Crohn's Disease Forum » Diet, Fitness, and Supplements » Advice on Iron, Please Help My Tummy Hates It!


 
01-17-2012, 08:18 PM   #1
Mountaingem
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Advice on Iron, Please Help My Tummy Hates It!

Hi Guys, After an especially bad bout of c. diff. I found out I am anemic and need iron supplements. I've been taking it, but it KILLS my stomach. Even with a full meal it is awful. I've tried taking it with almond milk, yogurt, bread, crackers, cheese, and with dinner, my biggest meal. Same thing happens, terrible pain and nausea, ugh!

Between Methotrexate, Vancomycin, and the Iron, my tummy and I are not on good terms...any advice? Is Ferrous sulfate a better option?

Right now I'm taking anti nausea meds but I realize this is just a short-term solution. I would really appreciate any and all suggestions!
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01-17-2012, 08:42 PM   #2
happy
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Hi Mountaingem,
I got iron injections twice a week and then weekly for a couple of months--I refused anything oral because of the elimination diet that I am following. I felt better after two injections. I get my blood tested again at the end of the month so we'll see if I am maintaining it.

Good luck with finding a solution that works for you.
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01-17-2012, 09:18 PM   #3
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I've had two infusions. I've been anemic (Hb 60) and I was tired and my stomach didn't like the pills either. I had Ferinject-infusions, 1000 mg at a time (it took about two hours in the hospital) and one infusion raised my Hb back to normal. Just ask your doctor, I'm sure you can get infusions too.

http://www.medicines.org.uk/emc/medicine/24167/SPC

I don't know how much they cost in different countries, but in Finland (we have a great healthcare system) I had to pay only less than 8 euros of the whole thing.
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01-17-2012, 10:07 PM   #4
pdenning2011
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There are natural things you can do to get more iron, for example Cream of Wheat or Spinach, red meat etc etc, every little bit helps
01-17-2012, 10:12 PM   #5
imisspopcorn
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I have good luck with children's chewable multi-vitamins with iron. Adjust your dose to the adult equivalent and see how it goes. Good luck
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01-26-2012, 04:56 PM   #6
newtluder
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I'm delurking to create an account and provide my experience with iron supplements.

I've found that any iron supplement in pill format upset my stomach. I've tried the really expensive to the very cheap. I was ready to give up until
I read on a running forum about a liquid iron supplement. After reading how successfully the liquid format was for a marathon runner, I thought it could help me.

I bought a bottle from Amazon and gave it a whirl. I'm currently using my second bottle and I've definitely noticed a difference in the way I feel and my energy levels. My stomach has not been upset once by the liquid iron. Additionally I hoped that one of the glorious side effects of iron - constipation - would hit me, but no luck.

FYI it tastes pretty damn awful. I've tried a variety of "chasers" with it and I found that Dr Pepper works best. The bottle recommends 1 teaspoon a day so I dump that into a shot glass and fill the rest with Dr Pepper. I take my iron shot and then 2 or 3 big swigs of Dr Pepper.

Good luck. I hope this helps.
01-26-2012, 05:48 PM   #7
Mountaingem
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Awsome! I'm going to get some right now-thank you so much!
01-26-2012, 06:01 PM   #8
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What dose are you on? Mine was awful at first, and my doctor let me reduce my dose to one pill a day. After a couple of weeks I think my tummy got used to it. I don't have problems now as long as I take it streight after food. Also, think about taking iron with Vitamin C to enhance absorption, and avoid foods with phytates in them, which will inhibit the absorption. Here is a page I found from a very quick google search on phytates - http://www.foodgraphs.net/food/phytic-acid.html You may be able to find a better one if you have a look!
I know this doesnt particularly help you with your stomach pains, but more general iron advice. If you are going through all this pain we want you to be absorbing your iron to make it worth it!!
The other thing I did when my iron was hurting me was to plan when in the day I took it. If I had nothing else to do for the afternoon I would take it with lunch. I would aviod taking it in the evening If I had to get up early the next day. I know it said you should take them at the same time every day, but this ment I could endure my pain when I didn't have to be doing something, and be in the comfort of my own home!
Hope you feel better soon!
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01-28-2012, 09:26 AM   #9
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Mountaingem, will you please update on how you do with the liquid iron as digestive system upsets are extremely common with iron supplementation so other things we can recommend would be beautiful if they work.

For those recommending plant based forms of iron, for a crohnie, heme iron rather than non-heme iron is going to be a better bet to focus on.

