Iron in pregnancy

[Bellyrumble]

Sorry if this seems a rediculous or stupid question but I’d rather seem stupid here than in front of midwife tomorrow!

I’m 33/34 weeks now.

I’ve been prescribed 600mg ferrous sulphate per day- 3 tablets of 200mg. About 4 weeks ago.

I’m a nightmare and keep forgetting to take them even with meals (and my meals are all over the place anyway as I’m so busy at work I sometimes forget to eat )

When I do remember the tablets they give me tummy ache and loose stools (tmi sorry!) but they just don’t seem to agree with me.

Is an iron infusion an option instead? Or is ghat an absolute no no abs waste of NHS time and resource?

Keen to get my levels up but also realistic that I will forget and the tablets play havoc with my digestive system

I’m exhausted at the moment and I suspect the low iron probably isn’t helping things!

Ironically, taking iron tablets a little less often might mean your gut absorb the iron better!

The gut is designed not to take in too much iron in one go (something to do with evolution) and therefore if your gut senses a large amount of iron it closes all the absorption channels and you get unpleasant bowel symptoms (as you describe) as the iron just passes through.

Best thing to do if you are getting lots of side effects is to try taking a half dose, or taking a tablet every other day instead of every day. Take the iron with orange juice if you can (helps absorption) and avoid caffeine (reduces absorption).

This is info was given to me by a lovely GP friend x

Congrats on the pregnancy. I can only assume they gave you little advice about anaemia? It takes 3mths for red blood cells to replicate, so even when you do take your iron tablets properly, it won't be a quick fix to return to a normal level! I was as low at a Hb 98, ferritin 2, but having a blood transfusion was never an option I considered reasonale. Yes, it was a quick fix, but I looked at my diet instead. For context, at that time, I wasn't pregnant, ate meat, no heavy periods, but realised my diet was the likely cause.

Tannins will deplete any iron you eat- so tea, coffee, berries, chickpeas and many other foods can deplete the absorption of iron. Vit C rich foods- peppers, citrus, rosehip, mango, spinach will help absord the iron from both food and your tablets.

Other sources like seaweed, nori, seaweed salad, spirulina and samphire are also great sourses of iron.

Set an alarm for your tablets and really look at your diet, also what contains tannins and what contains Vit C. If you are so symptomatic that a blood transfusion is recommended because you can't carry on, then obviously for got it, but if its a lack of managing your own pills and diet, then make it a priority for you and the baby. Best of luck x

If the iron isn't agreeing with you, contact your doctor or whoever prescribed it. There are things like spa water? (Not sure if that's the right name) or floridex, but you would need to check if these were right for you. Mumsnet does not have access to your medical records, so it wouldn't be safe for someone to say 'yes stop taking them'. You need to speak to a doctor and check what your alternatives are, if any.

If you need help with remembering, the 'round health' app is pretty good.

the GP prescribed iron tablets made me very ill, I only took 3 of them and I reacted very badly to them

I was suggested to take Solgar Gentle Iron instead which caused no such problems.

Thanks all of you I didn’t expect so many responses!!

I literally got a text from the GP following my 28w bloods saying there’s a prescription at your pharmacy for iron tablets to pick up- no advice at all and no idea what my levels even are/ were. In hindsight I should have made a tele appointment when started having issues rather than just carrying on/ not taking the tablets

Illl do as suggested- take with Vit C and set alarm to take it (thanks for the app suggestion!) and in meantime ring GP to discuss and see if anything else I can take instead/ how necessary the full dose is. Will mention to midwife when I see her tomorrow too.

Some good suggestions here thank you :)

I have zero appetite for food at the min as it is, think that’s due to knackeredness and generally being a bit stressed with work and pregnancy. switching to iron rich healthy foods isn’t a quick fix for me right now, a massive shame as I’m such a foodie normally and love eating healthily!

I get paid next week so with a bigger budget for food it may help too- currently eating batch cooked meals from the freezer (all home made and fairly healthy but not with iron deficiency in mind at the time…) . Hoping a combination of all your suggestions heads me on the right track :)

little tips, in case you don't know them already:

• don't take iron tablets with anything dairy at the same time, the calcium in milk/cheese/yogurt etc is counterproductive to iron absorption
• take them with something containing Vit C (orange juice is easy), this will aid absorption
• rule of thumb is to take vitamins in the morning and minerals at night (I can't remember why, my nutritionist explained it so I took her word for it)

best of luck

@Bellyrumble I was given iron tablets to take 3x a day because I had anaemia & I became extremely constipated to the extent I didn't go toilet for days.

Turns out when I called the GP, they first booked me in for a blood test to see if my iron levels were good [which they obviously were because I was eating the iron tablets THREE TIMES A DAY!] & they have now happily reduced my doses to once a day.

Once a day gives me loose stools but it's better than 3x.

I think they're giving you high dosage just to keep you safe with iron levels & reduce your doses just like they did with me

Update I saw midwife today and she took bloods again so will see if they have improved

Levels were 8 at 28weeka which she said was low (?) so will compare and see

She agreed taking 1 or 2 consistently is better than forgetting and taking 3 one day then none the next. I’ve set an alarm in my phone now too :)

Those of you who had it in pregnancy did you find your levels went up more after baby born?

Those tablets are gross and made me so sick so I stopped taking them.

My iron was down to 73 and they gave me an iron infusion so it's an option but I guess it depends how low your levels are and if they are continuing to drop.

I did drink Spatone with citrus juice which was nicer but don't think they made much difference.

Apparently it can take weeks for levels to improve.

no.
I had to take multivitamin with Iron.

I've been taking Spatone with orange juice as well, not sure if it's made a difference or not to my levels but it's not affected me the way iron tablets did. Floradix is also an option.

I had two x iron infusions in late pregnancy

They weren't successful and I had to have blood on standby for my c-section

I'm taking Active Iron Pregnancy Capsules and have no problems with them. I just take one a day with orange juice. My HB is only slightly low at 11.8 though. I'd contact your doctor and ask him to prescribe something else because the current ones aren't agreeing.