Low iron, ADHD symptoms, and sleep problems

[Gena]

DS had his semi-annual check with his Dev Ped last week. We were talking about his difficulties at school and how the school once again raised he question of ADHD. The psychologist feels that these issues are more a part of autism, but put in her report that we might want to consider a trial of medication. The DP also asked about DS's sleep and I told her that it has improved with the use of melatonin and a weighted blanket.

The DP wanted to do bloodwork to check DS 's iron (among other things). She told me that some recent research has found that some kids with ADHD issues and sleep problems are found to be low in iron and supplements to raise the level can help with those symptoms.

Sure enough, DS has an iron deficiency. It's not anemia, but low iron stores (ferritin). The "textbook" range of normal is 7-140, but the DP does not believe that range is reasonable and treats anything under 50. DS's level was 21.

So we are now doing liquid iron supplements. It's totally nasty: even favored it smells bad and tastes bitter. It needs to be diluted because it's so gross and it stains the teeth when full strength. I have to cajole and bribe DS to drink it twice a day. But if it helps, it will be totally worth it.

We go back in 3 months for another blood check. (Blood draws are a whole other nightmare.)

DS has been on the iron just a week, so it's too early to know if it will help with these issues. I'm sharing this because we have tried several different vitamin and mineral supplements, but the idea of low iron never crossed my mind. So maybe this will help someone else here.

I am so thankful that my son has a doctor who looks for medical reasons for his symptoms before turning to the option of prescription medication.

[karstmama]

interesting. thanks for all your sharing, gena. can your ds not swallow pills? i'm just wondering if iron tablets would be an option. and i bet you've heard this, but use a straw with the liquid to help keep it off his teeth.

[JTsMom]

Gena, did you look at Floravital? The taste isn't too bad, especially if you put it in OJ. It's pricey, but supposed to be really well absorbed.

[inmypjs]

That's really interesting, thanks for sharing. My DS has attention issues and lately has had some trouble falling asleep (though he does stay asleep). I wonder if I should have his iron checked. Does a regular multivitamin cover their iron requirements?

[mikala]

You can also mix the iron with OJ and shoot it towards the back of the mouth with a medicine syringe. It doesn't eliminate the taste but at least conceals it a bit.

[elliput]

:hug: I understand the blood draw issue. I just had a panel done on DD to check her thyroid (among other things). I had to lay across her while 2 technicians did the draw. It is so stressful for everyone.

[Gena]

interesting. thanks for all your sharing, gena. can your ds not swallow pills? i'm just wondering if iron tablets would be an option. and i bet you've heard this, but use a straw with the liquid to help keep it off his teeth.

DS can't swallow pills. We do mix the liquid iron elixir into OJ and have him drink it through a straw.



Gena, did you look at Floravital? The taste isn't too bad, especially if you put it in OJ. It's pricey, but supposed to be really well absorbed.

I looked into it. The problem is that DS is prescribed a much higher dose of elemental iron than is in the Floravital. Basically I would need to give him 7 doses of the Floravital to equal the amount of elemental iron he needs. Any that's just too much to get into him.


That's really interesting, thanks for sharing. My DS has attention issues and lately has had some trouble falling asleep (though he does stay asleep). I wonder if I should have his iron checked. Does a regular multivitamin cover their iron requirements?

DS was taking a multi with iron, but it wasn't enough. For most kids without an iron deficiency, the amount in a good multi is probably enough. For someone with an iron deficiency, a higher dose may be needed. DS was prescribed 3mg of elemental iron per kg per day (divided into 2 doses). He weighs 23.5 kg, so he's taking about 70 mg of elemental iron a day (4 ml of elixir twice a day).


You can also mix the iron with OJ and shoot it towards the back of the mouth with a medicine syringe. It doesn't eliminate the taste but at least conceals it a bit.

Yes, we always offer this as an option. But DS really hates the syringe and chooses to drink the iron and OJ instead.

[Gena]

:hug: I understand the blood draw issue. I just had a panel done on DD to check her thyroid (among other things). I had to lay across her while 2 technicians did the draw. It is so stressful for everyone.

The blood draw was awful. I had no idea the doctor was going to order bloodwork, or I would have made DH come with us. Usually it takes the two of us to hold DS down: one takes the top half and the other takes the bottom half.

When we went down to the lab, I didn't tell DS what was going to happen. Since I did not have adequate time to prepare him properly, it was better to not tell him at all. When we got called, DS saw that the room was labeled "Draw Room 1" and said, "I like to draw!" He happily sat down in the chair, rolled the table over, and asked for paper and a pencil. I told him it was not that kind of draw. Once the phlebotomist came in, DS started to get suspicious and began to protest. Anyway, I ended up holding him in my lap with my arms and legs wrapped around him while he screamed and fought the entire time. He broke free of my grasp once the actual blood draw was over, when the phlebotomist tried to put a band-aid on him. (He is terrified of band-aids.) DS ran around the little room with blood gushing from him arm. The phlebotomist and I recaptured him, and she manged to get a pressure wrap in place on his arm. DS refused to use that arm/hand as long as the wrap was still on, holding it at an odd angle away from his body so it (the wrap) wouldn't touch his side. I took the wrap off before I took him back to school.

I'm not looking forward to doing it again in 3 months.

[JTsMom]

:hug: Oh Gena, that's awful. :( We've done one blood draw that wasn't sedated, and now Jason freaks if he even hears the word blood. Would EMLA cream help at all, or is it too far beyond that for it to even make a dent?

