Iron Infusion reaction

Hello all,

This is my first time posting so please be gentle

A little background...

I'm a 26 year old lad from Sweden. I've read Peat's work for a while now and now he is pretty much the only person I trust when it comes to nutrition, hormones and all the like. A few months ago I switched to a new doctor since my last one basically contradicted EVERYTHING I've been reading from Peat and basically what he said just didn't make sense (thought that a TSH of 2.8 was a GOOD thing, :-? )

Anyways, a friend of mine gave me a tip about this doctor who supposedly is a thyroid specialist and I contacted him mostly to get help for my very, very low testosterone count (free T= 12). He took some labs and concluded that I was both hypothyroid as anemic. He therefore prescribed Iron infusion as well as T4.

I had the infusion on Thursday last week. A very high dose of 1000 mg in about 25-30 minutes. It was a very shocking experience since I hate everything having to do with needles, blood, basically intravenous stuff. I actually cried through half the session
That night, about 5 hours after the infusion I had serious chills. I was laying in bed literally shaking to sleep. The next day though I felt fine.

Two days later, on Saturday I had a workout in the morning with good energy and thought "wow maybe this iron thing really worked" but later on my joy turned to despair. After dinner I started to get this excruciating headache witch can only be described as a migraine attack (have never had migraine though) and soon after my whole body started tho ache. I though I was going to faint so I went to bed and was cold sweating through the whole night.

Next day was the same: headache, abdominal pain, achy joints and muscles, no appetite, etc. Spent the whole day alternating between my bed and sofa, sipping OJ and milk to get at least some nutrition. Now, 4 days after the IV my symptoms have lessened a bit but I'm still really fatigued (could be due to malnutrition, energy deficit) and have quite some stomach ache. Have no appetite but have been pounding ice cream just to get calories. Am already pretty underweight due to history of eating disorders so losing weight is the last thing I need right now!

So basically, what do y'all think of this? Can it be the iron or something else in the IV causing allergic symptoms? Can it be that I overloaded on Iron, seeing that it was such a high dose in such a short period of time? I have never contacted Ray myself and I know that he is already to busy as it is so I didn't want to bother. However, I think this is quite serious and I would very much appreciate your input as well as advice in this matter. I know that some of you have quite frequent contact with Ray, so if I could get his input as well it would be fantastic. Am kind of panicking right now

Thanks so much in advance!

In Peat World, Iron is one of the bad guys.

Maybe you should've taken the thyroid and just sort of forgotten you had to go to the iron infusion. Sorry doc, I forgot about it, but thyroid is making me feel well, so I'm just going to avoid the iron.

Yes I probable should have. But it's a little late for that now I'm afraid

What were your iron labs like?

Ferritin was something like 7 which is quite low and iron index (not quite sure which) was 12 - below 11 is considered too low

Anemia is one of the symptoms of hypothyroidism.
It is possible that your Anemia resulted from thyroid problem.
I think you will get a lot of good info from RP's article on iron.
http://raypeat.com/articles/articles/iron-dangers.shtml
Your doctor should have measured iron storage from
Serum Ferritin and Transferrin Saturation Index.You need both test.
Most doctors assume that all anemic patients are low in iron.
If your doctor did not do these test , next time ask for those.
I believe all the symptoms you described are side effects of iron infusion.
You can do a google search on side effects of iron infusion.
It would be a good idea to avoid vitamin C now.
Your TSH 2.8 is not very high and your are quite young.
You probably can lower your TSH just following a good diet.
I never would have agreed to iron infusion without doing some google read.
If you are really iron deficient you ask your doctor if a slower approach is better.
Beef liver, lungs and blood are very high in iron.
EDIT 1: Ferritin 7 and Iron saturation index below 11 are really low.
You can ask your doctor if slower approach is ok.
If this injection is sufficient to raise your iron level then
you do not need to worry about iron infusion again.
Edit 2:T4 only therapy is problematic for most people, since liver of
hypothyroid people are often sluggish.
But male patient has a better chance of converting T4 to T3 in liver.
You should be careful using only T4. If your thyroid symptoms
get worse on T4 ,you should think about adding T3 with T4.

Thanks Mittir!

