Food to boost dds energy and iron levels - gluten free

[Tirednest]

She's 16, anaemic and being tested for coeliac disease. We've gone gluten free while waiting for results and this is definitely helping with her tummy issues. She's been taking ferrous sulphate from the gp for a few weeks now and feels more tired than ever 😢

We eat healthily but with not much red meat which dh and I think we may need to change. Her typical diet is
Porridge and fruit for breakfast sometimes Greek yogurt
School lunch - she gets a cooked lunch which can be hit and miss, ie yesterday was a roast which was great, but Monday was chicken katsu curry so she was given rice only as the chicken was in breadcrumbs 😐
Dinner - this week she's had a vegan beyond meat burger (using up what was in freezer) with gf bun and salad and a few chips
Gf pasta with sausage peas and cream
Homemsde Chicken curry with rice

Any advice for food or snacks to boost her iron and energy levels? She just looks tireder and paler than ever. She does a lot of sport and is very active but I'm secretly hoping she'll give that a rest in half term.

Thank you.

Could you boost her protein intake? Rice for lunch is very poor for a depleted teen. Packed lunches are a nuisance but she could have had for example
A gf chicken sandwich
Full fat yoghurt
Tahini dip and carrots/broccoli/cucumber
gf flapjack
When she comes in she could have a smoothie with two scoops of protein powder in it before any carby stuff. I’m not against carbs for teens, just get the protein and greens in first. Also it’s really easy to put a handful of spinach in a smoothie without it tasting gross .
Iron needs a lot of greens to be absorbed which might be why she’s still tired. I would add vit c to take with her iron and greens with everything as much as possible.

Also eggs are good for iron, could she manage an egg in the mornings or have hard boiled eggs as a snack? Easy to keep in the fridge too.

Thank you, very helpful. She does make herself smoothies quite regularly with protein powder but has stopped- not sure if the protein powder is gf. I'll check. Vitamin c could be an issue, thank you. I did buy orange juice but dh drinks it so quickly I don't bother any more!

Would she eat any trad potato meals - shepherd's pie, cottage pie, baked potatoes with tuna or chilli con carne?

If she will eat something like bolognase/chilli, mixing ground lambs liver (it has less of a distinct taste than cow) in with the beef mince would be practically the best source she could possibly get.

Oh god she'd rather die than eat liver 😅 but I wonder if I could get away with it

Hi OP, personally I find iron tablets very harsh and can contribute to digestive issues (not to mention they can cause constipation).

I'm a big fan of floradix, an iron tonic drink (you take a couple of spoonfuls a day) it's a much gentler iron supplement and you can easily get hold of it in Boots, Holland and Barrett etc.

Is it as strong though? I'm nervous to deviate from GPS advice.

I'm an anemia veteran - ferrous sulphate is really hard on the tummy and also doesn't necessarily boost iron levels as so many things can work against absorption. It's best to take it with a glass of orange juice as Vit C aid absorption and have no caffeine an hour either side of taking it as that kills absorption. Also, avoid gaviscon or similar in that window too.

My personal favourite is Feroglobin Plus - it tastes fine and is v easy on the stomach. It's the one thing that really made a difference. You can take it as well as the ferrous sulphate. Ferrous sulphate is well known for its digestive side effects.

We’re veggie and my DH is gf.
My go-to meals high in iron are:
Broccoli frittata
Veggie chilli served with baked sweet potatoes or loaded twice baked potatoes
Chickpea and spinach baked eggs
https://www.bbcgoodfood.com/recipes/spinach-sweet-potato-lentil-dhal Lentil dahl
Jerk curry

Thank you! Do you think she could take both together then? I will get some today plus orange juice

This is fantastic thank you

It's a slow process to rebuild nutrients.

Don't rely too much on gf cereals/carbs to replenish vitamins, they are usually just fillers with not much in a way of nutrition, use lots of protein and veg instead.

Cooked breakfast, eg scrambled egg/omelette with ham, spring onions, mushrooms etc plus beans, tomatoes and black pudding etc on the side.

Home cooked veg soups (vits are better absorbed from liquids).

Chilli con carne etc with lots of colourful veg as well as meat, same for curries or casseroles etc.

@Tirednest - yes - I did for months! Hope she feels much better soon. It's a rotten feeling!

PS. Some black puddings are not gf, but there are some that are.

Would suggest eliminating oats - coeliacs are often intolerant of even GF oats. Also may be worth eliminating/reducing dairy for a short period and seeing how she feels when you reintroduce it. If she is coeliac (or gluten intolerant) she may be sensitive to dairy (while her gut heals itself). Make sure you're using toaster bags in the family toast bag, storing her GF food separately, separate spreads and jams to avoid cross-contamination – and don't forget to check things like soy sauce are GF, even medication. I changed my dry shampoo (Batiste) to a GF brand. Hope this is helpful! I think you'll find it's the oats. The Coeliac Society is really helpful (and they have a great barcode checker tool).

Her stomach and bloating are fine with oats, so we are hoping perhaps she is not actually coeliac, although she checked with Coeliac uk and they said oats are normally fine.

I'd consider eliminating them for a short period as part of the overall process, tiredness etc. can be a symptom. Anecdotally, a lot of people can't tolerate them. Hopefully she isn't coeliac! It'll be helpful when you get the results back.

@Tirednest yes, floradix is absolutely as strong as the tablets prescribed by the gp. I also suffer from anaemia (diagnosed by gp) and taking this supplement has brought my levels back into the normal range (confirmed by blood test!).

She absolutely loves porridge so I'm going to buy a gf cereal as an alternative but leave it up to her until we get results. Thanks for the info,much appreciated.

Based on the diet you've included she's not getting much protein and not enough vegetables. Add in a lot of fish, esp salmon and sardines. Also eggs, beans and pulses, cheese. And more veg with every dinner.
Might also be a good idea for her to take her own lunch to school unless they are able to provide her with a gluten-free lunch every day. Serving her just a plate of rice because the chicken has gluten on is not good enough.

Iron pills are very harsh on the stomach, given her diagnosis I’d be asking the doctor for the gentlest iron pills, these will be the more expensive ones so they’re not the first to be prescribed. You might have to push the go there.

the best way I’ve found is taking the iron pill every other day and a multi vitamin on the alternate day. It takes three months to see a difference so hang in there. On the days you take the iron pill don’t have anything with calcium or zinc or magnesium as these will inhibit the uptake of iron. Do take it with vitamin c.

I usually eat an orange (blood orange at this time of year) or two satsumas as the fibre helps it be a bit more gentle on the stomach.

ive known celiacs to struggle with legumes and watery veg like squash and courgette and potatoes, but those are good to add if she can tolerate it. Warm soups and bone broths too. It’s a long game though, don’t expect to see changes for three months and get a full blood test now and in three months.

final thought (sorry for length) are her periods contributing to low iron? Are they very heavy/long/painful for example? Might be worth a scan as endometriosis can cause celiac like symptoms and low iron.

Thank you. Yes she's having a blood test in three months. Her periods are very light actually.

Dark green leafy veg, stuff like kale, spinach and seaweed. Would she eat things like the Itsu seaweed thin snacks?

I mean I could ask her to stop the pills altogether and move to floradix or ferruglobin if they would be better