Iron deficiency anemia
is very common in pregnancy and with heavy vaginal bleeding when not
pregnant. Iron is present in many foods. Very good sources are: meats,
egg yolks, whole-wheat products, seafood, green leafy vegetables, and
nuts and raisins. Including these in your diet as much as possible will
help to prevent iron deficiency. Diet alone cannot replace enough iron
once you are anemic, however, or have low iron stores. Many women need
to take the small amount of iron in a multiple vitamin on a daily basis
during their years of menstruation.
I
recommend iron supplementation based on your history and your blood
count for anemia (hematocrit), and / or serum iron testing. I would
like you to take _________ iron tablet(s) per day. If you are
instructed to take two or more iron pills a day, take them at least one
hour apart. Ideally, they should be taken morning, midday, and
evening. Also, don’t take iron at the same time as a multiple vitamin
that has iron in it. You can take generic, over-the-counter iron
supplements. Ferrous sulfate, gluconate or fumarate tablets are all
fine. Each tablet should have 60 mg of elemental iron, which is
typically equivalent to 325 mg or 5 grains. If you are unable to
tolerate these over-the-counter varieties, call the office or email me
through the website www.mygyn.com, as there are some prescription iron
supplements that we can call into a pharmacy for you, such as
Chromagen.
If you can tolerate it, absorption is best when you
take iron on an empty stomach one hour before meals, two hours after
meals, or at bedtime. Take iron with Vitamin C (ie orange juice,
Vitamin C 50-100 mg tablets) to increase the absorption. If this
causes stomach upset, take the iron with a small amount of food in your
stomach, which is better than not taking it at all. Do not take iron
with dairy products, a vitamin with iron in it or calcium tablets, as
these reduce absorption.
Iron may be constipating. If so, add
fresh or dried fruits (prunes work well), prune juice, extra fluids,
vegetables, and/or whole grains including bran. Metamucil and Fibercon
are good fiber additives. If these constipation prevention and
treatment measures are not effective, please come in to discuss
different options.
