<<Disclaimer: Verify this information before applying it to your situation.>>

Dear Celiac List:

Judging by the 32 responses to my question about how to get supplemental
iron without producing major diarrhea, a lot of people are having trouble.
Diarrhea and constipation are very common side-effects of iron supplements.
One person says she's given up on all of it.

Apparently a question very similar to mine was posted in June, when I was
out of town and off the list for awhile--sorry for the repetition, but it
seems still to be an open question for a number of people.

The answers broke down into several categories:
--suggestions about particular supplements by brand names
--nutritional suggestions
--suggestions that B-12 deficiency is the real problem, that 300mg of iron
a day is a lot (most supplements are around 29 mg per unit), a warning that
you can get too much iron and further suggestions that hidden gluten,
Candida, refined sugar or some sort of pathogen is actually the problem. It
is always useful for us to remind ourselves that a symptom like diarrhea
can stem from any number of causes. In my case, cutting out the gluten-free
iron tablets solved the diarrhea problem in less than 24 hours.

One person wrote:
I got my body used to iron by taking 1/4 tablet at a time, along with
eating iron rich foods, working my way up to a whole tablet.  I take it
4 days per week, roughly every other day.  My iron levels have been
good.  Another consideration: Try taking B-12 supplements (sublingual
drops or tablets).  Anemia is sometimes caused by a lack of B-12.  Since
this vitamin is metabolized in the small intestine, many celiacs have a
hard time getting it through their foods (sublingual increases the
chances of absorption)


SUPPLEMENTS BY BRAND NAME

The person who asked for help in June has resolved his problem by taking
paediatric iron in syrup form (SYTRON in the UK) 5ml. 3 times a day on an
empty stomach. "At the same time I started to use soya milk and cut out
other dairy products. The result is that I am feeling infinitely better."

Several people suggested "Gentle Iron" from Solgar, iron bisglycinate
(sp??).  It comes in a vegetable based capsule with no colorings, etc. One
who takes it says taking it after supper obviates stomach upset.

Floradix - "it's a liquid iron supplement and apparently better absorbed."

Ferrous Sulfate 5grains i.e.65mg three times a day between meals
with some food.

Theragran-M produced by Mead  Johnson. Each has 18 mg of iron, 100% of daily
value.

Slow FE without trouble (and spoke with the manufacturer to verify GF status)

Chromagen (available by prescription)."The pharmacist said it was
gluten-free -- I can only hope he was right."

Feosol (I used to take that -- very constipating for me)

Two from SmithKline Beecham:
   Ferrous Sulfate Iron Supplement Therapy. 100 to a box (Iron equivalent
of 65mg per tablet).
    Carbonyl Iron. It's harder to find, but is also easy on the system.
(Around here, (the Detroit area) Arbor Drugs and Kmart  carry them.) The
person who wrote has done quite well with both of them now. (Hemaglobin up
past 14!)

One person suggested ferrous gluconate (sp?)? and said:  "It comes from organic
(i.e., vegetable/animal) sources.  It tends to be a little easier on the
stomach.  Taking vitamins A, the B's, and C will increase absorption,
and may help calm your stomach."


...and a VARIATION ON THE SUPPLEMENTS THEME

What would your doctor think of your taking Vitamin K and/or
L-Glutamine, both of which help your body absorb all kinds of nutrients.
Then quit the iron and assume, at least for a while, that you are getting
it from the greens, etc.


NUTRITIONAL---quotes from responders:

I thought dairy inhibits the absorption of iron but calcium does not
though I don't know for sure.  I thought it was ok to take calcium
supplements at the same time as iron.  I also think the combination promotes
constipation.

Several people said that taking Vitamin C while eating iron-rich foods helps
in better absorption of iron.

The oxalic acid in some green vegetables can actually prevent you from
absorbing it.  You can try other sources such as: Blackstrap molasses, kelp
(try adding to
soups instead of salt), soy beans, prunes, almonds, and lentils.  Herbal
sources are burdock root (can be eaten as a vegetable, too), parsley,
fennel seed (also good for digestion!), and peppermint.

You can try getting more iron from your diet, but the best place to get it
from is red meat- lots!

One person who described (herself?) as a formerly anemic vegetarian has
normal blood work for the first time in her life. The Celiac diagnosis and
gf diet has allowed her to absorb iron from her regular vegetarian diet.
Dried beans are a very good source of iron, and, when eaten with rice and
corn, the combination provides a full complement of amino acids.

I cook with cast iron cookware about once a week.

--------

The range of options and experiences offered proves once again what a
wonderful resource this list is. Thanks to everyone who responded.

Mary B
NYC