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Posted 8/26/2009 6:50 PM (GMT 0)
Hey all,

went to see my gastro on monday. He was his usual lovely self! Told me that we will move my infliximab infusions closer together so the infliximab wont wear off! Yippee!! He then told me i was severly aneamic and i had to take iron tablets. So i went to the pharmacy and picked up 100 ferrous sulphate tablets and started off slow with them. I was planning to take 1 tablet for 5 days, then up to 2, once i have no side effects then i go up to 3 tablets a day. Last time i took iron (4 years ago) i was absolutely fine on them. No side effects or anything! This time, not so lucky. As i say i've been taking one tablet a day, with food to try to give my system time to adjust. I take them in the morning, and by the evening i'm freezing cold (i have three blankets on me right now!) and as soon as i get one bite of food in my mouth i feel really sick. This continues till i throw up all the food in my stomach. Does anyone have any tips as to how i can continue taking the iron? I really feel like giving up on it right now, but i know i cant. I know i NEED to take it.
Posted 8/26/2009 7:18 PM (GMT 0)
I also have BIG problems with iron ! Nausea, diarrhea, stomach pains. I also tried IV infusion, what a nightmare & double the pain and suffering. I am now trying Flintstones children vitamins w/ iron. Just started, one at day, it has been tree days and so far it is OK. I hope it works, my blood count is low , 9.4. and at this point I am willing to try anything. 

 50 + woman, Crohn's disease for 25 yrs. , recently stopped Humira (after a year and 1/2) due to fever and night sweats. 

Also recently, diagnosed with a colon stricture, and thyroid nodules. Gone for biopsy and waiting for results.

 

Posted 8/26/2009 7:24 PM (GMT 0)
Hi i couldn't take ferrous sulphate as it whizzed through my body i now take iron in syrup form which absorbs quicker into the body its called sytron i have 20ml 3x day Bev x
Posted 8/27/2009 1:02 AM (GMT 0)
try the over the counter multivitamin. You need the womens version or the energy version, (the mens multivitamin typically doesnt contain iron) so read label preferably the smaller multivitamin pill, not the huge one. and it doesnt need to be 100% iron ...in other words taking the multivitamin rather than straight iron by itself,for what its worth it just might help a bit. You know when it passes as stool is black so test different foods when taking it as to the food with least discomfort upon passing.
Posted 8/27/2009 1:44 AM (GMT 0)
Honestly, I would encourage you to throw your iron sulfate in the trash. The crap that the doctors prescribe was the standard many decades ago, but new research proves that Iron Glyconate which is an amino acid chelate is both safer and more effective and easier on your stomach. A smaller safer dose of Iron Glyconate will raise your iron levels faster than a higher more dangerous dose of Iron Sulfate. Medical tests prove this beyond any doubt. Iron Sulfate is associated with a much higher risk of averse reactions, especially if you already have stomach issues. I dont know why doctors have not gotten with the times and switched to the superior form of iron.

Use a product called gentle Iron instead. Throw the other ones in the garbage if you dont want your stomach to bleed. (Not official recomendation, just what I would do in your position in my unofficial opinion).


Even the iron Glyconate can cause you problems if you already have crohns. Compare to the Sulfate it is way easier on your stomach, but all forms of iron will wreak havoc on your guts. If you are anemic and just just low ferritan you might consider IV iron supplementation.
Posted 8/27/2009 3:44 AM (GMT 0)
Just finished reading an article in the British Medical Journal "Gut" which reported the following:
All ferrous compounds are oxidised in the lumen of the gut or within the mucosa with release of activated hydroxyl radicals, which will attack the gut wall and produce a range of gastrointestinal symptoms and discomfort.76,77 Enteric coated ferrous formulations attempt to avoid this by minimising iron release in the stomach. If this is successful it also prevents iron absorption.

It goes on to say:
Ferric iron polymaltose complex, ferric trimaltol, or haeme iron polypeptide are also available in some countries. Ferric iron has less pro-oxidant potential but is sparingly insoluble and generally biounavailable. Surprisingly, in an open study, oral administration of ferric trimaltol complexes has been found to be safe and effective.80

The problem of poor iron absorption arises because the body reacts to inflammation by reducing the absorption of ferrous iron which is a pro-inflammatory agent (due to production of hydroxyl radicals). Attempting to supplement iron using ferrous compounds increases inflammation and thus reduces absorption of iron.
Posted 8/27/2009 9:33 AM (GMT 0)
thanks to everyone for your replies! I've decided to take a break from the iron today. Try to get some decent food in my belly! My mum is going to have a look for some kids multivits with iron. We'll see how i get on with that. This is so frustrating!!!
Posted 8/27/2009 10:36 AM (GMT 0)
Kids Multis wont have enough Iron. Children are sensitive to iron and can easily overdose. You need much larger doses than you will find in children's chewables.