I've read that article a few times, even before taking the IV. However my doctor (who I now don't trust anymore) convinced me that I was Iron deficient and this was clearly the best way. The Iron cost 2000 Swedish kronor ($300) a shot and I had to buy two so there is clearly big business in this whole Iron infusion thing. Reading Ray's article on Iron only makes me more anxious and depressed right now.

I will ask my doctor to take these tests next time. However, even if they are low I will not agree to another infusion. I have never felt this bad in my whole life from what I can remember. Prior taking the IV I hadn't been sick for years more than maybe a sniffle.

What should I do more except avoiding Vit C? Of course keep Pufa low to avoid oxidative damage but is there anything else that could mitigate the high Iron load? I know I'm not eligible for blood donation so that's out of the question. Maybe I should punch myself in the face, causing a nose bleed

Vitamin E and niacinamide, if I recall correctly, can help to handle iron.

Some threads that might help.

Link: Is there any way to lower iron without donating blood?

Link: iron chelation

Yes, from the serum ferritin result, the amount of storage iron was low. Dr. Peat has (admirably) raised awareness about iron excess, the other side of the spectrum.
http://raypeat.com/articles/articles/iron-dangers.shtml

The "inconvenient" thing here was the delivery system. In addition to the iron effects themselves, the IV/fluid volume can perturb the system temporarily, even with needed treatment and especially for those who are not used to it.

If your hemoglobin or hematocrit test results really low, and you were functioning very poorly, the prescribing doctor may have "felt" urgency. In most places, the style is to have people supplement orally for less severe cases. You can ask your doctor what the follow-up levels are, and how "anemic" he thinks you are now.

If the iron has been low, you can enjoy large amounts of iron-rich (ruminant) meats (beef, lamb, buffalo, etc.) after the infusion effects where off. As Mittir mentioned recently in a different thread, it's useful to keep calcium intake high at the same time. Hopefully, any further iron supplementing can be done through food, or if necessary, small oral supplementing.

The big question is: How did the iron get very low? It's unusual for a casual eater taking usual food to get very low in iron. Were you vegan or vegetarian for quite a while? Did the eating disorders create extended malnutrition with low protein, low iron, low cholesterol? If so, another part of the story might be low cholesterol. Cholesterol is a necessary building block for restorative hormones. Chronically low cholesterol could be a part of a low testosterone situation.

I know some people with eating disorders and seen some of the difficulties. I'd encourage finding a pleasant sustainable approach without concern about Peat-y perfection.

From the description of having a thin frame, high adrenalin may be a major adaptive factor for you. If you can take it comfortably, keep salt intake adequate, and/or see how baking soda baths work for you. Similarly, find fruit sugar sources you like.

It sounds like the post-infusion difficulties are gradually subsiding. If things lingered, you might think about liver supportive measures. Most of the Peat-y metabolism improving things also tend to improve liver function. If you read about iron overload, you may see that the large iron load of the infusion caused a "mini-mini" episode:

http://en.wikipedia.org/wiki/Iron_overload

While it's not good that things have been uncomfortable, the infused iron will gradually distribute over a larger area, hopefully to all regions where needed. You might experiment with occasional warm (NOT scalding) compresses to the sore areas over the SHORT term, just to boost the local circulation.

RP has recommended vitamin E to reduce damage causing ability of iron.
I believe there is old post about certain form of B1 vitamin helping with
iron reduction. RP has mentioned that stored iron is safe and problem starts
when cells are not energized. Keep your cells happy with sugar, protein and
nutrients. RP talked about protection against iron in KMUD Antioxidant interview .
http://www.functionalps.com/blog/2011/0 ... nterviews/

Wow, thank you So much for the response. Have been really worried about all this and from what I can read from your comments aguilaroja and Mittir this is just a temporary reaction to the IV? So you don't think I have done any permanent harm from taking this high dose Iron infusion?

You (aguilaroja) wrote that I should continue eating iron rich foods to keep my iron levels up. I think I get enough
calcium from the 1-2 liters of strained yogurt + cheese I eat every day. After this nightmare I had planned to avoid all high iron foods except liver once a week for the vitamins. Even if my Dr says I need another infusion there's no chance in hell I'll go through this again.

