Brief Answer:
Good Day! I understand that iron is making you feel ill

Detailed Answer:
and, that you have a low ferritin level despite your doctor stating you do not have anemia. Without your labs my comment regarding this situation is that a low ferritin in absence of criteria indicative of anemia can still indicate a nutrition problem of inadequate iron intake or excessive blood loss putting you at risk for anemia.

Think of it as a warning to you by your body. It is saying to you that you need more iron, but your iron stores are not yet so low that it is affecting your hemoglobin in any measureable manner. However, you still may feel the impending symptoms of low iron such as fatigue and poor exercise recovery.

You did not mention your current diet. However, you seem to be very sensitive to iron supplements, particularly at high doses. Currently, I feel that you have upset your gastrointestinal track and you need to calm it down for a few days before we try getting iron in you.

I suggest that you try getting iron from fortified foods such as cereal. Combine the cereal with a high source of vitamin C in a form that will not irritate your stomach. Combining iron with vitamin C (preferably not from pill) will increase the absorption of iron. Are you able to drink breakfast drinks that have nutrients in them? Again, combine with vitamin C.

I do not think you are going to tolerate iron supplements quite yet. Here is a list of high iron foods: heme sources are better absorbed than non-heme sources.
Heme: Beef liver, ground beef, chicken, fish, turkey; Non-heme: baked beans, almonds, bread, broccoli, prune juice, enriched noodles/fortified cereals, spinach

The next question is, what is the history of your low ferritin? Should the doctor be considering a bleed somewhere that is causing blood loss rather than just poor intake? Has an upper and/or lower gastrointestinal exam been done?

You want to know what to do to stop this. First, get some ginger and make tea out of it for your nausea. Gradually try to add high iron foods back in your diet combining them with high sources of vitamin C. Monitor your stools for blood or if you vomit blood; notify your doctor should this occur.

Check your ferritin in 3 months. If it hasn't improved, then the doctor will have to make some treatment decisions and possibly run more tests to see why you cannot get your iron up. This may include iron infusions.

If I have not answered your question, please feel free to write back. If I do not hear from you, then kindly close out the ticket.

Otherwise, if you need clarifications please include all medications, supplements, a 24 hour recall of all foods/beverages/amounts and all medical diagnosis/labs. Thank you for visiting HCM. XXXXXXX J. Shattler, MS,RDN

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Brief Answer:
Yes, you may try adaptogens

Detailed Answer:
I am sorry you sound so frustrated and also you have tried everything I have suggested already.

You want something to help with your energy without draining your nutrients - you can try adaptogens. Those are nutrients that help you control stress and fight fatigue. Ginseng tea, Ashwandgha herb, a multivitamin without iron or combine B-complex with omega-3 fatty acids. These are some very popular energy enhancers.

Please keep trying to eat a balanced diet. If you feel you need more personalized help, please visit eatright.org, look for "find a dietitian", click on it, enter your zip code and you can find someone to work personally with until you get your issues worked out and feel better. Is there anything else I can help you with? XXXXXXX Shattler, MS,RDN

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Brief Answer:
XXXX- I am glad we could figure something out

Detailed Answer:
If you have tried all of these things then you are truly well informed.

Asian Ginseng has been mentioned as being more stimulating of the two. According to the German Commission E Monographs dosage is 1-2 g per day of the herb spread throughout the day and may be taken as a tea or powder.

I am glad I could be of some help to you. Feel free to write back if another clarifation is needed or please close out the ticket.

Respectfully, XXXXXXX J. Shattler, MS,RDN

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