Over time, stopping my multivitamin and other supplements last year caused me to become iron deficient and anemic. My iron deficiency also caused issues with my thyroid medication. Getting back on the right supplements I believe has helped my anemia to begin resolving and has allowed me to correct my iron and perhaps other deficiencies. I can also take my thyroid medication again without issues.
In November 2017, I went to my doctor complaining that I was feeling unwell. She ran a B12 test, a complete blood count (CBC), and thyroid tests. On my own, I wondered if balancing iron and vitamin E in my diet may have been the missing link to my thyroid not recovering and that I now no longer needed my thyroid medication. I stopped taking it and felt much better. I was elated. Perhaps getting copper and zinc and well as vitamin E and iron balanced in my diet had made my thyroid fully functional, and the excess thyroid hormone was causing my problems. However, when I got my results back, my CBC showed mild anemia, and my TSH was elevated. My B12 levels were normal. I was shocked considering what I just discovered. Maybe something about the excess hormone caused a shock to my system, and I thought that staying off the medication long enough would cause things to correct themselves. In my mind, there was no way iron intake could be a problem. I had been balancing vitamin E and iron in my diet for several months by this time and had been feeling great up until this point. My skin had cleared up a good bit as well.
A few months later, my doctor ran CBC tests again. My CBC tests came back still showing anemia. I couldn’t believe it. Why would I still be anemic? Still in denial that iron could be the issue, I began to do research into other causes of anemia, and one that came up was folate deficiency. I already knew through 23andMe DNA testing that I was compound heterozygous for the MTHFR variant. I also found that the way I was cooking vegetables, mainly boiling, was destroying the water-soluble nutrients in them. Thinking that a folate deficiency might be the issue I was having, I decided to try taking a folic acid supplement and steaming my vegetables whenever possible. I could tell a huge difference making these changes. I was feeling so much better. For about a week, things were great, but I started feeling worse again. I then decided to try a full B complex supplement, but after about a month, that started causing problems too. After that, I decided to try 400 mcg of folic acid every other day. Things seemed to be progressing. Some persistent acne had begun clearing, and my skin became clearer than it had been in quite a while, since the time I had begun balancing iron and vitamin E in my diet. My dermatologist was impressed and decided I could wait a year before coming back for another appointment. I was thrilled. I was expecting great things when I went back to my doctor for follow-up blood work at the end of May. I thought I finally had things balanced concerning my diet and supplements. I thought I was doing fine off my thyroid medication and thought my anemia was resolving.
I had more blood work done at the end of May. I asked my doctor for additional tests. Since she had not done them to this point, I asked for iron labs. I also asked for folate, homocysteine, magnesium, vitamin B6, thyroid antibody tests, and others. When the results came back, I was hit with another huge shock. I was very iron deficient, and my anemia was worse. Folate and homocysteine were normal. My TSH was the highest I ever remember it being. It was nearly 10. Magnesium, vitamin B6, and other tests were normal. I wasn’t sure at this point what to do. The only way I knew to increase my iron without negative consequences was through a multivitamin with iron, but I stopped taking one over a year ago because of problems I thought it was causing. I decided I would give it a try to see if it would help. I bought a multivitamin, 250 mg magnesium tablets, and 600 mg calcium tablets. I decided not to try the cod liver oil again because the multivitamin had plenty of vitamin D, and I could get plenty of vitamin A through diet. I started thinking about where things were when I stopped my multivitamin, and I had not worked out the issue with iron and vitamin E yet at that time. I decided to calm my anxiety about going back on supplements with the idea that things might be okay with iron and vitamin E balanced in my diet. As for my thyroid medication, I was thrilled to discover that I still had refills left, so I requested a refill and began taking it again. None of the issues I had before have resurfaced. I believe now that the iron and vitamin E imbalance caused the issues I thought were being caused by my supplements and thyroid medication early last year, and I believe my iron deficiency caused the issues with my thyroid medication last November. Taking the supplements with my medication has allowed my medication to work again.
Because of the iron deficiency, anemia, and abnormal thyroid results, my doctor decided to refer me to an endocrinologist and a hematologist. The first time I visited the hematologist, she told me that my multivitamin alone would not be enough to help me recover from my iron deficiency and anemia. She wanted me to take extra iron. She didn’t think too highly of my idea to double up on my multivitamin because she was afraid the fat-soluble vitamins would reach toxic levels. This was shocking to me because I’d done this before with no issues, and the fat-soluble vitamins in the multivitamin were all balanced. There was a good bit more of vitamin D, but I could get enough vitamin A to balance it through diet. However, to placate the hematologist, I decided to try some extra iron and continue with just taking one multivitamin a day. I found a 65 mg supplement and a 100 IU vitamin E supplement that I thought I would try taking twice a week to start. That would keep the amount each day around double the rest of my supplements, so I was hoping this would be enough to keep things from getting too out-of-balance. About three weeks later, I decided to ask another doctor I was seeing for CBC and iron tests. I wanted to see where things stood, if things were improving with what I was doing. When I got the results back the following week, I was shocked to see that while my iron lab results had improved, my anemia actually seemed worse. I didn’t understand it. When I got the results back, it was after I had stopped taking the iron and vitamin E. The last time I took them was two days after I’d had the blood for the labs drawn. I stopped taking the combination because I began feeling really awful. Since the extra iron and vitamin E was the only recent change, I decided to stop taking them to see how I would feel and began feeling better. When I went back to the hematologist at the beginning of August, my anemia results looked quite a bit better. I believe the extra iron and vitamin E actually made my anemia worse. For some reason, I’m unable to tolerate relatively small amounts of extra iron, even when balanced with vitamin E, while others take multiple doses of the 65 mg tablets a day to recover from their anemia.
