NPR did an interesting story about deficiency in Cambodia; someone invented a unique solution which seems to be working.  http://www.npr.org/sections/th...t-could-fight-anemia

Yes I also have very low Iron levels and I was going crazy until I came across this supplement http://www.amztk.com/iron-vitamins This is extremely easy on the stomach and it didn't constipate me at all. Also what I liked about these is that it contains Vitamin C in it meaning that I didn't have to add on any additional supplement. Whoever I recommended this supplement to has not been let down! It's also extremely effective and it got my numbers to go up only after two weeks of taking it!

best I can tell my iron levels are okay, but my hgb drops as I bleed sometimes obvious to me, other times not, some of that might simply be due to forgetting to inspect my bowel movements. after almost 30 years of this I don't really pay much attention, I sit, go, wipe, flush, and move on. that said, I have taken slow fe with benefits to my blood counts, so I am not confident that that theory about having a colon is completely accurate. slow fe tablets also tend to have a little less iron content than regular ferrous sulfate tablets.

Love the little iron fish! Fantastic idea...

Adore people who think outside the box!

Sharon

I've had my JPouch for 23 years and for the past 12 years I've had issues with iron levels.  After struggling with very low energy levels and chest pains, doctor did blood tests and found my iron levels basically depleted and red blood cell count also extremely low.  Iron pills are too hard on my stomach and do not seem to absorb in my system.  To combat this issue, I receive 2 iron transfusions (IV) twice a month. The iron I receive is mixed with a sucrose agent which is better for the system and absorbtion.  If I get off this schedule, which I currently did the past several months, my iron numbers fall again and I have another steep climb to get my numbers back to a normal range.  I also struggle with low B12 levels.  After multiple tests to make sure I don't have crohns, etc the most my docs could come up with is the following:  When my colon was removed this also meant my Ileum was removed too which is the part of the colon that connects to the small intestine.  My understanding is that the ileum is where iron and B12 along with other nutrients are absorbed. Sitting for two transfusions a month is real pain but for now is what I need to do.  However, since I still have not received any real definitive answers about this severe deficiency, I've decided to look into Jpouch docs thru the the University of Chicago.  Any top Jpouch doctor recommendations in the chicago area (U of chicago or elsewhere) would be greatly recommended.  

JOM, I think getting a fresh set of eyes on your situation is a good idea. Hopefully you have already consulted with a hematologist, who can better sort out the reason for your iron depletion.

To clarify what you said, the ileum is in fact part of the small intestine. It is the longest part of the small intestine- about 2/3 of it (with the preceding sections of jejunum and duodenum being rather short). The ileum is about 11 feet or so, and attaches to the colon at the cecum. You may well have had some ileum removed with your colon, but not all of it, or you would be losing weight.

The terminal ileum (the last few feet) is where B-12 is absorbed. Iron is absorbed in the duodenum and jejunum. Iron absorption is a complex thing, affected by many factors. I see that your docs have ruled out Crohn's, but have they ruled out celiac disease or gluten intolerance? Another common problem is chronic use of proton pump inhibitors, because reducing stomach acid too much will block iron absorption. Anyway, lots of factors there. It does seem that absorption is one of your problem, since iron infusions takes care of things. http://www.hematology.org/Pati...Iron-Deficiency.aspx

I hope you get some answers soon!

Jan

http://www.amazon.com/s/ref=nb...=Vitron-%2Caps%2C318

The above is the brand my GI prescribes me. I notice it has elemental iron and vitamin C and they are coated. The coating is needed for my stomach.  The link above also has vitamin B12 and something else. I don't need B12 so think that is why he didn't prescribe it. In the past I just took C with the prescribed iron. My Internist had me do this combination. She said we should take C when taking Iron.

Iron pills cause me immense stomach pain. I have been getting Iron infusions throughout the year to keep my levels just below normal. The problem is the underlying inflammation in my pouch caused by pouchitis. So far the Iron infusions are fighting the fatigue off.

After 3 2/3 years since my GI hemorrhage, my iron and ferritin levels are finally stable and normal!  Initially I had to have iron infusions, but had an anaphylactic response.  I've been on oral iron since then.  I take 28 mg of ferrous gluconate and a Vit C chewable daily and it doesn't both my stomach at all (I even take it on an empty stomach first thing when I wake up).  Hope your doctor had a suggestion that worked!

Laura

I also have low iron levels  I have been taking a chewable Vit C 500 mg and B12 5000 mg dissolves under tongue  I buy them in Cosco   Kirkland brand   They seem to help  I take them in the morning after eating breakfast.  My blood work has been better since taking them.  I also take multivitamins, magnesium and calcium. and also vsl#3ds in the morning.  I do try to drink a lot of water  I also take a lomotil about 1/2 hour after taking vitamins every day. That helps me get thru the day   I have been trying not to take the antibiotic every night  When I feel that I am getting the start of pouchitis  I start taking them again at night. I also have  one  or two  bathrooms runs thru the night.  You just have to listen to your body. You have to try to figure out what works for you.  It took me a long time to get to this point.   Everyone is different.  I wish you all to be well and healthy   Grace

I have also been anemic on and off. I seem to have had the best luck with ferrous fumarate 100 mg supplements in bringing my levels back up. I used to take the Palafer brand name, but now I take a generic (Life brand) as it is much less expensive. I take it right before bed, as recommended by a pharmacist years ago, and which has remained very sound advice. There are few side effects that I've noticed, aside from a temporary darkening of the stool. The stool can be black or even very dark green depending on what else you have been eating, so don't be alarmed if you see this. It usually goes away after 2-3 BMs, until your next dose.  

I have issues with iron as well. I tried going the oral iron route but it didn't help at all. I started seeing a hematologist a few years ago and we decided infusions were the way to go. So he checks my levels every 4 or 5 months and if I dip too low we do an infusion or two to keep things in check. It's helped tremendously.  The downside is my insurance deductible is quite high so a lot comes out of pocket. Definitely try different oral iron pills first....you may find one that works for you. Good luck.