General Iron Info

On December 7, 2009, in Minerals, by Andrea

Some of the things discussed in our post-op health can be a bit confusing.  Iron is one of those things, IMHO.  So how about a session just on iron?

What is iron?
Iron is a mineral that can be found in plants, animals, soil, air, water, meteorites, and rocks, including on the surface of the moon.  Here on earth, plants absorb iron through their root systems; animals eat these plants.  Humans consume these plants and animals.  Many think iron is a heavy metal, which it is not.  Iron is an essential micronutrient.  Essential used in this way means that the body does not produce the nutrient; micronutrient means that the body only requires tiny amounts to function.

Types of iron?
There are two forms of iron – heme and nonheme.  Nonheme iron primarily comes from plants and heme iron comes primarily from meat.
Nonheme iron represents the majority of iron humans consume in their diets and is the type of iron in most supplements.  Nonheme iron is inorganic and is found in grains such as rice, wheat and oats.  It’s also found in nuts, fruits, vegetables, most iron pills, fortificants, or contaminant iron such as from water, soil or cooking utensils.
Meat, especially red meat is the best source of heme iron.  Heme iron is easily absorbed by the body and the best source of iron for people who are iron deficient.

Iron terminology

  • Transferrin – a protein that is the major transporter of iron and ideally is saturated with 25-35% iron; when working properly, transferrin binds to iron and transports it to all tissues, vital organs, and bone marrow so that normal metabolism, DNA synthesis, and red blood cell production can take place
  • Ferritin - a protein that acts like a large holding vessel; contains iron that we don’t presently need
  • Hemaglobin (hgb) – a protein that transports oxygen to the body
  • Hematocrit (hct) – proportion of blood volume that is occupied by red blood cells

So someone who is anemic can still have normal hemaglobin and hematicrit numbers because their ferritin is being depleted in order to maintain those counts.  But if the ferritin is in the toilet and no relief comes, the hgb and hct will eventually fall as well.

Types of non-heme supplemental iron:

  • Ferric salts: These include ferrous sulfate, gluconate, and fumarate.  Typically, the way these compounds are made is that pure iron is dissolved in sulfuric or hydrochloric acid.  Once dissolved, a counter ion  is added and the pH is adjusted to make neutral once again.  When this happens, the iron binds to the counter-ion and drops out of the liquid solution.  The slurry is then dehydrated and the dry stuff that is left is the iron salt.  Ferric salts, especially ferrous sulfate, are not known to be easy on the digestive tract.  Once ingested, it is imperative that the stomach contains acid to dissolve the iron salt.  If a person is taking antacids or H2 blockers, their stomach will be “achlorhydric” – their stomach won’t contain acid and the iron salt will not dissolve.
  • Carbonyl iron is often used by physicians because it is less toxic to accidental overdose.
  • Polysaccharide iron is a newer form that is coming up in popularity, absorbs better than the ferric salts, but is more expensive than the standard supplementation routes.

I discuss my current experiment with the heme iron, Proferrin, here.  Information about it from the Iron Disorders Institute:

About Proferrin(tm):  Performance studies indicate that iron absorption rates are between 15% and 20% withoute erythropoietin (EPO) therapy and as high as 30% with EPO therapy even in patients with high serum ferritin values (>600 ng/ml).  In one study, the change in serum iron from Proferrin(tm) was nearly 23 times greater than from an identical dose of ferrous fumarate.  Also, study participants were able to tolerate up to 60 mgs per dose on an empty stomach with fewer gastrointestinal side effects; a common complaint from patients taking traditional oral iron preparations.  An additional benefit of heme iron supplementation is that patients can take it with their meals, unlike ionic iron preparations, which must be taken on an empty stomach between meals.

Info courtesy of the Iron Disorders Institute

Guinea Pig? Yeahsureyoubetcha!

On December 3, 2009, in Minerals, Reviews, by Andrea

I want it plainly made clear that I will do things for my peeps — those of you in the WLS family that I wouldn’t do for many others.  Got it?  Good.  Lavish praise, free samples, protein to sample, My Little Ponies for the pre-schooler to dress up, balls for the toddler to throw at my head while I blog are all welcome to show your happiness at my willingness to be your guinea pig.  Just call me Winnie.

WonderPets WonderPets We're On Our Way!  (With IRON!)

WonderPets WonderPets We're On Our Way! (With IRON!)

So last night, during a not-so-routine check with a doctor, I had a blood draw.  This was after I dazzled him with my vitamin knowledge, and sharing my recent harrowing experience with blood draws of my children and not really wanting to drag them along.  Realizing that I probably knew more than he did, he walked to the lab and said “draw whatever she wants” — and she did after consulting her book as some of it wasn’t her norm.

So what does all of this mean for you?  I’m GETTING THERE.  It’s been a LONG day at work.  I’m slow.

I have issues with iron.  My hematacrit (hct) and hemaglobin (hgb) are always fine (which are the two main things that are determining factors for “anemia”) but my ferritin is in the single digits.  I have been taking 600mgs of elemental chemical iron, in three forms — polysaccharide, carbonyl, and fumarate.  And before someone does the smartass “But Andrea, are you taking it with C?  Away from calcium?  Away from tannins?  Away from legumes and whole grains?  With vitamin A?  Is your B-12 good?  What about copper and zinc — that chick on OH says you need those, too!”  Remember to whom you are asking.  OF COURSE I HAVE.  DUH.  For some reason, I just don’t absorb the chemical iron.  My ferritin has stayed at a 7 for over a year now.

So last night, I got a full iron panel pulled.  I have the hct and hgb levels now, but am waiting for the rest in the mail in about a week.  Hgb is 12.6 (12.0 – 18.0) and hct is 39.7 (37-51).  Not horrible, high enough to donate blood.

