Dr. Hive - how long would iron from iron supplement stay in your system?

[Kassia]

I am supposed to have a complete blood count done to repeat labs that were done in December when my red blood count, hemoglobin, and white blood cell counts were all low.  I started taking a multivitamin a few weeks ago that contains iron (100% RDA), but didn't think of it affecting the repeat lab work until a few days ago.

I switched to a different multivitamin that doesn't have iron in it on Monday.  How long do you think the iron supplement I took in the multivitamin would affect my lab results?  I'm wondering when the soonest I can get accurate results would be.  I'm supposed to have them done anytime now.  

 

[prairiewindmomma]

Which multivitamin do you plan to continue to use? 

Usually it's a six month course to restore your levels, but if you don't maintain, you'll see a gradual falling of levels.

Testing isn't a one and done thing with anemia unless you had a known blood loss due to surgery, were taking chemo and recovered, etc.

[Kassia]

12 minutes ago, prairiewindmomma said:

Which multivitamin do you plan to continue to use? 

Usually it's a six month course to restore your levels, but if you don't maintain, you'll see a gradual falling of levels.

Testing isn't a one and done thing with anemia unless you had a known blood loss due to surgery, were taking chemo and recovered, etc.

I guess the results will affect my decision on whether or not I supplement, which is why I want them to be accurate and not affected by the iron I was unknowingly taking.  

I'm just seeing my lousy family doctor right now and testing will be one and done if levels are back to normal.  If not, she wants me to see a hematologist.  

 

Edited February 5, 2021 by Kassia

[prairiewindmomma]

I would just get the labs done, and just tell her what you told us.  Here are my labs. I finished a multivitamin with x mcg of iron in it on Monday. The new one doesn't have iron in it. They can go from there.  

[Kassia]

27 minutes ago, prairiewindmomma said:

I would just get the labs done, and just tell her what you told us.  Here are my labs. I finished a multivitamin with x mcg of iron in it on Monday. The new one doesn't have iron in it. They can go from there.  

I don't know.  I don't think she would care.  All she seems to do is refer me to specialists and order expensive tests.  She's referred me to six different specialists in the past few months - five for the same problem.  I would understand if I needed to see an orthopedist for a broken bone, a dermatologist for a rash, etc. but why can't I see one doctor who can look at my symptoms and results and figure out what is going on?  It has been so frustrating.  

Edited February 5, 2021 by Kassia

[prairiewindmomma]

Sounds like you know you might be happier with a switch in primary care dr.

[ktgrok]

The only reason the iron would effect things is if the cause of your low RBC/Hemoglobin was iron deficiency. So if it is higher now, on the supplement that is good information to have. But iron wouldn't effect the WBC at all. 

Did you end up making an appointment with a hematologist?

[Kassia]

21 minutes ago, prairiewindmomma said:

Sounds like you know you might be happier with a switch in primary care dr.

Absolutely.  This one is close and good about ordering labs I request, but otherwise she's totally incompetent.  I've just had such terrible luck with doctors that I don't feel confident that I'll ever find a good PCP.  

 

19 minutes ago, ktgrok said:

The only reason the iron would effect things is if the cause of your low RBC/Hemoglobin was iron deficiency. So if it is higher now, on the supplement that is good information to have. But iron wouldn't effect the WBC at all. 

Did you end up making an appointment with a hematologist?

Yes, I am aware that the WBC wouldn't be affected by iron supplements, but don't want the RBC/Hemoglobin to be higher than it would be without the additional iron in the vitamin since I wasn't taking that vitamin with my last CBC.  

I was waiting to make an appointment until I got these test results.  If there's no change or they are worse, I will.  If things improve, I won't and just have another CBC at my next physical in September.  

[BeachGal]

3 hours ago, Kassia said:

I am supposed to have a complete blood count done to repeat labs that were done in December when my red blood count, hemoglobin, and white blood cell counts were all low.  I started taking a multivitamin a few weeks ago that contains iron (100% RDA), but didn't think of it affecting the repeat lab work until a few days ago.

I switched to a different multivitamin that doesn't have iron in it on Monday.  How long do you think the iron supplement I took in the multivitamin would affect my lab results?  I'm wondering when the soonest I can get accurate results would be.  I'm supposed to have them done anytime now.  

 

My understanding is that you should stop taking iron supplements 12 hours before your test. If you are taking biotin, stop that three days before the test. I asked a lab about eggs, which contain biotin, and was told they are okay to eat in those three days. Probably within moderation, I imagine.

[BeachGal]

Do you have any concierge doctors in your area? I think you could benefit from having someone who is willing to spend more time helping you figure out what’s going on and then finding ways to help you, if necessary. Usually they can spend a lot more time working with patients. They are a bit more expensive but might be worth it.

