Help me find a good vitamin?
November 17, 2010 7:10 AM   Subscribe

My doctor wants me to take a multivitamin for my slight anemia. Help me pick one please?

There isn't really much to elaborate on, aside from that I'm 24 and a woman. Pretty much any time I've had blood work done, it's shown mild anemia, so this isn't something new just because I've been feeding myself now; my mother fed me a pretty healthy and varied diet, and I do try to eat things like cooked spinach and beans, and I often cook in a cast iron pan (I admit I eat meat pretty rarely since I don't like dealing with cooking it).

So I'm still a bit anemic, and my doctor has told me to take a multivitamin. Does anyone have any suggestions? I just need something very basic and simple. I tried to turn to google but there's so much information out there and when it comes to vitamins and supplementation, I'm sure a good deal of it is a bit bogus.
posted by quirks to Health & Fitness (20 answers total) 9 users marked this as a favorite
I find multivitamins, particularly those containing iron, irritate my stomach. You may or may not find this as well, but at any event, I started taking a chelated iron tablet separately from other supplements, as recommended by the pharmacist. It goes down very easily. Solgar brand, if that helps.
posted by tavegyl at 7:18 AM on November 17, 2010

VitaFusion Gummy Multi Vites are really, really yummy. They have them at Costco for really cheap, if you have access to a Costco. Potential downside for you: no added iron. (But they actually taste like gummies!)
posted by phunniemee at 7:31 AM on November 17, 2010 [1 favorite]

My doctor recommended Slow FE as most multi-vitamins don't contain enough iron to really make a difference.

Slow FE is nice because it releases the iron gradually, which makes it gentler on your system. Also, it's a tiny pill, so it's easy to swallow.

I've been quite happy with it.
posted by Dragonness at 7:46 AM on November 17, 2010

I take Floradix. I prefer the liquid, but a lot of people can't handle it (especially once it's been open for a few days and starts to taste more metallic), so there are pills, which are tiny and easy to manage.

It's not a true multivitamin, though. It's iron plus vitamin C to enhance iron absorption, plus B-vitamins.

(I like the liquid because it makes me feel like I'm taking old fashioned tonic and I think that's funny. I generally refer to it as either my "Lydia Pinkham's for Female Complaints" or as "Vitameatavegemin").
posted by padraigin at 7:49 AM on November 17, 2010

I don't think the brand of vitamin matters as much as the actual vitamin & mineral content. Make sure you're also taking vitamin C to aid iron absorption. If you take a calcium supplement, do not take this at the same time as the multivitamin or iron supplement. Do not drink tea when you take your iron supplement (tannins and calcium both inhibit iron absorption). Soy milk & soy products have also been purported to inhibit iron absorption.

I normally don't use as a reference, but this this site has been particularly helpful:
The site does list its sources.

(Sorry to link this way - I'm having issues with the site today for some reason.)
posted by pecanpies at 7:51 AM on November 17, 2010 [2 favorites]

Also, calcium can interfere with iron absorption , so if you take a calcium supplement, you might want to take it at a different time of day than the multivitamin.
posted by Pax at 7:54 AM on November 17, 2010

Hema-Plex. Hema-Plex hema-plex hema-plex. Also has vitamin C and B-vitamins and other stuff to help you actually absorb the iron.

I was anemic-to-slightly-anemic for the longest time (kept getting turned away from donating blood) and then a Red Cross nurse recommended Hema-Plex. I'd been taking all sorts of various iron supplements of different types. Hema-Plex did the trick, within two weeks my levels were normal and I could donate.
posted by Anonymous at 7:58 AM on November 17, 2010

I compared the contents of a complete adult multivitamin to Flintstones Chewables -- virtually the same. So I opted for Flintstones. Tasty, fun, and available in a big bottle at Costco.

I was having very slight anemia problems -- every time I tried to give blood, they required a reading of "38" on their little iron-o-meter, and I consistently hit 34s and 35s. I stopped eating wheat for other reasons, but a week after giving up wheat, I went to try to donate blood and scored a 41. Haven't had problems with low iron since.
posted by themissy at 9:32 AM on November 17, 2010

Seconding reducing consumption of foods containing a lot of phytic acid, especially wheat. They can inhibit iron absorbtion, among causing other health troubles.
posted by Earl the Polliwog at 9:37 AM on November 17, 2010

I use the Whole Foods 365 Brand "Adult Multivitamin". It seems to have all the things other multivitamins have, and it was affordable. I suppose it is "working", as far as such things go. One thing I noticed when I bought it was that it has a LOT of vitamin C. Which I now understand is probably to help you absorb some of the other vitamins/minerals.
posted by Sara C. at 9:58 AM on November 17, 2010

Floradix and Floravital (the gluten free version) work pretty good, but are reeeeeeallllly expensive, and depending how much you will be needing to consume, can become pretty costly.

Hemaplex is recommended by many - but do you need the amount of supplement contained in it?

Then there's the question of, do you really need a "multi" vitamin? My understanding of these things at this point, despite the fact that IANAD and neither am I a nutritionist, is that really it's b12 & C that are the big go-to vitamins, specifically for assisting the absorption of oral iron.

I have taken many, and for me (so far!) the best price vs. convenience, with only the supplemental vitamins I want in it is Mega Foods' Blood Builder. YMMV.

