Friday, October 3, 2008

The Agony and the Irony

One year ago, my doctor advised me to start taking an iron supplement. I've been dutifully swallowing 18 mg of iron per day ever since. I thought I was doing alright, especially since I noticed an increase in my energy after I started taking the supplement.

But this year, my blood tests still came back showing low iron. I had the following phone conversation with my doctor's receptionist:

Her: "The doctor wants you to take more iron."

Me: "How much more?" (Thinking: I'm already taking the recommended daily allowance. Maybe he wants to up it by a few milligrams in case I'm not absorbing it all?)

Her: "300 mg per day."

Me (eyes bugging out): "Say again?"

Her: "He wants you to take a liquid iron supplement called Palafer. Take it in the morning on an empty stomach, and then a glass of orange juice to remove the taste."

Sounds like a rousing start to the day! There's nothing to jar one to wakefulness like a mouthful of disgusting medicine before breakfast.

Me: "So it's really 300 mg every day?"

Yes, it really is. That's a LOT of freaking iron. I worry because I know from working in health food stores: It's not difficult to accumulate toxic levels of iron, and the consequences aren't pretty.

Here are some of the early symptoms of iron overdose:

- diarrhea (may contain blood)
- nausea
- stomach pain or cramping (sharp)
- severe vomiting (may contain blood)

So you can understand why I'd really, really like to avoid taking too much iron.

I did a little more digging online and found some helpful instructions on how to take iron. Like, I should take it with vitamins A, B, and C which increase absorbtion. But not with zinc or vitamin E because those would inhibit absorbtion. Unfortunately, my vitamins and minerals are all mixed up inside one multivitamin capsule which I take with my dinner, so no help there.

Speaking of dinner, should I take the iron on a full or empty stomach? Both. Either. Damned if I do and damned if I don't. If I take it on an empty stomach I may experience indigestion, heartburn, and nausea. If I take it with food, I'll be lowering the amount of iron I absorb by 50%. Yay!

Additionally, my doctor's office advised me to take the dose first thing in the morning, whereas the product packaging advises me to take it just before bed. Never before has the proper way of consuming a supplement been so confusing!

I'm always afraid of side effects, because if there is a side effect to be had from something, I will have it. I can't take decongestants because the (pseudo-)ephedrine makes my heart race. I can't take a sleeping pill because my limbs will all go to pins and needles. Sulfa drugs (a type of antibiotics) nearly killed me one time. Even simple Advil burns holes in my guts.

At the very least, I can expect this nasty iron juice to dye my teeth grey. (I'm told that brushing with baking soda can remedy that, thank goodness.) I'm just hoping to avoid the worst of the stomach cramps (sharp), or severe vomiting (with blood - see above). Alright, so I'm overdramatizing just a tad, but I'm really not happy about this situation!

I could ignore my doctor, but honestly I wouldn't mind having more energy than I do. If there's a chance that I can get more of a spring in my step by complying with the doctor's orders, then it's worth a try.

I'm going to crack open the bottle on Saturday morning, and see what happens. Then I'll go back in a few weeks when I've consumed it all (assuming I can tolerate it - not everyone can) and see what the bloodwork says.

You can be sure that I'll be updating Twitter, so you can all find out exactly how vile it tastes, etc.


whatigotsofar said...

I've heard too much iron can also lead to unwanted magnetism.

savia said...

I took 300 mgs for several months before my iron levels got high enough that I could just go back to the recommended dose, so you should be fine.

If your iron is that low that your doctor wants you to take these steps, it will take awhile for it to build up, and just get your blood tested every month or two to see where you're at and you won't have to worry about toxicity.

Make sure you also take it away from calcium, as it inhibits absorption.

unsigned said...

Iron man!

Warped Mind of Ron said...

Just be careful... There is the chance you could mutate and start gnawing on bridges and railing like an iron termite. I admit the chances of that are a bit low, but you never know. I will blame the low iron in your system on a plot obviously hatched by the squirrels :)

Seriously, I hope it works and you feel much better soon.

Keera Ann Fox said...

All I've ever heard about iron is that vitamin C helps the body absorb it and milk hinders it, so the orange juice chaser should be all the help you need. I take iron pills with vitamin C pills, washed down with water, myself.

I find it weird that an overdose of iron leads to diarrhea, since the usual side-effect of taking iron is constipation.

And I see that my comments about magnetism and gnawing on metals like rodents gnaw on wiring are totally unnecessary. ;-)

Anonymous said...

iron sux.. i wont go into MY symptoms tho:)



Katie said...

well I hope that your iron levels come up! why is it that all these medications that doctors prescribe always have the worst side effects? you go on something to help you but wind up with so many more potential problems!!! and thanks for coming to my blog

Sparkling Red said...

Whatigotsofar: I'll have to get a note stating that I can't work while I'm on Palafer, because I'll stick to the filing cabinets.

Savia: Thanks for the advice! While I was writing this I remembered that you'd been through something similar yourself, and thought you'd have something helpful to add. :-)

Ron: The squirrels again! It seems they are behind many of the maladies of our times. Can we blame them for the sub-prime bubble too? ;-)

Keera: Iron seems to be all about paradoxical opposites, which is poetically apt as it embodies North and South poles within itself, which are always trying to get away from each other.

Syb: What, no gory details? Come on - that's the best part! ;-)

Katie: So true - the cure is often worse than the disease. The medical profession has a lot to answer for!

Dianne said...

I had this problem years ago. I don't remember how much added iron I took but, like savia, after a few months I was OK

and I got my blood tested every 6 weeks

good luck :)

Karen said...

I had to get blood a few times because they could not get my iron up. I promise you that no mater how gross the drink is, it is better than sitting in the hospital every week.

Good luck.

Aurora said...

I'm really glad to see from twitter that palafer didn't taste and feel too terrible. It's also encouraging to see from comments that once your levels are up you can stop. That's good that it's unlike a regular vitamin. I hope the iron makes you feel better!

Sparkling Red said...

Dianne: Thanks! It's good to know that I can look forward to a resolution in short order.

Karen: For real. You must have had a serious deficiency to warrant transfusions. That sounds like no fun at all.

Aurora: Thanks! I'm optimistic that whatever I have to deal with around this issue, there will be an end in sight.

Nilsa S. said...

Glad you're following doctor's orders. There's a reason they are required to go through all that schooling - so they hopefully know more than we do. Though, that doesn't take the burden off you for monitoring your own health. Here's hoping the re-upped dosage works like magic!