[Kassia]

7 hours ago, BeachGal said:

My understanding is that you should stop taking iron supplements 12 hours before your test. If you are taking biotin, stop that three days before the test. I asked a lab about eggs, which contain biotin, and was told they are okay to eat in those three days. Probably within moderation, I imagine.

I do take biotin, but knew that could interfere with test results so I've stopped taking that.  I eat a lot of egg whites, but I believe the biotin is in the yolks.  I'll have to double check that.  Thanks.

 

6 hours ago, BeachGal said:

Do you have any concierge doctors in your area? I think you could benefit from having someone who is willing to spend more time helping you figure out what’s going on and then finding ways to help you, if necessary. Usually they can spend a lot more time working with patients. They are a bit more expensive but might be worth it.

 

I don't know of any concierge doctors, but will look into it.  Certainly one more expensive doctor has to be cheaper than seeing five specialists.  I just want to find a good doctor!  I wonder if insurance will cover a concierge doctor?  Thank you for the suggestion.

 

[ktgrok]

11 hours ago, Kassia said:

Absolutely.  This one is close and good about ordering labs I request, but otherwise she's totally incompetent.  I've just had such terrible luck with doctors that I don't feel confident that I'll ever find a good PCP.  

 

Yes, I am aware that the WBC wouldn't be affected by iron supplements, but don't want the RBC/Hemoglobin to be higher than it would be without the additional iron in the vitamin since I wasn't taking that vitamin with my last CBC.  

I was waiting to make an appointment until I got these test results.  If there's no change or they are worse, I will.  If things improve, I won't and just have another CBC at my next physical in September.  

If it is higher due to the iron than you would know the reason it was low before is an iron deficiency. Which is good info to have. 

[Kassia]

38 minutes ago, ktgrok said:

If it is higher due to the iron than you would know the reason it was low before is an iron deficiency. Which is good info to have. 

I'm confused (sorry).  If I'm making the decision on whether or not to see the hematologist, wouldn't I want the blood test results not to be altered by supplements?  Or if the iron supplement increases the RBC/hemoglobin, does that mean there's not an issue I would need to see a specialist about?  I guess what I'm asking is if I had a more serious problem, would the iron supplements not make a difference then?  Also, if the levels are increased while I'm on the supplements, how would I know if they would have increased on their own or not - wouldn't that mean I'd have to supplement forever to keep the iron levels at a normal level?  

Hope that made sense.  Sorry for all the questions!  😛

 

[ktgrok]

5 minutes ago, Kassia said:

I'm confused (sorry).  If I'm making the decision on whether or not to see the hematologist, wouldn't I want the blood test results not to be altered by supplements?  Or if the iron supplement increases the RBC/hemoglobin, does that mean there's not an issue I would need to see a specialist about?  I guess what I'm asking is if I had a more serious problem, would the iron supplements not make a difference then?  Also, if the levels are increased while I'm on the supplements, how would I know if they would have increased on their own or not - wouldn't that mean I'd have to supplement forever to keep the iron levels at a normal level?  

Hope that made sense.  Sorry for all the questions!  😛

 

Right, if you are just iron deficient, and levels go back to normal on vitamins,  than that doesn't need a specialist, it just needs vitamins. Lots of people need to supplement iron forever, in order to get enough. Some few need iron infusions, as they can't absorb iron. 

But if it is cancer or a bone marrow issue that is causing low blood cell count, iron won't fix it. 

[Kassia]

1 minute ago, ktgrok said:

Right, if you are just iron deficient, and levels go back to normal on vitamins,  than that doesn't need a specialist, it just needs vitamins. Lots of people need to supplement iron forever, in order to get enough. Some few need iron infusions, as they can't absorb iron. 

But if it is cancer or a bone marrow issue that is causing low blood cell count, iron won't fix it. 

Thank you so much!  I had no idea.  

One more question - if it's just a matter of a supplement and I test while I'm supplementing and it is back in the normal range, how would I know whether or not it would be normal without the supplements?  I don't mind supplementing if I need it, but don't want to if I don't.  Not sure if that makes sense.  I've always been on the low side of normal for RBC/hemoglobin, but maintained in the normal range until now.  

 

[ktgrok]

3 hours ago, Kassia said:

Thank you so much!  I had no idea.  

One more question - if it's just a matter of a supplement and I test while I'm supplementing and it is back in the normal range, how would I know whether or not it would be normal without the supplements?  I don't mind supplementing if I need it, but don't want to if I don't.  Not sure if that makes sense.  I've always been on the low side of normal for RBC/hemoglobin, but maintained in the normal range until now.  

 

Well, I mean it is a decent idea to continue taking a multi with iron anyway, especially since you trend to the low side of normal at best. But you could always stop taking it and recheck again. A CBC isn't a bit deal to recheck. 