In August, I decided to order thyroid labs from discountedlabs.com so I could check on my numbers and take the results with me to my endocrinologist appointment. I didn’t want to wait until the appointment, which was still three months away at this time, to see if things were improving since starting back on my thyroid medication and supplements. My TSH, when things were normal, would be between 1 and 2. My results showed a 2.42 for my TSH, so while it was much better, it was not quite where it normally stays. My thyroid antibody results were also still negative. I was thankful that restarting my multivitamin and my thyroid medication was making things better with my thyroid as well.
I visited the hematologist again at the end of October, and my CBC results were probably only marginally better than they were in August. A few days later, I found out that once again my iron was low. I couldn’t believe it. I decided to try a different multivitamin to see if it would make a difference. I was taking Nature Made Multi for Her and decided to try the Centrum Women’s Multivitamin instead. I really wasn’t sure what to try, but since I had tried the Adults version previously and felt better on it, I thought I would try it. Perhaps my feeling better was from more than just the correction of the copper toxicity. Since the Women’s version is also much higher in zinc than copper, I decided to try taking the multivitamin with some cocoa powder mixed with sweetener and warm water. Starting out the day with cocoa sounds like a winner to me! Maybe this simple change would be all that’s needed to get my iron back up, but if not, I can think of no other alternative than to ask the doctor for some kind of comprehensive nutrition testing to see if there are any nutrients out-of-balance that might be causing poor uptake and utilization of the iron I’ve been getting. There may be something physically wrong causing an issue as well. I absolutely don’t believe throwing more iron at the problem will solve it. I refused to fill a prescription for iron tablets and refused the doctor’s request to come in to the office for an iron infusion.
I always thought a balanced multivitamin formulation would have, at least for the most part, the same RDA percentages of each essential nutrient. The Nature Made multivitamins that I’ve tried come very close to this formulation. With few exceptions, the nutrients are included in the multivitamin at, or very close to, the RDA. It seemed like the perfect fit to me. By contrast, the Centrum multivitamins that I’ve tried have had percentages all over the place. Some were included at lower percentages, and others were included at higher percentages. They never seemed like the right ones to me. I tried the Adults version back in December 2016 to see if it would work better, but I thought it had just served to uncover and correct my copper toxicity. I didn’t think it would work any longer once the toxicity was corrected and that balance between copper and zinc in my diet and supplements was required. Naturally, when I decided to go back to a multivitamin back in June to correct my iron deficiency and anemia, I went to the Nature Made multivitamin, because I thought its formulation was the best. I still can’t believe it could not correct my iron deficiency. In fact, when I saw the latest iron results from my hematologist, they were almost as bad as they were when I started! After just one day on the Centrum Women’s multivitamin, I felt better and could tell a difference with it. Perhaps the multivitamin with so many different percentages of nutrients that makes it appear so unbalanced is actually the one that’s right for me.
On Christmas Eve, I decided to have my CBC and iron checked on my own. I wanted to make sure things were truly progressing. I didn’t want to go into my next hematologist appointment blind. I got my results back two days later. While my MCH was low, the other values were within their normal ranges. My iron percent saturation and ferritin were still low, but they were better than they were back in October. I’ve read that it could take months for iron levels to recover, and since I’m not taking any iron supplements, it could likely take even longer in my case. One option I’ve considered if I need extra iron is taking an 18 mg supplement along with a Boost Original shake, which as of this writing has 100% of the RDA of vitamin E, a few times a week. I may also need to revisit my supplement regimen to see if anything else needs to be tweaked.
Trying to recover from iron deficiency and iron deficiency anemia has indeed been very difficult and has been made even harder by the fact that iron supplements seem to hurt rather than help. It seems like iron in multivitamin preparations and food has been helpful, but it has made recovery very slow. Even in the cases of multivitamin preparations, the percentages for each nutrient need to be more favorable for iron utilization and absorption. I can’t just take any multivitamin with iron and expect it to improve my iron deficiency and anemia. I’m hoping at this point that I’ve found the correct combination of diet and supplements and that over time, I’ll finally be out of the woods.
If you like this post, please consider subscribing by e-mail and/or grabbing the RSS feed. Feel free to comment on this post or use my contact form to send me a message. Also, please consider sharing this post to your favorite social media sites. Thanks!
RSS - Posts
