Iron

[Shnoogy]

I have read lots of posts about not taking iron supplements and watching how much iron we intake...Is that just if your on treatment or all the time..and why?...and what about vitamin A

[jmjm530]

I would leave those decisions up to a doctor, assuming you're seeing a hepatologist (liver specialist). If not, you might want to consult with one, but I suggest that to most folks on treatment who have questions. Gastro's and their staffs generally are not equipped the same way in terms of training and expertise.

-- Jim

[virgocharm]

my anemia has nothing to do with tx. had it before tx . low iron. i started tx at 12.9 and holding at week 10 at 11.1. please comment.

[jmjm530]

You might start by showing your nurse this Q&A from the John Hopkins site:

http://www.hopkins-hivguide.org/q_a/patient/favorites/combo_therapy___iron_supplements_.html?contentInstanceId=377948&siteId=7151

You can also print out this article from Medscape. (Free registration required)

http://www.medscape.com/viewarticle/507060_12

Or this fact sheet from HCV Advocate:

http://74.125.47.132/search?q=cache:MKMZvs46T7IJ:www.hcvadvocate.org/hepatitis/factsheets_pdf/SEM_anemia_08.pdf+hcv+hemolytic+anemia+iron+supplementation&hl=en&ct=clnk&cd=6&gl=us

Or this from the Projects In Knowledge Web Site (free registration required)

http://www.projectsinknowledge.com/init/G/1628/1628-Handbook.pdf

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Then ask your nurse for some sort of documentation on what  she's basing your iron supplementation on.

[jmjm530]

The treatment for Hemolytic anemia (the kind of anemia we experience on treatment) is Procrit (epo) and not iron supplementation. Iron supplementation is only recommended if your iron stores (Ferritin and TSAT) are low.

I agree with your nurse that you should stop believing everything you read on the internet. I will add that you should stop believing everything your (or any nurse or doctor) tells you, especially when it goes against respected protocols. Your responsibility as a patient is toward yourself first which sometimes means taking responsiblity of the choices you agree to by using independent research and/or additional medical consultants.

I could be wrong but I have a feeling your nurse is not working for a hepatologist (liver specialist) but probably a gastro? In any event, I would challenge the recommendation for supplemental iron and ask on what basis. Personally, I'd be picking up the phone for an outside consult with a hepatologist. Being "und" is great but the trick is to stay on treatment long enough for that und to turn into an SVR.

-- Jim

[virgocharm]

thats exactly what my nurse told me. as long as there was not to much iron stored. my anemia was from heavy cycles. but since i started tx have not seen a cycle. hope to never see another.  but she still insisted i continue to take my iron , which i had stopped taking.  but i still take it every day. feel fine.

[virgocharm]

i have been takin 2 iron pills a day for 10 weeks. my study nurse insisted i take them since i was anemic. i told her i heard we with hep c did nt suppose to take iron. she said stop beleiving everything i read on the internet. i am u n d .

[IMstacie]

Just to confirm, my doctor said the same thing as lalapple's post.  So, I'm taking one multiple vitamin without iron.  

[lalapple]

in previous post i meant "thread" not "treat"  sorry typo

[lalapple]

this treat might help with the discussion:
http://www.medhelp.org/posts/show/659112

in the mean time to sum it up, it's just better to get an iron study to see if you are iron deficient or not.  anemia from tx is called hemolytic anemia and it doesn't have much to do with iron stores in the body, so there is no point in taking iron supplements if one has hemolytic but not iron deficient anemia.  people are not commonly iron deficient in America today, but women may be an exception esp when they still get their menstral cycles.  but i got an iron study and turns out i wasn't iron deficient.  so i basically don't see a point in iron supplements bc excessive iron actually cause free radicals in the body, it's actually an oxidant in contrast with the good antioxidants.  i guess it's ok as long as you have moderate amounts of iron in regular foods you eat but don't add to it with supplements or enriched foods..

and for vit A, it's a fat soluble vitamin which means it gets stored in the body (specifically in the liver) when in excess as opposed to being excreted with urine as water solubles.  from the jest of it, i had the idea that i get sufficient from the regular foods i eat.  and i guess sweet potatoes are ok ones in a while, but don't add to it by taking vit A supplements.

hope this helps