[Kassia]

1 minute ago, ktgrok said:

Well, I mean it is a decent idea to continue taking a multi with iron anyway, especially since you trend to the low side of normal at best. But you could always stop taking it and recheck again. A CBC isn't a bit deal to recheck. 

Right, CBC is easy to recheck, but I don't know if my doctor will order it (or if insurance would be a problem) without an expensive office visit since she doesn't make anything by continually ordering labs for me and evaluating the results.  Or she may just think it's not needed.  

[gardenmom5]

It can be days or weeks.   I had issues, and my dr told me to stop taking any iron.  We watched it slowly come down.

[Kassia]

3 minutes ago, gardenmom5 said:

It can be days or weeks.   I had issues, and my dr told me to stop taking any iron.  We watched it slowly come down.

Thanks.  One of my sons is a frequent blood donor and a vegan.  His hemoglobin wasn't high enough to donate one time so he took iron supplements for a week and was eligible to donate again.  If his responded that quickly to the increase, I'm wondering if it takes a while for it to come down again. He was on a higher dose, though - I think he said 300% of the RDA, while my multivitamin is only 100%, but I've been taking it for a few weeks while he only took it for a week.

[Arcadia]

20 hours ago, Kassia said:

4 hours ago, Kassia said:

Right, CBC is easy to recheck, but I don't know if my doctor will order it (or if insurance would be a problem) without an expensive office visit since she doesn't make anything by continually ordering labs for me and evaluating the results.  Or she may just think it's not needed.  

Yes, I am aware that the WBC wouldn't be affected by iron supplements, but don't want the RBC/Hemoglobin to be higher than it would be without the additional iron in the vitamin since I wasn't taking that vitamin with my last CBC.  

I was waiting to make an appointment until I got these test results.  If there's no change or they are worse, I will.  If things improve, I won't and just have another CBC at my next physical in September.  

Insurance pay my oncologist for evaluating lab results as it’s charge as a doctor’s visit. My oncologist would either video call or see me at the clinic and go over the results.

I think whether you need follow up would depend on how much the improvement is. 

8 hours ago, Kassia said:

I'm confused (sorry).  If I'm making the decision on whether or not to see the hematologist, wouldn't I want the blood test results not to be altered by supplements?  Or if the iron supplement increases the RBC/hemoglobin, does that mean there's not an issue I would need to see a specialist about?  I guess what I'm asking is if I had a more serious problem, would the iron supplements not make a difference then?  Also, if the levels are increased while I'm on the supplements, how would I know if they would have increased on their own or not - wouldn't that mean I'd have to supplement forever to keep the iron levels at a normal level?  

My iron supplements made a difference while I was on chemotherapy but I was taking the same dosage as when I was pregnant and anemic. It’s about 250 to 300% RDA. 
 

When I discontinued iron supplements, my haemoglobin count would just flatlined and generally stay below the normal range. If I eat red meat daily, it goes up without iron supplements. If I need it to go up fast, I have to eat red meat every meal for days. In my case, I absorb heme iron better than iron from non-meat source. 
 

I have had CBC every 3 weeks for more than a year and every 3 months for a year. For both pregnancies, I had blood draw every visit because I am anemic. So it was just easier to see the trend for myself with regards to iron supplements and diet. 

[Kassia]

43 minutes ago, Arcadia said:

Insurance pay my oncologist for evaluating lab results as it’s charge as a doctor’s visit. My oncologist would either video call or see me at the clinic and go over the results.

When I discontinued iron supplements, my haemoglobin count would just flatlined and generally stay below the normal range. If I eat red meat daily, it goes up without iron supplements. If I need it to go up fast, I have to eat red meat every meal for days. In my case, I absorb heme iron better than iron from non-meat source. 
 

I have had CBC every 3 weeks for more than a year and every 3 months for a year. For both pregnancies, I had blood draw every visit because I am anemic. So it was just easier to see the trend for myself with regards to iron supplements and diet. 

We have a high deductible so I don't want to have a bunch of charges for office visits just for reading labs. I wish medical care didn't always come down to money.  😞  

Do you know how long it would take for your hemoglobin count to decrease after discontinuing the iron supplements?  That's the information I'm really looking for.  

 

[Arcadia]

30 minutes ago, Kassia said:

Do you know how long it would take for your hemoglobin count to decrease after discontinuing the iron supplements?  That's the information I'm really looking for.  

My CBC was every 3 weeks so I don’t know if it drop faster than that but it did drop and continued dropping. 
My lowest haemoglobin count was 8.0 and highest was 12.8 (standard range 11.7 to 15.7g/dl)

RBC was lowest 2.36 highest 4.35 (standard range 3.8 to 5.2 MIL/ul) and correlates to haemoglobin count.