Also while on your quest for your fave iron supplement, remember that it typically can take anywhere from a few to many months before you may notice a difference in your bloodwork.
posted by bitterkitten at 10:36 AM on November 17, 2010

Here is my go-to guide for vitamins. It's worth printing out for both careful review and for taking with you to the store.
posted by NortonDC at 11:30 AM on November 17, 2010 [1 favorite]

take a multivitamin for my slight anemia

You possibly need a better doctor because this is a terrible idea. The amount of iron in there will be low and it's bioavailability will be even lower (the the point of being useless) because the other metals in there block iron absorption really effectively. Multivitamins are not appropriate treatment for iron deficiency.

The kind of supplement you need is one that contains ferrous iron (ferrous glutamate and ferrous sulphate are common types used) and vitamin C and nothing else. Anything extra in there is either going to negatively affect absorption or do nothing except increase the price. Many iron supplements are full of other stuff because it sells well, but it's not based on any kind of science and is the wrong thing to do (this is a really egregious example of how vitamin companies don't care about improving your health, just selling you stuff). People here will tell you all kinds of other supplements but if it has anything besides iron and vitamin c then don't take it.

You also need to make sure you're not taking it at the same time as drinking tea (it's the tannins rather than the caffeine so coffee is generally OK), eating cereal, consuming anything with high levels of calcium or other divalent metals (manganese is the worst), or taking anything that reduces your stomach acidity. A couple of hours in between is usually fine. I take my iron tablets with dinner (usually meat and vegetables) and that works well. Taking them when you eat can help with the constipation etc that some people get with these supplements.

I did my masters thesis looking at iron absorption in the intestine and have kept up to date with research in this field (it was also relevant to my PhD looking at Crohn's disease). So I know what I'm talking about.

If you do have actual iron deficiency anaemia, which is the later stage of iron deficiency when the red blood cells are damaged and not the same thing as just being low on iron, then it's not exactly 'mild' any more and needs effective treatment. Which is why I suggested a better doctor since this one doesn't seem that well informed.
posted by shelleycat at 11:44 AM on November 17, 2010 [8 favorites]

Oh, and some more recent supplements contain heme iron instead of ferrous iron, and that's OK too as long as there's nothing else in there besides vitamin C (ascorbic acid).
posted by shelleycat at 11:46 AM on November 17, 2010

Shellycat - really? taking B12, specifically, simultaneously - which you need to be able to absorb iron in the first place - is going to inhibit iron absorption? I don't think so... this of course assumes you can absorb b12 orally, but I don't wanna get into a discussion about pernicious anemia.

Also, while a multivitamin (typically) has a 'regular' or low amount of iron, compared to supplements that may be specifically designed for better iron absorption, I am pretty sure this is not always the case anymore. The chances of finding a multivitamin these days with a crazy large amount of everything which you probably don't need are better than ever, although I would not recommend it.

ALso, I think that some people probably do just fine taking a multi with iron in it. Everybody's different. You just might not need to. A regular multi with iron did not work for me.

However, as I listed above the MegaFoods Blood Builder contains only the stuff I wanted in mine, all made out of actual foods, according to the manufacturer. I believe it is b12, folate, iron, and vitamin C. Beats me if I need the folate, but the b12 & C mean a few less pills for me to take...

Not sure if this should be a private message or not, mods, but it is relevant.
posted by bitterkitten at 12:32 PM on November 17, 2010

B12 doesn't inhibit it, but it's not necessary for iron absorption either (iron metabolism is different). If you have a B vitamin deficiency also then you can address that seperately, but the OP did not say anything about such a deficiency. It's filler, added because people think they need it when they usually don't. Folate is the same. Ascorbic acid, on the other hand, has been shown to greatly increase bioavailability and absorption of all types of iron so having it in there is appropriate.

The main issue with multivitamins is that the other metals in there directly, and strongly, inhibit iron absorption. They use the same transporter protein and have higher affinity (manganese in particular). The iron in there will not be entering your body. If you are deficient in iron then you need iron, and a multivitamin will not give you that (no matter how it is designed). Doctors should know better than to suggest one when a proper iron supplement is both better and cheaper. Again, if there are other deficiency issues then more complicated supplements may be necessary, but even then a multivitamin is not the appropriate way to deal with it.
posted by shelleycat at 1:52 PM on November 17, 2010

Response by poster: Ok, wow. A lot of good information and a lot of links I need to read. I might see if I can get my actual lab values and figure out if an iron supplement would be appropriate or if I need to take a more mild approach.

Thank you so much for your help everyone! I'm not going to mark a best answer just yet because I'm still not sure what to do, but you've all be very helpful and have given me a great starting point!
posted by quirks at 2:28 PM on November 17, 2010

This is a readable, recent review about iron bioavilability and stuff if you're interested in a bit more of the science. It's not highly detailed but gives a good overview. Hopefully it's available to everyone, I'm at work so it's difficult to know if it's just my proxy that's making the full text come up.
posted by shelleycat at 2:40 PM on November 17, 2010 [1 favorite]

I have had excellent luck with Bifera taken with a glass of water + an Emergen-C packet every morning. Bifera isn't super cheap but damn, is it worth every penny.
posted by corey flood at 8:00 PM on November 17, 2010

> My doctor recommended Slow FE

Mine, too.
posted by The corpse in the library at 8:31 AM on November 18, 2010

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