Anaemia question if you can’t tolerate the 200mg tablets

[ksksn10]

I’ve dealt with anaemia on and off all of my adult years due to a combination of heavy periods and coeliac (now under control).

The ferrous sulphate always used to sort me when I had awful bouts. I am now running at ferritin 7 and haemoglobin 119 or just under and over and I constantly feel like crap!!

The tablets just give me terrible digestive problems and I don’t feel better like I used to. GP not interested, basically suck it up. So my question is if you stopped tolerating the tablets, arent eligible for an infusion what have you done?

Can anyone recommend different tablets?

Can I get by with the general shop bought 14mg with these levels?

My GP has prescribed me a liquid solution. It tastes SO BAD- not helped by them adding chocolate and mint flavouring to it- but it has cut down significantly on the side effects.
I was on ferritin 3 and am noticing a difference. But why wont your GP refer you for an infusion? I had one, due to heavy periods and autoimmune conditions

I take the 200mg tablets on and off over the years and I've found that after about 2 weeks of gastro symptoms they do settle down for me, but you might have tried that. I also find taking it during a meal with a glass of orange juice reduces my gastro symptoms too. For me the 14mg are not at all sufficient to improve my iron levels despite taking them for several years my iron remained low until I realised there was a higher clinical dose. My GP just told me to pick up iron tablets over the counter so I didn't realise for long time I was on the wrong dose.

Are you under a specialist for coeliac's? If not your GP should be able to refer you. They might be able to advise or prescribe something specific. Could you be reacting to an ingredient in the iron tablet that's changed if you've been fine previously? I think they may be able to refer you to an NHS dietitian to improve your iron intake too maybe?

Buy a diff form of iron supplement: any iron called bisglycinate or chelated will be far easier to tolerate. Also far more bioavailable than ferrous sulphate, so you may find you need a lower dose for the same improvement.

Ask for ferric Maltol. I'm absorbing that much better than the others.

Some people who struggle with ferrous sulphate have been a lot better on ferrous fumarate.

How often are you taking them? One alternate days is actually more effective than taking them more often.

If you still can't tolerate them, you might be OK with a different type like ferrous fumarate instead.

And if still no, then you likely need an iron infusion.

14mg is not enough.

how many tablets are you taking? the side effects are mainly due to saturating the iron absorption mechanisms. Advice these days is to take maybe one tablet a day or every other day - you absorb the same amount of iron but may have fewer side effects.

14mg is not enough to correct a deficiency, that is a maintenance dose only. Don't get me started on people that recommend spatone- which is only 5mg! Red blood cells take 3mths to replicate, so taking a week or tablets or the odd one won't make any difference either (not that you are doing that OP).

Are you taking your meds and iron rich food with Vit C rich foods? Citrus, peppers, kiwis etc? Vit C helps absorb iron, whereas tannin rich food can prevent absorption. When I was anaemic with a ferritin of 2, I tried cutting out most tannins overall from my diet and also ensured I never had tea/wine/grapes etc when having my iron meds.

I started eating liver (more tolerable with onion gravy, bacon and mash) and being conscious to eat more red meat. Trickier if veggie/vegan though.

Another supplement which can be used in addition to prescribed supplements is a blue-green algae called spirulina. It comes in a powder form or tablet/capsules and I believe normally tolerated. If you could only have the prescribed meds every 2nd day, the spirulina daily might help.