Take your vitamins

Note that calcium inhibits iron absorption, so if you are eating your cereal with milk, you’re not getting as much iron as you might otherwise.

Are you male or female? RDA for women 19-50 is more than twice the RDA for me (18 mg vs 8 mg)

Do you take aspirin or other NSAIDS? (Alleve, Motrin, Advil, ibuprofen, and naproxen sodium are common brand and generic names).

RDA is a general recommendation, and in the case of iron, these factors can greatly change how much iron you need.

Are you a vegetarian or vegan? There may be problems with the form of iron you’re getting from your diet.

Also, there are mixed messages in this thread, so let me summarize.

  1. If you don’t have any health problems, generalized supplements aren’t going to help you be healthier.

  2. If you do have a health problem, a supplement specifically for that problem recommended by your doctor is going to help you; e.g. iron supplements for anemia.

So many possible answers depending on what exactly is measured low, how low it is, and what else has been checked.

About some of the Problems with “supplements” (beyond only Vitamins one)

Anemia is a lack of healthy red blood cells or hemoglobin and that can be caused by more than iron deficiency.

So will the extra iron help the red blood cells or hemoglobin improve?

They ran the B-12 levels and mine were way out there so yeah, taking too much of that is not a good thing.

The doctor just expounds information but never really explains. I am the type that needs to know all sides of the problem to understand it.

Female over 50
Yes I have taken NSAIDS but not often.
Not a veg of any sort. I eat meat. (You missed my feeling about bacon :eek::eek:)

Want the actual results? If you have something you can help me understand that would be great

You either need to ask him more directly until you are satisfied you understand; or you need to change your doctor.

Esp. if he can’t find the reason / a way to treat the anemia.

My personal impression is that most doctors, esp. general practice, tend to give short answers, one, because their time is scarce, and two, they don’t want to confuse the patient with details. For many patients, this is good enough to know that the doctor knows what’s wrong and how to treat it; but for some, they want to fully understand it, so those patients need to keep at it.

A new factor in that relation is the internet - hypochondriacs existed before, but with WebMD and similar, it gets very tiring for some doctors to have several patients each day who googled their symptoms and are convinced it’s disease X, when the doctors far more detailed knowledge and experience tells him it’s just common cold.
And in the US doctors worry a lot about law suits, so they may not want to tell you too much.

he·mo·glo·bin - a red protein responsible for transporting oxygen in the blood of vertebrates. Its molecule comprises four subunits, each containing an iron atom bound to a heme group.

You need iron to replace any blood lost. So if your anemia is due to blood loss, yes, iron will help.

The “Female 19-50” is basically discreet shorthand for “Women who are menstruating”. If you’re still menstruating, you may be anemic simply from that.

Frankly, that’s probably what your doctor is assuming, since that’s the most common cause of anemia in women.

If you’re not still menstruating, you may simply need to get some supplementation to get your hemoglobin levels to an adequate point so that your regular diet can handle normal post-menstrual iron replacement. You should probably also point this out to your doctor, and request that you get retested after taking the iron supplement for certain time period to make sure the supplement is actually helping, because blood loss is NOT the only cause of anemia, and you may need to have other possible causes investigated.


My history - I started having really bad headaches in college (1980) to the point where I was swapping between aspirin and tylenol and probably taking more of each than I should.
When I finally went to the qua… errr, student clinic, they diagnosed me with anemia, and pointed out that the aspirin would actually make my anemia worse.

Note that at the time I did not have heavy menses - in fact I was probably on the light end of the spectrum. (if a spectrum can be all red)

Since then, I’ve read pretty much anything to do with anemia and iron supplementation.

One of the best rushes I have ever had was a B vitamin injection. It gave me so much energy.

A word on iron supplements. There are two different type of iron used in supplements

Ferrous Sulfate is the most common form, but it can have some unpleasant side effects - constipation, diarrhea, stomach upset, and nausea. (Frankly, the side effects are similar enough to IBS that I wonder if anyone has ever studied the relationship between the two.)

Carbonyl Iron is supposed to be easier on your digestive system, and I’ve found that to be true for me.
However! The carbonyl form of one of the biggest name brands of iron supplements has the “inactive” ingredients lactose and sorbitol - two substances which are known to cause stomach upset and diarrhea in some people. Why? :mad:

How would you even know which end of the menses spectrum you’re on?

Serious? Tampon boxes often come with booklets, and a Young Girl starting her period should get free Information material on how Menstruation works.