I'm not sure why my iron stores were low. I haven't been vegan or vegetarian but I guess many years of under-eating + over-exercising has seriously taken it's toll. I have also had a history of serious nose bleeding which also could be a factor. My Dr did mention that one reason why he prescribed intravenous iron was because he suspected intestinal difficulties and therefore absorption issues.

I know some people with eating disorders and seen some of the difficulties. I'd encourage finding a pleasant sustainable approach without concern about Peat-y perfection.

From the description of having a thin frame, high adrenalin may be a major adaptive factor for you. If you can take it comfortably, keep salt intake adequate, and/or see how baking soda baths work for you. Similarly, find fruit sugar sources you like.

Click to expand...

I'm with you on the whole "not worrying about Peat-y perfection" considering my history of somewhat harmful perfectionism but at the same time I really want to do the best I can do to find my way back to health.

So, you think I shouldn't worry to much about this and just keep following the Peat-principles and go from there?

Infinite Fred said:

.... Even if my Dr says I need another infusion there's no chance in hell I'll go through this again.

I'm not sure why my iron stores were low. I haven't been vegan or vegetarian but I guess many years of under-eating + over-exercising has seriously taken it's toll. I have also had a history of serious nose bleeding which also could be a factor. My Dr did mention that one reason why he prescribed intravenous iron was because he suspected intestinal difficulties and therefore absorption issues....So, you think I shouldn't worry to much about this and just keep following the Peat-principles and go from there?

Click to expand...

Hi I.F.,

My impression from the description is that there was a bumpy ride from rapid supplementing of iron. It is different from an allergy, in the strict sense of the word, which would be an individual sensitized immune response. Most people would be sensitive to iron overload in certain situations. (That's not a criticism of the doctor-things may have appeared severe to him.)

Yes, the view from here is that the response to the IV is short term, and will settle down. Mittir gave excellent suggestions for nutrient protective measures if needed. Peat-y restorative methods can work very well even in rough approximations.

I don't know exactly how much iron would be helpful. Since you have been low in iron for a while, it seems like you could eat iron-rich foods (especially meat as a protein source) more than people who have iron stores that are already high. I had a period where I "successfully" avoided iron-rich protein so well that I got pale & tired and very low in iron, by lab tests. For several reasons, if you need more iron, food sources are preferable.

It is just a guess that even with the IV boost, the iron might still be low. It could be that your boost from the I.V. is plenty already. I expect the doctor will check labs to get some approximate idea. It is hoped that with post-infusion difficulty the first time, that the doctor would suggest milder measures in the future.

If the doctor suspects reduced absorption, over time perhaps there will be investigations about absorptions of other nutrients. When metabolism is low, absorption may be impaired. High adrenalin states are one situation where absorption is often reduced. The good counterpoint is that when metabolism improves, digestion and absorption improves, which in turn improves metabolism. Things getter better.

If there are specific symptoms, like indigestion/reflux/food intolerance/constipation/diarrhea/etc, you can read about grated carrot salad, bamboo shoots, gelatin and other things on the forum. If fine tuning assistance is helpful, that could be a separate forum thread.

I think you have to wait till your next iron test. What was your Hemoglobin?
Once you reach your target of hemoglobin then your doctor can choose
daily dose of iron instead of mega dose.
I think there is good reason to get vitamin E to protect oxidative damage to
organs. Here is one quote from RP's article on iron.

Ray Peat said:

In one of Hans Selye's pioneering studies, he found that he could experimentally produce a form of scleroderma (hardening of the skin) in animals by administering large doses of iron, followed by a minor stress. He could prevent the development of the condition by giving the animals large doses of vitamin E, suggesting that the condition was produced by iron's oxidative actions.

Click to expand...

Another mice study found administering vitamin E before giving large dose iron
was protective against liver damage. Even vitamin E after iron dose was protective.
They showed how liver's vitamin E storage was depleted by large iron dose.

Data in this study indicate that vitamin E may be a useful antidote for iron toxicoses and that iron-induced depletion of vitamin E may play a role in the pathogenesis of iron toxicity.
http://jn.nutrition.org/content/123/10/1649.long

Click to expand...

