Hello doctor, I am a 41-year-old woman with low iron (just above being clinically anemic). I have always eaten lots of wild red meat (moose, bison, caribou, dall sheep) and I do not seem to be absorbing enough iron. I have been taking 300 mg elemental iron supplement per day for seven months with minimal improvement. I have cut back my dairy intake and started taking 150 mg Iron with 1000 mg Vitamin C with no noticeable change. I had a minera IUD put in six months back and the spotting finally stopped, but I still do not feel better. If I miss taking Iron for a day, I am dragging the next day and the brain fog comes back. I have restless legs, broken ridged nails and my hair is falling out. Is there other ways I can increase absorption? Other options for increasing my iron?
Hello. You have taken treatment for iron deficiency for seven months. It is enough time to raise your hemoglobin level and iron level. So now you have to check your hemoglobin level, serum ferritin level and TIBC level to rule out iron deficiency anemia. If these values are altered and iron deficiency anemia present than you should consider iron deficiency anemia as a cause for the brittle and broken nail. The different causes for iron deficiency anemia include chronic blood loss, impaired gastric absorption for which endoscopy is done to look for any ulcer if present, parasite infestation for which stool routine micro examination is done. As per my opinion, you need to consult the nearby physician for your detailed physical examination. For primary workup, you can investigate with an iron profile, routine CBC, serum TSH estimation, serum ANA estimation, and micronutrients estimation. According to the cause, specific treatment is given. Do not try self-treatment with Iron tablets.