Mountaingem, how do you feel about liver and/or liverwurst? They are THE best forms of heme iron as well as a bounty of other vitamins and minerals crohnies desperately need.
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01-28-2012, 01:26 PM   #10
Mountaingem
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I am on 65 mg of iron which is the equivalent of 325 mg of Ferrous Sulfate. I started the liquid and so far no upsets; the downside is I have to take alot more of the liquid because it soesn't come in a higher milligream concentration. I would imagine this is the reason there is less digestive upset, because of the lower amount of iron per dose.

I am definitely up for trying liver or liverwurst; any suggestions on best way to prepare it? My Granny from Kentucky says with bacon and smothered with onions, not very Crohn's friendly lol!
01-28-2012, 01:37 PM   #11
David
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Good info on the liquid iron, thank you. Please keep us updated!

If you're open to liver, eat that rather than the liverwurst. If you can find grass fed animal liver, all the better as that'll have an improved ratio of n-3 fatty acids to n-6. I unfortunately don't have any good recipes Maybe post a request thread in the cooking forum?
01-28-2012, 01:57 PM   #12
Mountaingem
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Will do-I know there are many excellent cooks on this forum, and vonfunk has professional training, so let's see what they can come up with! I will definitely keep everyone updated!
01-28-2012, 02:34 PM   #13
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I don't know if anyone else has heard of this product...GlobiFer Forte.

It is a haem and non haem iron preparation...

GlobiFer ForteŽ is a natural, gentle, dual acting iron supplement which contains haem iron for minimal gastrointestinal side effects and highly bioavailable iron (animal source) and non-haem iron.

GlobiFer Forte has been developed because iron supplements are notorious for being poorly tolerated and poorly absorbed. By developing a haem & non-haem iron product there are 2 very different mechanisms of absorption which are additive in their effectiveness. Haem iron receptors in the upper intestine absorb the entire complex molecule and this process is unaffected by body stores of iron. This is a completely different mechanism of iron absorption to non-haem iron supplements and there is good evidence to show that it is also many times more effective.

The rationale for developing a haem iron product can also be made from the poor tolerability of so many non-haem iron preparations. Problems such as gastric pain, nausea and constipation are quite common with non- haem iron supplements. There are remarkably few side effects associated with haem iron preparations.

GlobiFer ForteŽ has a unique combination of haem iron and non-haem iron.

GlobiFer ForteŽ is a new product to the UK but much experience has been gained from its widespread use in Sweden where it has been available for 25 years.
http://www.stanningleypharma.bluesky...obifer-q-and-a

Haem iron is found in animal foods that originally contained hemoglobin, such as red meats, fish, and poultry. Non haem iron is found in plant foods and those foods that are fortified with iron.

A Japanese study regarding haem and non haem iron:
http://www.cedrugstorenews.com/usera...28120995A10C1A

I know that GlobiFer is now available in the UK but I don't know of its availability outside of Sweden and the UK or if equivalents are available in the US. I have read up on it a bit and it something I would try, or recommend my children try, if the need arose.

Dusty. xxx
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01-28-2012, 05:20 PM   #14
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I have the same problem - very anemic and react badly to iron supplements. My doctor prescribed SlowFe (45 mg elemental iron), which you can get at any drugstore. I'm supposed to take 1 a day but it ends up being more like 1 a week because I hate the pain,nausea and gross bowel movements that it causes (not just SlowFe, but all of the iron supplements that I've tried). Here are some tips for taking iron:

1- Take it right after eating a meal - and wash it down with some citrus juice if your meal didn't have any vitamin C rich food (e.g. peppers, broccoli, etc) - or take a vitamin C supplement with the iron. Vitamin C will help with absorption and the meal will help with reducing stomach irritation.
2- Don't eat any calcium-rich food a few hours before/after taking the supplement. Calcium interferes with the absorption of iron.

For foods rich in heme iron, I try to eat a lot of liver and clams. I like chicken liver a lot - a quick blanch and drain, then saute in olive oil with garlic ginger and scallion until just cooked. Clams/mussels are tasty as well. I try to limit my red meat intake, but when I do eat it lamb is my favorite.

For non-heme iron I enjoy beans, broccoli, dried apricots, and nuts.
01-31-2012, 11:03 PM   #15
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I also have had major stomach upsets with iron -- it felt like a balloon in my stomach! Very uncomfortable. I didn't have any other intestinal side effects though (e.g. constipation), so switching to SlowFe completely resolved my problems. Both Target and CVS make generic version that are cheaper as well.