I’ve heard of Proferrin, which is a heme iron — something completely different.

Wonder Iron?

Wonder Iron?


Increased Absorption*

Absorbing iron orally is difficult and Proferrin helps solve this problem. A study performed at the University of Colorado compared taking 20 mg. of elemental iron as heme iron polypeptide to taking 20 mg. of ionic iron (ferrous fumarate) with a standard meal. The study demonstrated that HIP increased serum iron levels 23 times greater than ionic iron on a milligram-per-milligram basis.1

Contains Only Iron from Natural Sources*

The HIP in Proferrin is extracted from hemoglobin, a naturally occurring iron source found in red meat and poultry.2 Proferrin does not contain common allergens, such as milk or wheat products, gluten, or significant amounts of oils or fats. If you have specific allergies, please contact your physician or Colorado Biolabs for more information.

Doesn’t Compete with Other Nutrients*

The HIP found in Proferrin is absorbed differently than traditional irons. Unlike other irons, Proferrin does not compete with other nutrients.3,4

Fewer Dosing Restrictions*

HIP does not appear to be affected by calcium, coffee, or other foods, and can be taken with meals.1 It may even replace intravenous irons.5

Fewer Side Effects*

Traditional iron supplements are made with ionic irons, which can cause side effects such as constipation, cramping, gas and other forms of digestive system problems.6,7,8 Proferrin causes less gas9 and is unlikely to cause common iron-related digestive system side effects. This is due to Proferrin’s heme iron polypeptide being absorbed differently than that of non-heme iron.

I thought — well, why not?  So here’s the experiment.  I’m going to take 3 a day (which is per the bottle — 1-3 per day) for 90 days and have another draw and see if there is any change.  I won’t take any chemical iron between now and then just to see what this can do.  I’ve heard it’s wonderful, so I’m willing to give it a shot.

It’s quite expensive — comes out around $50/ per month — so if chemical iron is working for you, then stay with it.  But maybe this can eventually keep a needle out of my arm?

Taking bets — what does anyone think?  Hype or not?

Bariatric Advantage 60mg Iron – Lemon Lime

On November 30, 2009, in Minerals, Reviews, by Andrea
60mg Lemon Lime

60mg Lemon Lime

Our Chewable Iron was designed to meet the iron replacement needs of patients who have undergone bariatric surgery. Our iron is in a form that is both easy to take and tastes great. Our Strawberry Flavored Iron provides 18 milligrams of elemental iron from Ferronyl®, and our 29 milligram iron is a blend of Ferronyl® and ferrous fumarate. Both contain vitamin C to optimize iron absorption and utilization. Tablets are designed to be easy on the digestive system, to support maximum absorption, and to minimize side effects like constipation.

And Andrea digs back into the OH ATL swag bag and pulls out this sample from Bariatric Advantage — Their 60mg Lemon Lime Flavored Iron with Vitamin C.

At first glance, it’s a small gray tablet — which isn’t shocking since it’s made of carbonyl iron. It’s slightly larger than a sweet tart, which is ironic since that is what it tastes like — in fact, maybe a bit tarter than a sweet tart.  Not too tart, but very palatable.

However, it does, after some time, have a bit of an aftertaste — as most irons do.  And I’m burping it — although it’s not nearly as good as it was when it first went down.

Ferronyl® carbonyl iron. Ferronyl® carbonyl iron powder is elemental iron (Fe) with > 98% iron content. A key physical property of Ferronyl is its small particle size, which is considerably smaller than other forms of elemental iron. As a result, Ferronyl has higher human bioavailability than these other forms. The net absorption per unit dose of Ferronyl is also greater than that of any of the currently used ferrous (Fe2+) salts.

Vitamin C. Vitamin C is known to enhance iron absorption. Vitamin C benefits the absorption of iron by reducing ferric iron (Fe3+) to ferrous iron (Fe2+) and forming an iron-ascorbic acid complex. A 1999 study conducted in gastric bypass patients suggested that the combination of iron with vitamin C was more effective than iron alone at restoring ferritin and hemoglobin levels in anemic patients.

Short-Chain Fructoligosaccharides. Fructoligosaccharides (FOS) have been studied for their ability to improve the uptake of select minerals (including iron, calcium and magnesium) from the colon. In animal models, use of FOS with iron has been shown to increase ferritin levels and aid in the recovery from anemia. In one study in rats who had been subjected to total gastrectomy, the combination of FOS with iron was successful in preventing the development of anemia. This strategy makes sense for individuals who have undergone weight loss surgery where there is both partial gastrectomy and short bowel to aid in the optimization of iron uptake and support the maintenance of body stores.

Nutrient Amount %DV
Iron (Ferronyl® carbonyl iron) 60 mg 333%
Vitamin C 250 mg 417%
Fructoligiosaccharides (FOS) 66.5 mg NA

Now, I LIKE carbonyl iron.  Carbonyl is easier on the GI tract than any of the ferric salts — and is so much easier than ferrous sulfate.  I’d rather gnaw on a rusty pipe than take ferrous sulfate.  I mean it.  Ferrous sulfate is evil to my system — bloating, cramping, constipation.. it’s evil.  Carbonyl, because it’s straight elemental iron, doesn’t have those nasty side effects.

But what I would have liked more would have been more C.  There is plenty of research that shows an ideal balance of C to elemental iron is 200mgs of C to 30mgs of elemental iron.. so this falls short in that regard.  Still, it’s much much better than many things on the market so it’s a reasonable thing to take, unless you are taking a massive dose of iron like I am — then you’d just go bankrupt.

Available at Bariatric Advantage, 90 count for $36.95, 270 ct for $68.95.

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