Can any pharmacists or chemists or just darned clever people help me understand? I'm confused after seeing nurse practitioner.

[BroccoliSpears]

With appologies - I'm still wittering on about iron.

I was put on Ferrous Sulphate 200mg tablets. Take 1 3X a day.

I explained to the NP that I wasn't getting on with them (constipation) and she suggested I drop the dose to 2X a day. I admitted that I've been a bit haphazzard about taking them and was probably on about that dose already so she said to take 1X a day.

So, she is quite happy to advise me to cut my dose to a third of what the hospital advise. Fine.

Then I asked about liquid iron supplements and she said they wouldn't be suitable because the doses were so much lower that they were only given to children.

I don't think that's strictly true. And I don't understand why I can't just take more of the liquid then.

I bought some liquid supplement (Spatone).

From the Spatone packet: "A sachet has 5mg of iron, approx 1/3 of the RDA. However, because the iron is Spatone is better absorbed (up to 40%), 1 sachet should fulfill 100% of your body's daily requirement".

It says it's okay for pregnant women to take 2 sachets a day.

Does 2 sachets equal 1 tablet? I have no idea. Is it silly to mess about with what I've been advised. I don't want to be difficult but the NP really didn't fill me with confidence and I'm confused. She explained it all by showing me a table, but all the numbers were the same. I am a secretary, not a chemist. My brain hurts.

If one tablet contains 200mg, and one sachet contains 5mg, one tablet is equal to 40 sachets. So the NP would be right in telling you there is a lot less iron in the liquid supplements. And you probably could take more liquid, but you would be having A LOT. However, there might be an issue with how well the body absorbs iron in the sachet vs tablets, maybe someone else will know about that...

As there is so much less iron in the sachets, I would do what the NP said and see how you get on with one tablet a day. Hope it works out.

You cant directly compare the number of mg in the tablets to the liquid because of differences in how well your body can absorb the different forms of iron.
I would go with what the NP advised you - you could also look at ways of increasing the amount of iron in your diet.

Remember to take your iron with some vitamin c, eg a glass of orange juice. It helps with absorption.

The tablets are designed for people with true iron deficiency anaemia.

Spatone is more of a supplement that a medication as it is a much lower dose, but I agree that it can be more easily absorbed and reduce the risk of constipation.

I would continue with the tablets (I assume you are properly anaemic) but take it with orange juice, and increase the fibre in your diet to prevent the constipation. Particularly good are apricots, figs and prunes, oats, and fibrous vegetables.

Oops should be than not that.

Just to throw a spanner in the works .. whenever I've been diagnosed anaemic (which I am prone to) I've been given the ferrous sulphate prescription which I've never got on with

so I take flouradix (from health food stores) instead

there's a lot of non-absorbtion of the ferrous sulphate anyway ..

it's always worked for me

maybe you could try for a month then get a repeat blood test (not that I'm advising you to ignore medical advice but that's what I would do)

I am anaemic following major illness and surgery. My doctor has put me on ferrous fumarate which does not make me constipated.

Like ferrous sulphate it still takes a month to have a real effect. I went from 9.4 to around 10.4 in the first month (was 12.5 pre surgery) but haven't been retested lately. They'll probably leave me to it after two months.

The ferrous fumarate doesn't upset your tummy either. I take two 210mg tablets a day, morning and evening, after/with food.

As far as I could understand floradex (which I'd used when pg and bf) and spatone are OK for minor problems but not ok when severely anaemic. I had no appetite and was thin (oh joy) and had put on over half a stone within a month on extra iron as my appetite was restored.

You need to ask your GP specially for it as it is a bit more expensive but it is not a particularly pricey drug as these things go so NO excuse for not prescribing if ferrous sulphate is upsetting you.

Obviously keep on eating the food with high iron content mentioned above.

What were your Hb levels?

I have been prescribed liquid iron by the hospital before - it's called Syntron

Ask for a prescription of Ferrous Fumerate. I got that on the advice of a nurse friend and didn't get the hideous constipation of ferrous sulphate.

Thank you all for your posts.
I'm still not clear about the dosage or feasibility of substituting liquid for tablets, but I now have some alternative avenues to explore.

I'm not sure how anaemic I am. I could get the numbers from my notes. I think they're trying to really boost my iron levels because they're concerned that if I haemorrhage again giving birth (in sixish weeks) it wouldn't be great with current numbers.

I would try and see your GP

My haematalogist NP seems to be mostly experienced with the elderly - I don't have confidence in mind as he fails to listen to me

Having just reminded myself why I'm supposed to be getting my iron levels up, I think you're right and I will re-book to see a gp.

My NP asked me how my periods were (as if that was causing my anaemia) - I was 7 mths pg

Excellent. I see why you'd be so confident about putting your health in the hands of this NP!

Your GP should be able to tell you what your levels are
If necessary you may be able to have an iron drip (not sure if they do that when you are pg)