I also tried the liquid supplement -- it's called Floradix and you can order it online or buy at the Vitamin Shoppe in the US. However, it only has 10 mg elemental iron per 2 tsp and (as other commenters have mentioned) tastes awful. I mixed mine with orange juice and it cut the flavor a little bit, but SlowFe was so much easier (and less expensive) I mostly stuck to that.
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01-31-2012, 11:07 PM   #16
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Anna, were you anemic prior to taking the SlowFe and if so, how has the SlowFe improved your anemia?
01-31-2012, 11:18 PM   #17
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David -- I was anemic, but I wasn't flaring at that time. Through process of elimination, it turned out to be related to my 6-MP dosing and so once I lowered my dose my counts improved. I was also taking SlowFe and I remember slowly feeling better, but it's difficult to know whether it was the dose change or the iron supplementation that helped.
06-13-2012, 04:26 PM   #18
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It is well known by old timers particularly in the Appalachian region, that blackstrap molasses is a good iron source. Hillbilly women took it during their menstral cycle. I have the same issue with iron supplements cramping my stomach and my level is 9 - shd be 12-16 I'm told. I have started a tablespoon a day (2 tsp. = 13% of daily levels). It's a slower process but I like the taste (something like licorice) and over time my iron levels should increase. I'll update down the road. I have taken Flintstones with iron in the past and tolerated them ok....but I can't find my bottle and since I have molasses I'm trying an old remedy...... you can put this in baked goods - really good in bran muffins and people put it in baked beans. Some people put it on waffles...it's a bit rich for me to want to smother my waffles in it. Some people make health drinks with it. There are probably recipes on the web. It's simpler to just jam a tablespoon in the mouth. Done.
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06-14-2012, 02:57 AM   #19
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you can mix ground liver with ground meat.
At 10% you probably won't even taste it
06-14-2012, 03:00 AM   #20
skippy111
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Cream of Wheat has Iron and Calcium in it!
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06-14-2012, 06:45 AM   #21
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Now I like the Cream of Wheat option! I don't think I could handle the liver even ground up into burgers. Blackstrap molasses also has calcum and several other minerals. It is very nutritious. I tried the Blackstrap yesterday --- its more like a dark burned sugar taste....something along the order of peanut brittle only darker. I researched and most people take 2 TBSP daily so I did. No issues with my Crohns. I'm making little applie pies this morning and I'm going to add some.
06-14-2012, 07:13 AM   #22
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I didn't think vancomycin and dairy were good friends.
I'm on vancomycin at the moment for K.Oxytoca however getting no-where.
Think of the worst chronic UTI and that's part of what this bug does. Apart from digging holes in my body had the UTI symptoms for 4 years now... Pretty over it.
Anyway, if you are trying to kill bacteria with the anti-biotics you are on, you should really stay away from dairy as it will give you nausea etc.
I don't think the iron suppliments should be causing those issues...
If so, choose another brand,make,non-mixed suppliments.
06-15-2012, 06:43 AM   #23
skippy111
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the reccomended daily dosage for Iron supplements is only 18-30mg
this includes Ferrous Sulfate..

if you have been diagnosed with an iron deficiency, you should always take iron supplements seperately rather than in a multivitamin and mineral formula.

you should not take iron supplements UNLESS you have been diagnosed as anemic. (most of us chronies are also anemic)

The reason why you want to take Iron supplements seperately rather than in a multivitamin is because you really should not take Iron and Vitamin E at the same time.

Ferrous Sulfate will oxidize vitamim E so when taking an Iron supplement, go with an organic form such as ferrous gluconate or ferrous fumarate.

Iron will absorb only if there is enough Hydrochloric acid in the stomach, you also need your copper,manganese, molybdenum, Vitamin A, and the B complex vitamins. Also, taking vitamin C can increase Iron absorption by as much as 30%.

you can get Iron in eggs, fish, liver, meat, poultry, green leafy vegtables, whole grains, enriched breads, cereals, beets, peaches, pears, rasins, and a whole bunch of other foods.

You really want to watch how much iron you are putting into your body daily because if you are getting too much it can cause problems.

ok now maybe someone can explain something to me,
I love cream of wheat, It has both Iron and Calcium in it, BUT. In Phyllis Balch's book, She says that you should not mix Iron and Calcium together because Calcium Inhibits absorbtion of Iron...

I have never had any problems from the cream of wheat so I do not understand what the deal with that is, but this is what she is saying.