My WBC is all over the place, lowest 2.8 highest 10.4 (standard range 4.0 to 11.0K/ul) 

My platelet count is always in standard range 

[BeachGal]

2 hours ago, Kassia said:

We have a high deductible so I don't want to have a bunch of charges for office visits just for reading labs. I wish medical care didn't always come down to money.  😞  

Do you know how long it would take for your hemoglobin count to decrease after discontinuing the iron supplements?  That's the information I'm really looking for.  

 

I hate the money aspect as well. As do many MDs!

I’m also curious about how long it would take for hemoglobin to drop after stopping supplements so I asked a lab. If they respond — and they have in the past — I’ll pass their response along. Could be Monday, though.

[Kassia]

6 hours ago, BeachGal said:

 

I’m also curious about how long it would take for hemoglobin to drop after stopping supplements so I asked a lab. If they respond — and they have in the past — I’ll pass their response along. Could be Monday, though.

Thank you so much!  I thought about contacting a pharmacist, but the lab is even a better idea.  

 

[Amy Gen]

I would think that how long it takes is directly related to why you are anemic. For example, I got 5 bags of IV iron last year and my hemoglobin was lower after each bag, because I had occult bleeding. 
 

The doctor on call said that iron is like giving me bricks when I need shelter. It might work eventually, but it would take way too long to be effective. 
 

I had a couple of blood transfusions after that. They only helped short term too, and my level didn’t stay up until they were surgically able to stop the source of the bleeding. 
 

So I guess I’m wondering if there is a standard answer to how long iron supplements last affect your blood test results or if it really is a situation where there are too many underlying factors to predict this. 

[Kassia]

8 minutes ago, Amy Gen said:

I would think that how long it takes is directly related to why you are anemic. For example, I got 5 bags of IV iron last year and my hemoglobin was lower after each bag, because I had occult bleeding. 
 

The doctor on call said that iron is like giving me bricks when I need shelter. It might work eventually, but it would take way too long to be effective. 
 

I had a couple of blood transfusions after that. They only helped short term too, and my level didn’t stay up until they were surgically able to stop the source of the bleeding. 
 

So I guess I’m wondering if there is a standard answer to how long iron supplements last affect your blood test results or if it really is a situation where there are too many underlying factors to predict this. 

Thank you.  What a scary situation for you!  

[RootAnn]

See, and my PCP wouldn't recheck my iron levels until I'd been on supplements for 30 days since that's how long she said it would take to make new blood cells. So I have no idea!

[Arcadia]

26 minutes ago, RootAnn said:

See, and my PCP wouldn't recheck my iron levels until I'd been on supplements for 30 days since that's how long she said it would take to make new blood cells. So I have no idea!

Mine went up in 5 days going on a diet of lamb meat for every meal. I had to get my haemoglobin count up fast to meet surgery requirements and not by using iron supplements.

https://www.webmd.com/a-to-z-guides/qa/how-long-does-it-take-symptoms-of-iron-deficiency-anemia-to-go-away

“How long does it take symptoms of iron deficiency anemia to go away?

ANSWER

Your iron deficiency anemia symptoms should start to go away after about a week of taking iron supplements. Your doctor will check your blood to see if it has improved.”

ETA:

Maybe its an insurance issue. Every time my haemoglobin is below a certain level, I have to have a blood draw a week later for monitoring purposes. 

Edited February 6, 2021 by Arcadia

[Kassia]

43 minutes ago, Arcadia said:

Mine went up in 5 days going on a diet of lamb meat for every meal. I had to get my haemoglobin count up fast to meet surgery requirements and not by using iron supplements.

https://www.webmd.com/a-to-z-guides/qa/how-long-does-it-take-symptoms-of-iron-deficiency-anemia-to-go-away

“How long does it take symptoms of iron deficiency anemia to go away?

ANSWER

Your iron deficiency anemia symptoms should start to go away after about a week of taking iron supplements. Your doctor will check your blood to see if it has improved.”

ETA:

Maybe its an insurance issue. Every time my haemoglobin is below a certain level, I have to have a blood draw a week later for monitoring purposes. 

This explains how ds' increased in a week so he could donate blood again.  I was surprised it was so quick.  I had no idea!  He's vegan and I'm vegetarian, so lamb wouldn't work for us but I'm glad it did for you!  

 

[Arcadia]

49 minutes ago, Kassia said:

This explains how ds' increased in a week so he could donate blood again.  I was surprised it was so quick.  I had no idea!  He's vegan and I'm vegetarian, so lamb wouldn't work for us but I'm glad it did for you!  

 

I am more anemic whenever I am on a vegetarian diet so I had to supplement with Floradix (vegetarian) or Floravital (vegan) liquid iron supplements.