There are a few good forms of Iron on the market and none of them are Iron Sulfate. I dont know why they still use Iron Sulfate other than because its cheap. Its effective for some people in ultra high doses, but is associated with more adverse reactions and is a horrible idea for Crohns disease.

Go to your health food store and look for a product which is an adult Iron only supplement, preferably some kind of amino acid chelate. Some people prefer liquid, but steer clear of Iron Sulfate. 25mg of Iron Glyconate is more effective than 100mg of Iron Sulfate for raising Iron levels...you may still need to take it with food and back off if you have any discomfort.

Vitamin C, white but NOT red wine, lean protein and B vitamins all increase iron absorption. Other minerals however, like those found in a multi will actually decrease iron absorption, as will caffeine and especially green tea due to the polyphenols.
Posted 8/27/2009 1:17 PM (GMT 0)
I have a friend who took Prenatal vitamins to help her Iron. Just a thought!
Posted 8/27/2009 3:00 PM (GMT 0)
I took Slow FE for 4 days and it stopped me up. I was feeling better, but the not being able to have a bowel movement was bad (who would think that I would not like that). I felt worse not being able to go than I do when I can go. Now I am back to being tired and worn down. :(
Posted 8/27/2009 3:25 PM (GMT 0)
Is it Iorn or another type of anemia??Did the Dr check for sure?
Posted 8/27/2009 5:00 PM (GMT 0)
he definatley said i was needed iron cos i was severly aneamic. Not sure what part of my blood results he was looking at. Was sat too far from the screen!! I'm mad about it, cos i've been having pre-infliximab blood tests done since march and NO-ONE thought to flag the fact i was getting more and more aneamic even though i always ask how my bloods are! All it would have taken was a quick phone call to flag it to my IBD nurse and she could have sorted me out quickly. Grrr!!! I shall be having words with the nurses next time i'm due for my infliximab. Dont get me wrong, i genuinely like the nurses and i ont want to fall out with them, but some-one has dropped the ball with this.

I didnt take any iron today and i've been perfect! No sickness, no vomiting, no pain. I'm tyring to convince my mother that i cant keep going with the iron as i am. Think is i'm not earning right now so she has to pay for it. She isn't to happy about the idea of it especially since she just bought the first lot of iron. Does life ever move smoothly for anyone?
Posted 8/27/2009 8:25 PM (GMT 0)
Solgar's "Gentle Iron" and similar supplements contain Iron Bisglycinate, which is easier to tolerate. Solgar's supplement comes in 25 mg - you could double up the dosage. The best way to take it is 2 hours after and before any meal, med, or other supplement - and take it with orange juice.

Keep an eye on your zinc. Crohn's patients tend to be low in zinc, and iron supplements can interfere with the absorption of zinc. (And zinc interferes with iron.)

 

Posted 8/27/2009 8:34 PM (GMT 0)
my doc never lets me take tablets i get iron through IV and all the UC, CD paitents get them through IV.
Posted 8/27/2009 9:36 PM (GMT 0)
Agreed that iron infusions are more effective, but they take time and have adverse reaction hazards for some. Ferrous salts are harmful in whatever format they are taken in - some just spread the problem around so the reaction is less acute. The use of Ferric Trimaltol avoids the problems of damage and resulting down-regulation of iron absorption.

It seems to be only available in the UK and India currently, but since it is not patentable, it may be available elsewhere in a generic format.

SlowFe is a timed release format and seems to offer the worst chance of success. It releases most of its iron in the gut where it is poorly absorbed (iron is usually absorbed in the duodenum) and it causes harm there as a result of the formation of reactive hydroxyl radicals and subsequent indiscriminate oxidation by those radicals. The resulting inflammation causes even more down-regulation of iron absorption, so that iron is not absorbed even in the duodenum.
Posted 8/28/2009 2:02 AM (GMT 0)
That's really interesting about the SlowFe, Keeper. Do you have a source? My wife just started taking them today (she doesn't have CD but her iron is a bit low).

Mike
Posted 8/28/2009 3:49 AM (GMT 0)
Not for SlowFe by name, but the quote in my first post above talks about iron in the gut causing discomfort - the original article was more specific about damage caused in mouse and human studies by iron in the gut. SlowFe is timed release, so it is released mostly after it passes out of the stomach/duodenum where it might be absorbed. In fact most high dose iron supplements would not be absorbed due to transport limitations and so would end up in the gut also. The original article was: http://gut.bmj.com/cgi/content/abstract/53/8/1190
This link is for the abstract. The full article can be viewed by registering with them.

