Not getting on with ferrous fumerate iron pills; can I ask doctor for iron injections?

[grilledhalloumi]

I've been feeling like crap and shedding lots of hair. blood tests show a shockingly low iron count and off the scale low ferritin count. I've got a doctor's appointment on Monday to discuss results, but I've already started taking iron pills.

Problem is they make me feel sick and constipated - and I know this from previous experience.

Can i ask for iron injections? Will they give them to me? I have private health insurance...maybe I should explore it there?

And - will they look to investigate why it's so low?

I'd ask for investigations as to why, certainly.

If you're not tolerating the tablets have you tried Spatone? It's sachets of iron rich water that you put into a glass of orange juice. You can get it from most supermarkets and Boots.

Problem is the sulphate also give me constipation! And I like Spatone but it's not enough iron for me.

Thyroid is okay - not great but within normal range.

So...no injections then?

What's the suspension? Is it liquid? Less chances of constipation? I CAN"T STAND constipation...!

How low is your iron count? Why is it so low?
I'm under investigations for a very low iron count. I had to have a 3 unit blood transfusion and then iron tablets but I couldn't tolerate them so I have to have regular iron infusions. These need to be prescribed by a haematology consultant (go privately if you gave insurance, I waited six months) but you'll be referred from there to NHS for infusions. You have them in a drip form over a few weeks, an hour or so a week. Be warned though you get a horrible 3 day headache every week from them. They're not an easier option than iron tablets at all, so try a different type of iron tablet first if you can.
It's important to find out why you're anaemic though, they will probably want to rule out gynae bleeding first. I'm 18 months along the road and had gynae ruled out eventually now waiting for gastroenterology. If you are anaemic you are either losing too much blood or not absorbing enough iron, or both, the trick is to find out which and as you have private insurance you'll find out much quicker than I am!

Eighttosixer, sorry to hear you've been so unwell.

My serum ferritin level is 4.9ug/l (the range should be 13-150).

My iron levels are - 5umol/L (the range should be 5.4-28.6)

Hopefully the GP will explore why you're anaemic. Occasionally a cause won't be found, or there will be an untreatable cause, but it's always better to treat the cause than (or as well as) the symptoms if possible. Iron infusions aren't an easy option, but an option if there are no other solutions.

I'm on the liquid as I can't tolerate the pills, and for me it's much better. No GI upsets at all (I had severe diarrhoea rather than constipation). Still makes my poo black tho! (Sorry if tmi!)

That's interesting Ipswitch. Does it give you as much iron as the pills?

Welovecouscous - my Tsh is 2.71mu/L.

don't know what T4 is...

I had iron injections here in Australia as I could not get on with iron tablets. From what I've heard it is hard to get them done on the Nhs, maybe they're expensive. You might beable to get them done privately or have an iron infusion.

I tolerate one of the suspensions a lot better than the pills, I can't take them at all.

I have in the past asked for the injections when the pills have made me ill or the suspension not working quickly enough and have been told no. I have no idea why.

Please tell me what this suspension is called.

I have been trying to raise my ferritin levels for three years. NHS here agree that many people struggle to tolerate oral iron, but injections are not available in this area and infusions are only available if you are below range.

I have recently spoken to the pharmacist at our largest branch of Boots who said I had tried everything he knew about.

If I can find out what the suspension is called then maybe I can investigate that.

I'm not sure as I had 2 different ones. The first one didn't help at all but the second one did and tasted nice.

I will try and find the bottle.

Did the suspension cause constipation?

And if I try to continue with the pills, will the constipation ease? And what can I do to minimalise it? I have a v healthy diet and exercise a lot.

Also - sorry, lots of questions - how long does it take to raise ferritin levels?

Thanks all

The suspension didn't seem to make me as constipated and my stomach didn't really hurt like it did on the pills.

I don't know that the constipation eases. :( You could try lactulose, maybe?

I was very anemic, I'd been taking iron tablets but like you made me sick and constipated. I spoke to a lady who run a birthing company and worked for the NCT and she advised taking Spartone, cook all meals in iron pots, eat steak once a week with loads of green veg and I can honestly tell you at my next blood test I'm levels where normal and I felt fine.

Iron injections are not that common these days, you would be more likely to have an IV transfusion if needing iron urgently.

Have you tried different iron compounds? The more commonly available forms of iron in supplements such as ferrous fumerate are notorious for causing stomach upsets. Iron bisglycinate is a compound that is very well absorbed & well-tolerated GI-wise. The liquid iron supplements are better but the actual iron levels would not be enough to raise ferritin levels decently. Haeme iron supplements are the most absorbable although expensive. They are available in health shops or over the net, try Victoria Health for quality supplements.

Once levels are raised you could go onto liquid iron for maintenance. Clearly you should have it thoroughly investigated though.

"Your GP must rule out every underlying pathology first."

And how do you get them to do that?

I have seen three GPs and nine consultants since my ferritin deficiency came to light - no-one has suggested any form of investigation into what is clearly a broader absorption issue.

I am OK with oral supplements for B12 and D, but if I can't take iron tablets (which I can't - they all give me explosive diarrhoea) the NHS is not able to help.

Iron injections aren't as common as in the past. They're also pretty unpleasant. I don't tolerate Ferrous Sulphate or Fumarate so was offered IV infusions which have def helped. However, I have Crohns. You must push your GP for why they think you have low iron stores, find out what's causing it and get it treated.