These all mention that an average period is between x and y ml. of blood, and the booklets from the Tampon Company also often say how much a Tampon of size small, middle large can absorb (if not, you can measure it yourself).

So knowing that three Tampons of size small will be enough for your period means you’re on the low end of the spectrum; knowing that you Need the large size every three hours (and a pad to be on the safe side) means you’re on the heavy end of the spectrum.

Thanks.

Sure. (Of course not your doctor, not diagnosing or treating, and all the other cautions.)

Specifically what would help is of the CBC, the hemoglobin and the MCV (mean corpuscular volume). A reticulocyte count. The total iron binding capacity (TIBC), ferritin level, and serum iron. If done hemoglobin electrophoresis and fecal occult blood test.

The overview, potentially more than you want to know …

The first question is what specific result is actually being referred to as “levels low.”

For the sake of discussion let’s assume it is the hemoglobin level.

A common cause of persistent mildly low hemoglobin (mild anemia) is, as mentioned above, ongoing chronic blood loss, such as from heavy menstrual flow, or from another source such as in the GI tract. This causes iron loss and the body needs iron to make new blood cells to replace the loss. Ongoing loss and inability to make enough new ones leads to anemia. It is not the only cause, just a very common one.

In that case the red cells floating around tend to be older ones (as there are fewer new ones being made) and older red blood cells (corpuscles) are smaller … hence there is a low mean corpuscular volume (MCV) aka “microcytic” anemia. They also have less color, IOW are “hypochromic.” If tested the reticulocyte (a step that is a precursor to new RBCs) should be low.

So if there is a low MCV (microcytic) anemia then iron deficiency often from ongoing loss is often the leading suspect. If female and after menopause probably checking stool to make sure that is not the source of ongoing loss would be prudent. If the MCV is not low then right off it is likely not due to iron deficiency and iron won’t help. A whole different differential.

But iron deficiency is not the only cause of low MCV anemia and if there is no source of loss and no significant response to iron supplementation, then it is likely reasonable to confirm that there is iron deficiency and possibly to check for other main causes of low MCV anemia. First actually checking the various measure of iron status more directly: the serum iron level (low in iron deficiency); the TIBC (should be high in iron deficiency as the body has more available sites, more capacity, to bind iron on the various carriers of it in the blood); and ferritin (which should track along with serum iron. If that pattern is not present then the diagnosis should be questioned.

Other fairly common causes of low MCV anemia include lead elevation, chronic inflammation from chronic disease, and probably most common in someone who is otherwise well, beta or alpha thalassemia trait. More iron won’t help any of those.

About the thal traits - hemoglobin is actually made up of two different kinds of proteins, called alpha and beta globins. Beta globin is the one involved in beta thal; alpha in the alpha one (aint we clever). We get one copy of the gene that controls each of their production from each parent and having two defective copies is bad but one defective copy coupled with one normal copy just causes a mild anemia if that. One in four chance of passing the gene onto a child and if the other parent also has trait a one in four chance of the child have full blown disease. Prevalence of the thal traits varies by ethnicity so possibly a more likely explanation if someone is of Mediterranean, African or Asian ancestry.

Hemoglobin electrophoresis can test for a thal trait and if that is the case then iron can be stopped (not going to help and not causing any problem) and the children of the person may want to know if they are carriers too since if they are they might want to know the status of a partner before having children together.

Hope that helps.

Oh fun aside. The thal traits may, like sickle cell trait, somewhat protect from malaria, hence the trait condition may have been selected for despite the harms of the full blown disease. Best to avoid taking iron in thal trait as it increases the risk of iron overload. Doubling back to a theme of this thread: significantly more than you need is not better.

Sorry for the multi-post.

Another aspect is what gets labelled as “statistical anemia”, which is really just a recognition of how normal reference ranges are defined. In general a normal range is determined by taking a large number of samples run through the instrument, throwing out outliers, and defining the middle 95% as “normal.” By definition 1 in 20 of a large enough sample population is outside of normal range at any time and being in that 1 in 20 can just be statistical variation not the result of any pathophysiology.

Also another possible cause of iron deficiency in addition to blood loss or inadequate dietary intake is malabsorption of iron. Undiagnosed true celiac disease (not trendy “I don’t eat gluten”) would be one such possible cause of that. Supplemental iron orally does not do much for that unless the cause of the malabsorption is addressed as well it is not absorbed well.