I thought that the common practice of using ferrous salts with negative results needed some light on it. From the articles I have seen, ferrous salts cause damage and result in a reduction of your ability to absorb iron by worsening inflammation. The reported reason for iron deficiency in CD is that the inflammation of your gut causes a reduction of the ability to adsorb iron. This is because iron is pro-inflammatory and the body restricts absorption to limit further inflammation systemically. It can't protect the lumen of the gut though.
Posted 8/28/2009 8:41 PM (GMT 0)
I have been using the slow fe iron tablets, an offbrand name. I don't even notice taking them. Says 47.5mg ferrous sulfate.

They do make it easier to keep my body temp. regulated. Without them I get so cold, even out in the hot weather I am freezing if I don't take iron.
Posted 8/31/2009 2:25 PM (GMT 0)
I use a 21/7 tablet...Se-Vate (Repliva). FERROUS ASPARTO GLYCINATE 70 mg Ferrous Fumarate 81 mg with Succinic acid, Vit.c, Vit. C complex, Folic acid & Vit. B12. It has worked wonders for me & I haven't had any side effects It is RX for doctor. I also was severe iron anemic.
Posted 8/31/2009 2:47 PM (GMT 0)
I liked Thorne's Iron citrate, I think that one went down the best. Anabolic Laboratories makes a timed release iron with a liver concentrate in it that I like. It is the only liver I've taken that went down fine, I think it's predigested. Liver is a huge boost when you're anemic. My nutrition teacher doesn't even use iron with most of her iron anemic patients. She uses vitamins, mainly large amounts of B12 to overcome the anemia. The product she uses is a sublingual B12 by Douglas Labs. All the B12 is taken in under the tongue, so it avoids the problem of inflammation interfering with absorption. However, I have read that some people the mouth is only capable of taking in a tiny fraction of this B12. I don't know if there evidence to back it up though. I tried it and the sucrose bothered me. All of these products are only available to licensed health care practitioners though. Also, try eating dates and figs. You'll feel the boost. Fresh is easier to digest, but you can soak the dried fruit overnight to make it easier to digest. If it's still hard to digest then you cook them in a rice porridge. Not great food combining, but it works.
Posted 8/31/2009 5:41 PM (GMT 0)
B12 anemia and iron anemia are quite different things, as far as I understand. I don't think taking B-12 will boost your ferratin.
Posted 8/31/2009 7:14 PM (GMT 0)
I also take prenatal multivitmins for the iron. Also, about the SlowFe, my sister has always been pretty anemic and she has also found that slow release iron supplements have helped with her iron-associated nausea.
Posted 8/31/2009 8:26 PM (GMT 0)
SlowFe will help with the nausea because it is mostly released well below the stomach. The problem that you get with it is poor absorption due to its pro-inflammatory character and the lack of iron transport mechanisms south of the duodenum.

There is no iron elimination process in the body so iron levels are controlled by absorption regulation. In chronic disease, the disease-related inflammation causes iron absorption to be restricted despite low levels. This is one of the body's responses to chronic inflammation.
Posted 9/1/2009 3:55 AM (GMT 0)
I'm not talking about B12 anemia. According to my nutrition teacher, B vitamins need to be taken for iron anemia. They all work together. And since B12 is such a big problem with Crohn's it's necessary to take a good supplement. She gets people over their iron anemia without using iron supplements most of the time. Instead they get their iron from natural sources. She does this because of the toxicity issues already mentioned. She also mentioned some function in men that can't occur when too much iron has been taken. Anyway, what I want to point out is that the B's and iron work together.
Posted 9/1/2009 5:11 PM (GMT 0)

Keeper said...
Not for SlowFe by name, but the quote in my first post above talks about iron in the gut causing discomfort - the original article was more specific about damage caused in mouse and human studies by iron in the gut. SlowFe is timed release, so it is released mostly after it passes out of the stomach/duodenum where it might be absorbed. In fact most high dose iron supplements would not be absorbed due to transport limitations and so would end up in the gut also. The original article was: http://gut.bmj.com/cgi/content/abstract/53/8/1190
This link is for the abstract. The full article can be viewed by registering with them.

I thought that the common practice of using ferrous salts with negative results needed some light on it. From the articles I have seen, ferrous salts cause damage and result in a reduction of your ability to absorb iron by worsening inflammation. The reported reason for iron deficiency in CD is that the inflammation of your gut causes a reduction of the ability to adsorb iron. This is because iron is pro-inflammatory and the body restricts absorption to limit further inflammation systemically. It can't protect the lumen of the gut though.

Thanks Keeper.  I've always suspected that iron pills not only cause me pain, but increase inflammation as well.  I've had some success with Proferrin iron pills, which are completely heme iron made from chicken livers.  Quite expensive, but no side effects that I can notice.

Mike

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