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I had to have a gastrectomy with a small bowel resection and my iron count has gone progressively lower and lower and lower. Iron tablets and prenatal vitamins all make me vomit. My prealbumin was 21 but my ferritin was 4. I have been getting B12 injections for the last 20 years too.
I eat primarily chicken, cheese, occasionally beef and a few veggies, but I can't seem to get my ferritin level up. Any dietary suggestions?
This is a great question. Even though I often write about avoiding supplements, there are times where folks do need them as replacements - as in your case.
We know from studies that iron absorption is dependent on stomach acidity. With yours being removed, this may be part of the reason for your inability to keep your iron levels high enough. Acid reducing medications such as omeprazole (Prilosec®) or ranatidine (Zantac®) can have the same effect.
One option for you to try may be to take Vitamin C along with your meals. Ascorbic acid has been shown to help with iron absorption. Interestingly, the studies show that this can be from foods that have a high ascorbic acid content or from supplements.
Check with your doctor or dietitian about combining these supplements with any other medications that you might be on.
Thanks for writing,
Timothy S. Harlan, MD, FACP