Question:

Case of ulcerative colitis, low iron stores. How to correct with foods?

Hi! I really enjoy this web site and find it to be very informative. I have had ulcerative colitis off and on for about 16 years. For the last 6-8 months I have not had any bleeding but I have been feeling fatigued, have muscle and joint aches, feel light headed and have dark circles under my eyes. My doctor checked my thyroid function and it was normal. She also measured my ferritin levels which proved to be low normal around 30 mg/dl. My hemoglobin is normal and my G.I. specialist said that he is not worried unless I became anemic. My doctor wanted me to try palafer a high dose iron supplement but because it can cause a lot of constipation and stomach upset, which I already have due to my existing condition, I am nervous about taking it. Instead I am trying to eat more foods rich in iron to try to boost my ferritin levels. But it is confusing when for example pumpkin seeds are supposed to contain about 30% of ones daily iron needs in a quarter cup. But does that mean I will absorb that much. From what I have read a person absorbs only about 10 % of the iron from non heme sources but can double that by eating vitamin c foods. Also I believe we can absorb about 25% of the iron from heme sources, but although I do eat fish and poultry and some beef I don't want to consume too much meat. I realize that for someone like me with gastric issues perhaps I am not absorbing enough iron. But if you could suggest other foods which are high in absorbable iron and explain how much roughly I might expect to absorb I would appreciate it.


Thanks

Paul

Answer:

Photo of Scott Clack
Dear Paul,

If you still eat gluten-containing foods (e.g. wheat, barley, rye, spelt, oats), you should be tested for Celiac disease and gluten intolerance. The blood tests are serum IgG and IgA transglutaminase, as well as IgG and IgA antibody testing for gluten and wheat. If you are positive for these tests, your difficulty in absorbing and retaining iron will be governed by gluten-intolerance. Many gastroenterologists and doctors may test for Celiac disease (and claim that formal diagnosis can only be made from a biopsy of the intestine) but don't test for allergy/sensitivity to gluten.

Iron is also a complex mineral to absorb. If your digestion is deficient, particularly in terms of stomach acid production, absorption of iron will be reduced. Low iron stores (based on serum ferritin results) might be a sign that you're not absorbing enough iron to keep the storage level high enough. In turn your body keeps tapping into those iron stores to keep you from being anemic. Vitamin C is one key vitamin, that when taken with an iron supplement, should increase your iron stores. You will then feel more energetic, stop feeling light-headed, and your dark circles will decrease or disappear.

You should consult with a Naturopathic Doctor or Holistic Nutritionist. One key symptom they should look for is whether your stomach becomes bloated soon after eating. This is often a sign that you're deficient in stomach acid. If you're taking supplements like Nexium or acid-blockers (e.g. Pantoloc), your stomach acid level will indeed be low. Your treatment should include supplements that would improve your digestion, as well as provide you with an iron supplement and diet suggestions (e.g. pumpkin seed, legumes, molasses) that will increase your iron intake. The iron supplements that are recommended in my practice rarely constipate the way that prescription medicines do.

Good luck!
Scott Clack, B.Sc., N.D.
Touchstone Naturopathic Centre
Mississauga, Ontario
Response by Scott Clack B.Sc., N.D.

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