John A. Boyle, DO, FAAP, FACOP
Roberta A. Bobal-Savage, MD, FAAP
Helen S. Economy, MD, FAAP
Michelle D. Ober, MD, FAAP

Iron Labs and Iron Supplements

Ferritin: A protein in the body that stores iron, and low levels of ferritin (indicating iron deficiency) are strongly linked to restless sleep, particularly a condition called restless leg syndrome (RLS), where people experience uncomfortable sensations in their legs, often leading to disruptive sleep; research suggests that low iron stores in the brain, reflected by low ferritin levels, can disrupt dopamine (a hormone and neurotransmitter that plays a role in many bodily functions) production which is involved in leg movement control, contributing to RLS symptoms. For restless leg/periodic leg movement disorder, a ferritin level above 50-75 is recommended.

Serum iron: This test measures the amount of iron in your blood.

Serum ferritin: This test measures how much iron is stored in your body. When your iron level is low, your body will pull iron out of the "storage" to use.

Total iron-binding capacity (TIBC): This tells how much transferrin (a protein) is free to carry iron through your blood. If your TIBC is high, it means more transferrin is free because you have low iron.

Transferrin Saturation: This test measures the percentage of transferrin that is attached to iron. Iron supplementation (ferrous or gluconate) comes in many different forms and the amount of iron that will be helpful for your child is based on his or her weight. There are several types of iron supplements on the market, most of which are available over the counter, which means you do not need a prescription. The amount of elemental iron in a supplement is what is important.

Elemental Iron: Elemental iron is the total amount of iron in the supplement available for absorption by your body. Elemental iron supplements increase the ferritin iron stores.

Note: Iron is best absorbed when taken with orange juice. Please AVOID dairy products and foods high in calcium for 2 hours before and after taking the iron. Calcium decreases the absorption of iron.

• Iron can occasionally cause constipation or stomach upset. Therefore, we recommend that iron is taken with food and that miralax is started if you are noticing hard or infrequent stools. Begin at ½ capful mixed in at least 4 oz. of a liquid as directed. Miralax (or generic) can be purchased over the counter at any pharmacy. If more help needed, please call our office.
• Keep all iron products out of reach of children; accidental ingestion can be dangerous
• If your child cannot swallow pills, there are several forms of liquid iron supplements and some chewable tablets available. If your child takes the liquid iron supplementation, please have them drink it with a straw to avoid staining of the teeth.
• It can take at least three months for iron stores to build up in the body, if not longer. Please continue the iron and repeat the laboratory studies per provider plan. HOLD IRON FOR 24 HOURS PRIOR TO COMPLETING LABS. If you have any questions in regards to iron, please call our office at 248-926-1411.

Iron Rich Foods: Food has two types of iron – heme and non-heme iron. Heme iron is found in meat, fish, and poultry. It is the form of iron that is most readily absorbed by your body. You absorb up to 30 percent of heme iron that you consume. Eating meat generally boosts your iron levels far more than eating non-heme iron. Non-heme iron is found in plant-based foods such as fruits, vegetables and nuts. Foods with non-heme iron are still an important part of a nutritious, well-balanced diet, but the iron contained in these foods won't be absorbed as completely. You absorb between 2 and 10 percent of the non-heme iron that you consume. Some iron-rich foods are:

Meat and Eggs	Seafood	Vegetables	Bread and Cereals	Fruit	Beans and other Foods
Beef	Shrimp	Spinach	White bread (enriched	Strawberries	Tofu
Lamb	Clams	Potatoes/sweet potatoes	whole wheat bread	Watermelon	Beans (kidney, garbanzo, or white)
Ham	Scallops	White or oyster mushrooms	canned)	Mulberries	Tomato products (e.g., paste)
Turkey	Oysters	Peas	quinoa	Raisins	Dried peas
Chicken	Tuna	Broccoli	enriched pasta	Dates	Dried beans
Veal	Sardines	String beans	wheat products	Figs	Pumpkin seeds
Pork	Haddock	Beet greens	bran cereals	Olives	Lentils
Dried Beef	Mackerel	Dandelion greens	corn meal
Liver (all organ meats)		Collards
Liverwurst		Kale
Eggs (any style)

2300 Haggerty Road, Suite 2110 ▪ West Bloomfield, MI 48323 ▪ Phone 248-926-1411 ▪ Fax 248-926-5338 ▪ Web pedcarecorner.com

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Iron Supplement Options

Flintstones Complete with iron: A multivitamin with iron, 10mg iron per tab

Flintstones Complete with extra iron: 18 mg iron per pill

Novaferrum Yummy!: 15mg/5mL

Novaferrum Wow: 125mg/5mL

Fer-in-sol: 15mg/mL

Hiya Daily Iron: 7mg/tab

Slow Fe: 45mg/tab

Mary Ruth Vegan Iron: 65mg/tab

Iron Nature Made: 65mg/tab

2300 Haggerty Road, Suite 2110 ▪ West Bloomfield, MI 48323 ▪ Phone 248-926-1411 ▪ Fax 248-926-5338 ▪ Web pedcarecorner.com