grace and humor). At the end of sixteen weeks, I still hadn't improved enough. So I had another round of sixteen infusions. That was nine years ago, and I'm still flirting with anemia. But my new doctor doesn't seem very concerned, which is fine with me. So yeah, that's a long-winded way of saying that it isn't unusual for anema to accompany Crohn's, especially if you've had any of your terminal ileum removed.
Posted 7/4/2012 7:50 AM (GMT 0)
I too have always been borderline anemic - recently more severe. As part of that workup they ordered Upper GI with SBFT, which shows active TI disease - I just started a new post on this, asking for advice on those results.

I also have terrible trouble with Slow Fe and just stopped taking it after about a month of misery -- am waiting for GI consult to know what to do next. This thread is very helpful...
Posted 7/4/2012 10:58 PM (GMT 0)
You might want to Google Pernicious Anemia. I have had Crohns for 15 years and Pernicious Anemia for almost all of that time. I can't absorb B12 so I have to take injections monthly.
Posted 7/5/2012 12:21 AM (GMT 0)
I have decent results with a heme iron- it isn't suppose to irritate things to much either- with that said, my ferritin stores alway hover from 5-20 so i usually have symptoms of low iron-- this has been going on for 5 years now and I have been on supplements on and off for that long. I recently gave up gluten and am going to see if that helps.
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