As for the Floravitol, we haven't been dealing with it for long, so I don't know a lot about it, but from what I understand, the way it's formulated lets much more of it actually get absorbed, and that's why the levels are lower. I showed DS's ped that, and a chewable form, and she said to go with the Floravitol, and to only do it 3 times a week (he's also on a multi with iron). We haven't re-checked yet, so I don't know how well it's working, but she tends to know her stuff when it comes to supplements.

One other thought- have you ever tried one of those pill swallowing cups?

[hellokitty]

Gena, thanks for sharing this info. It really makes me wonder about DS1. He too has these symptoms AND he complains that he is cold all of the time. Looks like we need to get some labs drawn, but like your son, he is horrible about blood draws, my 2 yr old handles it better than my 8 yr old.

[Gena]

:hug: Oh Gena, that's awful. :( We've done one blood draw that wasn't sedated, and now Jason freaks if he even hears the word blood. Would EMLA cream help at all, or is it too far beyond that for it to even make a dent?

As for the Floravitol, we haven't been dealing with it for long, so I don't know a lot about it, but from what I understand, the way it's formulated lets much more of it actually get absorbed, and that's why the levels are lower. I showed DS's ped that, and a chewable form, and she said to go with the Floravitol, and to only do it 3 times a week (he's also on a multi with iron). We haven't re-checked yet, so I don't know how well it's working, but she tends to know her stuff when it comes to supplements.

One other thought- have you ever tried one of those pill swallowing cups?

Are you using Floravitol to correct an iron deficency?

I'm comparing the amount of elemental iron, regardless of the formulation. The Floravitol has 10mg of elemental iron per serving, while DS needs 70 mg of elemental iron a day. It would be hard to give him that much Floravitol.

I might try one of those pill swallowing cups. DS has a lot of oral motor issues, do I'm not sure how well it will work, but we can try. Thanks for the suggestion.

EMLA helps for things like stitches, but it doesn't help for blood draws. It's not an issue of pain. He objects to the whole procedure.

[Gena]

Do you have any articles about the absorption of Floravitol vs other forms of iron? Are you suggesting that DS might not really need 70mg of elemental iron if it's given in a different form?

Trying to research the different forms of iron supplements is so confusing. I'm still trying to wrap my head around the concept of "low iron stores, but not anemia".

[mytwosons]

I don't have a link, but the regular dosage of florvital (floradix, the GF option) got my levels back up after I couldn't take the higher dose prescribed. It was so much gentler on my system.

[JTsMom]

Gena, I'm trying to remember exactly what I read where, but it's kind of a blur. I remember searching here and seeing a bunch of threads mentioning Floradix, so I could have read something in one of those, or maybe it was something I saw in an Amazon review, or on their site, or maybe a combo of a couple of those.

This was the thread I started, but there's not a ton of info in it:
http://windsorpeak.com/vbulletin/showthread.php?t=423782&highlight=iron

I think that the idea was that if you absorb more of the iron, vs most of it running right through you, you wouldn't need as high of a dose, but I don't have any hard research to back that up with. I know it didn't make much sense to me at the time either b/c I did the math, and the amount I was going to have to give him to equal the 65 mg of additional iron 3x/week that the ped had rec'd was crazy. But yes, it is to correct a deficiency. IIRC, both his stores, and actual levels were low.

[JTsMom]

"Floravital and Floradix Herbal Iron Extracts have the highest rate of iron absorption at 25%, compared to the average absorption rate of iron tablets at 2-10%."

This is from their site, but I don't see a citation or anything to back it up.
http://www.floravital.com/

[JTsMom]

Just combing through a couple of old threads (search Floradix) seeing what I could find. Here's one with a few different users who might be good to check with:
http://windsorpeak.com/vbulletin/showthread.php?t=245026&highlight=floradix

I think I probably just kept seeing that it worked for a lot of people with pregnancy-related anemia, so I went for it.

brittone2 mentioned using it in one of those threads, and she always knows her stuff, so she might be able to point you in the right direction.

[Gena]

Lori-

Thanks for all the info. DS has been doing a lot better taking the prescription iron in his OJ these past couple of days, so we're going to stick with that for now. I'm going keep all the info on the Floravital though, in case we run into problems down the line.

Has iron supplementation had any effect on your son's symptoms?

[Tondi G]

Lori-

Thanks for all the info. DS has been doing a lot better taking the prescription iron in his OJ these past couple of days, so we're going to stick with that for now. I'm going keep all the info on the Floravital though, in case we run into problems down the line.

Has iron supplementation had any effect on your son's symptoms?

Just make sure he doesn't get constipated! Iron supplements can be awful in that dept.

[JTsMom]

Lori-

Thanks for all the info. DS has been doing a lot better taking the prescription iron in his OJ these past couple of days, so we're going to stick with that for now. I'm going keep all the info on the Floravital though, in case we run into problems down the line.

Has iron supplementation had any effect on your son's symptoms?

That's great Gena! I can imagine that having low iron levels has to make you feel terrible. Unfortunately, I haven't notice any real improvement with Jason behavior-wise. He looks better to me- he was starting to look a little pale and sickly to me, and that has gone away.

We started a few new supplements as well- a new probiotic, and 5-HTP. I swear, every time we start something new, things seem to get worse instead of better. I'm supposed to gradually increase the 5-HTP and see if that helps, but I'm not holding my breath. The newest thing seems to be an increase in anxiety. I'm hoping it's temporary, but if not, I'm probably going to start medicating for that. He's also getting really emotional about everything, almost in an OCD-like way.