Calcium content of strained yogurt usually is quite low.
RP mentioned that liver's ability to detoxify estrogen is decreased in
people, who ate low calorie and low protein diet for a short period of time.

Ok, fifth morning after the infusion, waking up with a pounding headache which I guess can be described as migraine-like i.e pulsating pain, seeing stars, etc.

I think you have to wait till your next iron test. What was your Hemoglobin?
Once you reach your target of hemoglobin then your doctor can choose
daily dose of iron instead of mega dose.
I think there is good reason to get vitamin E to protect oxidative damage to
organs.

Click to expand...

I'm not quite sure what my Hemoglobin was like, he didn't give me the test results on paper just by phone
What kind of vitamin E do you recommend? Any particular brand?

Calcium content of strained yogurt usually is quite low.

Click to expand...

I eat yogurt mostly because I don't like milk so much. I strain because of the lactic acid issue but actually I have never had any of the bad reactions Peat have mentioned eating yogurt without straining it so maybe it's unnecessary? Maybe the benefit of getting more calcium outweighs the cons of lactic acid? I always eat it with fruit and/or sugar.

RP mentioned that liver's ability to detoxify estrogen is decreased in
people, who ate low calorie and low protein diet for a short period of time.

Click to expand...

I'm sorry but I didn't quite understand this Do you mean that there might be an overbalance of estrogen and that this can be a factor in this?

That rat study on liver and iron load, used natural alpha-tocopherol from Sigma Lab.
RP recommends mixed tocopherol. I use GNC mixed toocopherol vitamin E 400 IU. RP also mentioned that
using high potency 1000 IU capsule will minimize the possible problem from soy oil in the capsule.
There are few threads on discussion about various vitamin E brands.
toxinless.com has a list of supplements with information on excipient and source materials.

I think tolerance to lactic acid and any other problematic substances depend on individual
health. Calcium to phosphorus ratio is a big part of his recommendations.

I mentioned that about estrogen and liver after reading about your eating disorder.
I believe there is a thread ,where a poster talked about her anemia and low iron storage.
IIRC she also had eating disorder. You can look up her posts on anemia.
I think her iron numbers were very similar to yours but her doctor did not give
her any IV infusion of iron.

Thanks once again!

With the risk of sounding like a broken record I just want to make sure I've understood it correctly...

From what I know, no one here is a MD so it's hard to make a medical statement without checking labs and the all that but just from interpreting Peat - you don't think I have made any major, permanent damage from receiving such a high dose of Iron since I was so low beforehand?

I sometime have a hard time wrapping my head around some of Ray's stuff. Obviously he thinks Iron in excess is very bad and harmful and that it most often does more harm than good. However in my situation, can it actually be of benefit getting so much Iron in to my system or is it inevitably going to cause damage? And if so, is it reversible?

From what I understand it's not quite like PUFA where it's basically always the less the better, or is it? :?

I have never been in contact with Ray myself so it's hard for me fully get his stance on the matter. Seriously, really appreciate all the input!

Infinite Fred said:

From what I understand it's not quite like PUFA where it's basically always the less the better, or is it?

Click to expand...

With iron, it's pretty well established you need some.

Regarding PUFA, there is controversy. Peat thinks it hasn't been proven that you need any, others disagree and believe you need some.

Well, if your body was saturated with iron, if I'm correct it would take a long time with just a low iron diet to normalize (assuming 1mg/day loss for a male, but it could be greater if you drink coffee or milk apparently), and a lot less if you donate blood regularly.

I do not know if 1000 mg is large enough dose to cause permanent damage to
anything. You can check side effect list of the medicine.
As i mentioned earlier that RP thinks stored iron is not harmful
unless there is other factors involved. He mentioned that
iron saturation index below 25 is cancer protective.

There are about 2 gm of iron in the adult female, and up to 6 gm iron in the adult male. About 1.5 to 2 gm of this total is found in red blood cells as heme in hemoglobin, and 0.5 to 1 gm occur as storage iron, mainly in bone marrow, spleen, and liver, with the remainder in myoglobin and in enzymes that require iron. http://library.med.utah.edu/WebPath/TUT ... /IRON.html

Click to expand...

It does not look like your iron saturation index will be too high from 1 IV injection.
A healthy body is good at keeping iron in safe storage form.