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Suggest Remedy For Fatigue, Headaches And Low Ferritin Levels
Question: I have a very low normal (23) Ferriin level. I have excessive fatigue, weakness, hypothyroidism, headaches, restlesslegs, hair loss, brittle nails and just plain feel like crap. I am a 60 year old female who had surgical menopause at age 29. I have been severely Vitamin D deficient. I CANNOT take oral iron. It "tears" my stomach up so to speak, even if I take it with food. My stomach has delayed emptying. I have been on Protonix for at least 2 years. Would I benefit from iron injections or infusions? At times I feel I'm going to die. No one seems to want to help me. My Neurologist ordered the test because my sleep apnea test shows I have RLS plus sleep apnea. I use a bipap. He says my Ferritin level needs to be between 70 to 80. I am 5' 3"tall and weigh 138 pounds. Please help me or recommended someone in the Kansas City MO area who can help me. I do not enjoy life at all and have become very depressed. I am not anemic, just iron deficient. Thank you. I look forward to hearing from you. I am completely at the end of my rope. I would even drive 500 miles to get the help I need. XXXX
Brief Answer:
Please find details below regarding correction of iron deficiency
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The incidence of iron deficiency without anemia is more common than thought. Sorry to hear the discomfort you are experiencing and hope I am able to address your problems to some extent.
2. Protonix contains pantoprazole and this delays the oral absorption of iron. You might like to have a discussion on this matter with your doctor and if your low ferritin has anything to do with protonix.
3. The recommended treatment for your condition is taking iron orally as ferrous sulfate 200 mg twice daily. With this it is also recommended to take 500 mg Ascorbic acid or vitamin C to improve iron absorption. If ferrous sulfate make you feel uncomfortable then you might choose to take oral ferrous fumarate or ferrous gluconate and these cause side effects.
4. There is a provision to take iron as injection or infusions.
Intramuscular injections have a higher rate of side effects. Many doctors prefer treating iron deficiency with intravenous infusions and this has a higher rate of acceptance. In intravenous infusion, a test dose of 25 mg iron dextran is given slowly and closely monitored for the development of side effects. If there is no obvious adverse reaction then it might be given as a slow infusion containing a regular dose over few hours.
5. Among the safer methods for you would be to include high iron containing food in diet like meat proteins and green leafy vegetables. When taking these foods, you might add citrus juice like lime or orange juice to enhance absorption. This works well in many people who are intolerant to taking iron tablets orally.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please find details below regarding correction of iron deficiency
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. The incidence of iron deficiency without anemia is more common than thought. Sorry to hear the discomfort you are experiencing and hope I am able to address your problems to some extent.
2. Protonix contains pantoprazole and this delays the oral absorption of iron. You might like to have a discussion on this matter with your doctor and if your low ferritin has anything to do with protonix.
3. The recommended treatment for your condition is taking iron orally as ferrous sulfate 200 mg twice daily. With this it is also recommended to take 500 mg Ascorbic acid or vitamin C to improve iron absorption. If ferrous sulfate make you feel uncomfortable then you might choose to take oral ferrous fumarate or ferrous gluconate and these cause side effects.
4. There is a provision to take iron as injection or infusions.
Intramuscular injections have a higher rate of side effects. Many doctors prefer treating iron deficiency with intravenous infusions and this has a higher rate of acceptance. In intravenous infusion, a test dose of 25 mg iron dextran is given slowly and closely monitored for the development of side effects. If there is no obvious adverse reaction then it might be given as a slow infusion containing a regular dose over few hours.
5. Among the safer methods for you would be to include high iron containing food in diet like meat proteins and green leafy vegetables. When taking these foods, you might add citrus juice like lime or orange juice to enhance absorption. This works well in many people who are intolerant to taking iron tablets orally.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What kind of specialists would order iron infusions if my General Practitioner won't? My regular GP left the practice, my Internal Medicine Doctor won't treat me for it and either will my Neurologist who ordered the test. I don't see my new GP until August 19th. I feel like no Doctor wants to help me. The new GP I am seeing does treat the Whole person, but I don't know if this includes iron infusions. Also does it usually take more than one infusion to feel better and for my Ferritin level to go up. I can't even enjoy life because I feel so exhausted. There is no way I can take iron pills. I have a very sensitive stomach and am nauseated most all the time. I was diagnosed with gastroparesis at least 13 years ago but I am not diabetic. I know there are Doctors who do intergrated medicine but I don't think they take Medicare and I probably can't afford to pay out of pocket since I'm on disability. Thank you, XXXX YYYY@YYYY
Brief Answer:
Please consult a gastroenterologist or wait for the new GP
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. In your situation, there are two possible course of action which you might benefit from. Since you have a stomach condition and are experiencing nausea and stomach discomfort after oral iron therefore you might consult a gastroenterologist to treat your condition. The other solution is to wait for your new GP who appears to treat the patient with care. Once month is a short interval and the wait might be fruitful.
2. Please increase oral intake of iron containing foods as mentioned earlier till such time that you consult and get treated with iron infusion. Taking small amounts of fortified foods will help you increase the ferritin level slightly.
3. I understand the discomfort you are in and hopefully you should make a complete recovery and proceed with a normal life in a few months from now.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Please consult a gastroenterologist or wait for the new GP
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. In your situation, there are two possible course of action which you might benefit from. Since you have a stomach condition and are experiencing nausea and stomach discomfort after oral iron therefore you might consult a gastroenterologist to treat your condition. The other solution is to wait for your new GP who appears to treat the patient with care. Once month is a short interval and the wait might be fruitful.
2. Please increase oral intake of iron containing foods as mentioned earlier till such time that you consult and get treated with iron infusion. Taking small amounts of fortified foods will help you increase the ferritin level slightly.
3. I understand the discomfort you are in and hopefully you should make a complete recovery and proceed with a normal life in a few months from now.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr.Vivek
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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