I am going to ask my DR about this and then let you know what he says...



too much tea or coffee can also contribute to an iron deficiency as well
06-15-2012, 10:28 AM   #24
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Seems like you have to be a biochemist to get it into your system! Thanks for the update on the iron. I did not know about the Vitamin E issue. Interesting post.
06-15-2012, 11:30 AM   #25
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the reccomended daily dosage for Iron supplements is only 18-30mg
this includes Ferrous Sulfate..

if you have been diagnosed with an iron deficiency, you should always take iron supplements seperately rather than in a multivitamin and mineral formula.

you should not take iron supplements UNLESS you have been diagnosed as anemic. (most of us chronies are also anemic)

The reason why you want to take Iron supplements seperately rather than in a multivitamin is because you really should not take Iron and Vitamin E at the same time.

Ferrous Sulfate will oxidize vitamim E so when taking an Iron supplement, go with an organic form such as ferrous gluconate or ferrous fumarate.

Iron will absorb only if there is enough Hydrochloric acid in the stomach, you also need your copper,manganese, molybdenum, Vitamin A, and the B complex vitamins. Also, taking vitamin C can increase Iron absorption by as much as 30%.

you can get Iron in eggs, fish, liver, meat, poultry, green leafy vegtables, whole grains, enriched breads, cereals, beets, peaches, pears, rasins, and a whole bunch of other foods.

You really want to watch how much iron you are putting into your body daily because if you are getting too much it can cause problems.

ok now maybe someone can explain something to me,
I love cream of wheat, It has both Iron and Calcium in it, BUT. In Phyllis Balch's book, She says that you should not mix Iron and Calcium together because Calcium Inhibits absorbtion of Iron...

I have never had any problems from the cream of wheat so I do not understand what the deal with that is, but this is what she is saying.

I am going to ask my DR about this and then let you know what he says...



too much tea or coffee can also contribute to an iron deficiency as well
Hmmm....shortly into my flare, I stopped taking my multi and my b complex. Was looking at my last blood results, and my rbc and hemoglobin have both been going steadily down since September. I, of course, had to point that out to my doc, that my rbc actually had "low" listed by it this time, which made me compare it to the earlier results I had from Sept. and Jan. He told me to take iron, and prescribed me folic acid. Folic acid is for folate, which is B9, which helps us produce red blood cells. This is why I should not have stopped taking my b complex, duh!
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06-15-2012, 03:10 PM   #26
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I am eating Iron fortified baby rice cereal daily to try and get my ferritin up as I was also having problems tolerating the iron suplements. Red meat upsets my system as well. I found a plant based supplement, but it gives me heartburn.
06-15-2012, 03:22 PM   #27
skippy111
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and then with the green leafy vegtables we have the ruffage issue

I like the idea of eating the baby rice cereal for Iron..

these minerals are complicated, lol Iron will absorb if certain other vitamins are at normal levels, and then those nutrients are dependant on others, and so on and so on lol

the nutritionist who came to see me while I was in the hospital had given me her card with her email and told me if I ever had any questions to just email her... I think I just might take her up on that,

I was just reading one of the other posts on Magnesium which is dependant on Calcium and Potassium.. yet we can't take Calcium with Iron?
08-09-2012, 08:22 AM   #28
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MY GI informed me that Iron tablets were not advised for my gut, in fact he said they could make it worse. He booked me for an infusion which I had last week. It took two hours, easy, I didnt experience any pain or side effects.
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08-09-2012, 11:22 AM   #29
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I love iron infusions they are much easier, too bad when you get to a certain Hemoglobin level they refuse to give them to you lol. If you are sensitive to iron I would recommend Feosol Bifera HIP & PIC iron tablets. Unlike high potency tablets which use a synthetic iron compound Bifera uses natural iron contained in meat. They have found a 22% increase in Hemoglobin levels from taking Bifera even compared to taking high potency iron, it takes a little longer but the results are proven and since it's easier on the stomach if you can digest it then it's the way to go.

http://www.feosol.com/
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08-12-2012, 11:10 AM   #30
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I have the exact same issue with typical iron supplements however, google angostrom (spelling) supplements. These types of supplements have been reduced in size which allows them to be absorbed almost instantaneously and they avoid entering the large and most of the small intestines. I've been taking these and my iron is normal with no stomach issues. The only negative is the taste as they come in a solution. These are especially good for people with active flares who aren't really digesting and absorbing old properly.
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