Jordan,
I wouldn’t be asking this if I couldn’t find the answer somewhere else (I’ve looked at Examine.com, searched this forum, and the nutrition forum at the old site), but my wife has severe anemia. We are trying to find the right supplementation, but it’s a morass of bad answers and I thought I could pick your brain. I appreciate any answer, because I know that your time is very valuable. I know, we could ask her doctor, but I find that your medical explanation tends to deliver far more detail than hers.Also, I realize that you might need more information, but there are other diagnosed issues that I’m not willing to share publicly.
She basically got the answer to just take an iron supplement. Does it matter what type of iron she takes? Examine.com suggests that taking it in combination with citric acid increases the absorption, so we purchased a supplement that includes vitamin c. Also, when it says that iron derived from plant compounds, should we steer clear of supplements that say they are plant based?
Again, thanks for your time.
Has she had labs confirming the presence of significant iron deficiency?
If so, and if she’d like to replace this with oral supplementation, the typical regimen is iron sulfate taken every other day, with or without vitamin C.
If she has not had labs confirming iron deficiency, we would recommend doing that first.
She has had labs done twice in the last 3 months, with the last one on Monday showing lower . Again, several factors may be causing this (including potential medication side effects and potential pre-menopause, as well as having always been diagnosed as anemic), but it’s hard to get enough time with the physicians she’s been seeing, especially since they are specialists in areas not related to nutrition. She is extremely sedentary due to chronic migraines (20+ days per month, though that has been reduced by some new medications just now coming to market), so I don’t know if the lack of exercise is contributing to this. She’s kinda at her ropes end and is just looking for something to give her at least some energy . Her neurologist has prescribed her Cymbalta and Aimovig as long term treatments for migraine prevention. I don’t know the name of the medications for episodic pain. From what I’ve been able to glean, it doesn’t seem like those medications have the side effect that could lead to anemia.
Is there a manufacturer of iron sulfate you would recommend? Or at least parameters for knowing we are purchasing from a reputable source? We don’t usually supplement
Again, I track what I eat, and she usually follows a similar diet and I know she eats relatively healthy. I’m confident in that.
As always, very grateful that you guys, as busy physicians, are willing to provide answers.
This sounds like a far more complex situation than initially described.
I don’t have any specific manufacturers I’d recommend, as I usually just prescribe it.
I will also say that fatigue is often quite complex and multi-factorial - it sounds like she has some debilitating medical conditions, which puts her at higher risk for depression and sleep problems, all of which can compound fatigue as well.
Yeah, I was reluctant to describe everything so openly (it’s her condition, not mine). I appreciate, again, just the recommendation for iron. Just a little bit that will make her feel better is all I’m looking for.
Sorry to hear about your wife. You can try asking your doctor for heme iron supplements like OptiFer Alpha. These absorb easily with fewer side effects.