Are there ANY iron meds which won’t wreck my stomach?

[Twoweekcruise]

I am really quite anaemic and have been for a few years.
My HB is 9 and ferritin is 4. It goes without saying that I feel like crap.
The reason for the anaemia is years of heavy periods, I am now on a waiting list for an ablation.
In the meantime I am desperate to get my iron up but I have IBS and a super sensitive digestive system.
I can handle Spatone in a little oj but it’s not raising my levels quickly.
Ferrous fumerate, ferrous sulphate, floradix, feroglobin, better you spray etc all upset me.
Is there any other iron that I’ve missed? Is there anything I can do to raise my levels without getting stomach cramps, diarrhoea or constipation!
GP is no help, he gave me two options, take nothing and put up with the anaemia or take the tablets and put up with the bad stomach which is easy for him to say as he sits in his room with a toilet near by. I, on the other hand drive for a living and driving and the poops is not an option I fancy opting for!

Bugger spatone was the only one I could suggest. Are you taking two sachets a day?

I take 'gentle iron' from Holland and Barrett. Sorry, I don't know what it actually contains and I'm sure that you may well need something more specialised, but thought I'd put it out there.

Can you eat more iron rich foods?

With levels like that, oral iron just won't cut it. You need an infusion.

Eat oranges everyday, vitamin C helps your body absorb iron. Eat lots of spinach, broccoli, pumpkin seeds, legumes, dark chocolate and now Xmas is upon us, Turkey and fish, you get more iron into your system through non heme (veg) than heme (meat).

Have a look on Healthline.com.

I was taking 2 sachets of spatone a day with berocca. First thing on empty stomach so it gets absorbed. It did raise mine considerably, I couldn't tolerate any other iron supplements...

Look up alternate day dosing, it's much easier on the stomach and absorbs better too.

Try solgar gentle iron - you probably need at least 2 a day. That worked well for me for a number of months (6-8 roughly) but I did eventually start getting some unpleasant bowel symptoms.

If they don't work for you I have managed to raise my levels by taking 4 "Active iron" tablets a day. It's bloody expensive though. Definitely working as when I stopped my levels plummeted again. No stomach or bowel issues at all on these.

Make sure whatever iron you are taking you take it with vitamin c to aid absorption and reduce constipation.

I currently take 500mg of vit c with iron twice a day (best to split it up if you can as you can only absorb so much iron at a time).

I can’t take iron supplements either.
I just have to make sure I eat plenty if red meat and eggs.

@DeedIDo

With levels like that, oral iron just won't cut it. You need an infusion.

Yep, request one of these. I'm also wondering how sure they are of a diagnosis of IBS and whether it's worth querying a digestive disease such as IBD.

Iron bisglycinate. Gentle on the tummy and actually raises iron unlike spatone which is such a low dose it barely registers. I take 50mg (337% daily RDA) or 100mg when period is super heavy. Feel loads better for it.

I’d second requesting an infusion. You sound like a good candidate for this b

Along with the iron rich foods and/or spatone alongside vit c, avoid calcium based foods at the same time as this reduces iron absorption.
As a midwife I see pregnant ladies receive ferrinject if iron supplements are not sufficient/not tolerated, dont know of this would be an option for you?

@RavingAnnie

Try solgar gentle iron - you probably need at least 2 a day. That worked well for me for a number of months (6-8 roughly) but I did eventually start getting some unpleasant bowel symptoms.

If they don't work for you I have managed to raise my levels by taking 4 "Active iron" tablets a day. It's bloody expensive though. Definitely working as when I stopped my levels plummeted again. No stomach or bowel issues at all on these.

Make sure whatever iron you are taking you take it with vitamin c to aid absorption and reduce constipation.

I currently take 500mg of vit c with iron twice a day (best to split it up if you can as you can only absorb so much iron at a time).

I second the Active Iron. It’s not really a high enough dose for bad anaemia but it’s super easy tolerate compared to others. I’ve been doing 2 a day with liposomal vitamin C for absorption.

I also take Active Iron. I swear by it.

@Twoweekcruise

I am really quite anaemic and have been for a few years. My HB is 9 and ferritin is 4. It goes without saying that I feel like crap. The reason for the anaemia is years of heavy periods, I am now on a waiting list for an ablation. In the meantime I am desperate to get my iron up but I have IBS and a super sensitive digestive system. I can handle Spatone in a little oj but it’s not raising my levels quickly. Ferrous fumerate, ferrous sulphate, floradix, feroglobin, better you spray etc all upset me. Is there any other iron that I’ve missed? Is there anything I can do to raise my levels without getting stomach cramps, diarrhoea or constipation! GP is no help, he gave me two options, take nothing and put up with the anaemia or take the tablets and put up with the bad stomach which is easy for him to say as he sits in his room with a toilet near by. I, on the other hand drive for a living and driving and the poops is not an option I fancy opting for!

I had to double check I hadn't posted this! You need to speak to another gp and get referred for an iron infusion. This is the only thing that has helped me. My ferritin at its lowest was 3. I was out of breath just getting something out of a cupboard or walking up the road. I had zero energy or enthusiasm to do anything. Have you been told why you are having heavy periods? Mine was due to fibroids and polyps. I had a hysterscopy under ga and they removed the polyp and did a d&c. I continued bleeding for another 6 or so weeks and then it's just stopped. I had been bleeding since April this year. I suspect having the Zoladex injections to prepare for the procedure has brought on the menopause and hrt is helping me with the symptoms. I don't know how old you are so this might not apply to you, I've just turned 50.

Up the spatone? I took 6-8 every other day for a month.

I also got something called Lucky Iron Fish, where you boil it in water and you end up with iron rich water to drink. Boiled up loads whenever I was working from home and stuck it in the fridge with slices of lemon.

I managed to raise my ferritin from 11 to over 30 over 3 months doing that?

I also ate a lot of steak and apricots.

My story is almost identical to yours OP, similar levels and the same other issues.

I had iron infusions for the first time a few months ago. I am not anaemic for the first time in decades. It wasn’t the magic fix I was hoping for but I do feel a lot better.

I also had a pelvic ultrasound to see if there was a reason for the heavy period (none found) and had already had detailed investigations into my stomach issues to rule out internal bleeding as a cause to the anemia too (colonoscopy, endoscopic gastroscopy and finally camera gastroscopy (private so I think they did everything they could think of).

You meet the NICE guidelines for an infusion, well almost as I think it suggests below hb of 8 but my GP referred me with a level of 8.7 I think. I was prepared to go private but was surprised how easily my GP agreed when I asked.

I also think you need an infusion. I was given one after my ablation surgery. Before that my GP recommended Maltofer liquid iron supplement as I could not tolerate the ferrous ones. It was not a good choice for me but apparently works well for others. The ablation and infusion sorted me out. Oh and I also had a Mirena inserted at the time of surgery and haven’t had a period since.

The advice from your GP is very poor, as if you're getting diarrhea you won't be able to absorb the iron in the tablets anyway. If your levels are really low I agree with the suggestion to ask for an infusion.

I’m a doctor. Second the iron infusion.
I presume you have tried gradually increasing ferrous sulphate tabs from 1 to 3 a day? That can sometimes help, as the GI side effects will improve after a few weeks.
Constipation and reflux more common that diarrhoea though. Appreciate both constipation and diarrhoea normal with irritable BS, but do check with your GP that you do not have inflammatory BS (causing malabsorption (and diarrhoea)or pernicious anaemia too.

Everyone posting about Spatone/active iron etc … the levels of iron in these are woefully insufficient to address anaemia. Active iron has 14-17mg per tablet. Normal ferrous sulphate dose is 400-600mg daily! The at is the main reason the OTC versions don’t upset your stomach - there’s not enough iron in them to do so.
No harm of course, but you will be spending a fortune on something that ultimately won’t have much effect until the cause (heavy periods or other) is stopped.
Hope you get this sorted and feel better soon. Ablation works really well for most.

Thank you all for your welcome advice.
I have fought tooth and nail for an ablation over the last few years. One gp said she wouldn’t recommend them as they are far from a pleasant experience. I spoke to a gp a couple of weeks ago who agreed that I now need one but she didn’t have the power to refer me, it was either the gastroenterologist I’m under or the gynaecologist. Luckily I had an appointment with both the following week. The gastroenterologist wasn’t particularly helpful and said he can only refer his IBD patients. The gynaecologist was wonderful, not only did she put me on the waiting list for an ablation she said that even though she normally doesn’t refer for infusions she understood how awful anaemia was and has referred me, lovely woman.
I have tried alternative days for the iron but still end up with awful pain and nausea.
I will try the iron bisglycinate as I have not tried that one.
I had a series of full digestive investigations in late 2019, a colonoscopy, gastroscope with biopsies, ultrasound scan, a ct scan, fit and calprotectin stool tests and multiple tests for coeliac disease. Thankfully, all clear.
Longtompot isn’t it just awful, just walking upstairs whacks me out, people think I am lazy but I am just knackered. I am 48 and have been having reoccuring polyps for years which are causing the heavy bleeding, I keep having them removed but the buggers grow back!
Notlostjustexploring Wow 6-8 sachets, maybe I should try that?

quince2figs I had my vitamin B12 tested in March it was 319, I was told this is ‘normal’. Calprotectin tests have come back normal.

I was prescribed duodenal tablets that only dissolve in the small intestine (duodenum).

soaked flax seed or chia seed helped with the constipation.

Do the tablets help with diarrhoea? That is what I mainly experience with the iron tablets, that and nausea/stomach cramps.