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Hi,I had a question that I hoped you could help me with since you seem very knowledgable about medications and nutrition.I need to get on a prenatal vitamin but have bad IBS-D problems and don't want to take anything that may aggravate that (ie cause more D). If it causes C, that would be an added bonus for me!So I read that many prenatal vitamins automatically add a stool softener because most women get C from the addediron. Do you know what ingredients may indicate a stool softener or laxative has been added? I want to make sure not to get one that adds that to the vitamins. Thanks!
 

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I wonder where the idea comes from that iron causes constipation. It has the earmarks of a medical myth.
Anyway, it does appear that these vitamins can contain stool softeners (usually docusate sodium). They kind of act like grease to let things slide by better. I don't think that is going to necessarily make diarrhea worse.You might be able to do better with regular vitamins that are just tailored to your needs. You might get good advice by seeing a registered dietician who can advise you on diet as well as the right vitamins for your situation.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.
 

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I wonder where the idea comes from that iron causes constipation. It has the earmarks of a medical myth.
Anyway, it does appear that these vitamins can contain stool softeners (usually docusate sodium). They kind of act like grease to let things slide by better. I don't think that is going to necessarily make diarrhea worse.You might be able to do better with regular vitamins that are just tailored to your needs. You might get good advice by seeing a registered dietician who can advise you on diet as well as the right vitamins for your situation.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.
 

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I've generally heard that iron is constipating, although alot of pregnant woman have constipation that may be from other things as well.Docusate sodium is the most commonly used stool softener, and I dunno if that would have any effect on diarrhea or not. I'd think it would be alot less likely to cause problems than a laxative would.Here is what I found trying to see if iron causes constipation (and like everything else your mileage may vary). It seems like constipation is seen as a side effect in some studies with some types of iron supplementation.Title: Side effects of alternative iron supplementation: a pilot study. Author: Roth JL , Pugh LC Source Pa Nurse, 53(6): 16-8 � 1998 Abstract: Iron deficiency anemia is a significant health problem for women. An intervention utilizing home visits by a nurse and the intake of alternate iron supplements was examined. Outcome measures of hematocrit levels and side effects are reported in this manuscript. Ten African-American inner city homeless women in transitional housing agreed to participate in this longitudinal study. Each participant was encouraged to take the alternate iron supplements for a three month period. Hematocrit values increased from recruitment through the third month. A paired t-test was significant (t value -5.39; df, 9; p < .0001). In addition, the side effect of fatigue decreased from recruitment through the third month. A paired t-test was significant (t value 3.18: df, 7: p = .015). During the weekly and monthly visits, when the subjects were asked if the supplements had any effect on their feelings of well-being, two women stated they had "little effects." In terms of side effects there were no complaints of nausea, stomach ache, or black tarry stools. Of the approximately 12 visits to each subject, constipation was reported only two times by two subjects. While the women did not report black stools they did offer that the vitamins seemed to color their stools green (three reported it one time and two subjects reported it three times). The benefits and the lack of side effects may have far-reaching implications for client populations such as the elderly and pregnant women who typically have difficulty with anemia and constipation alike. The weekly visits by the nurse may have added to the compliance and success of this program. Title: Iron supplementation in preterm infants: a study comparing the effect and tolerance of a Fe2+ and a nonionic FeIII compound. Author: Naude S , Clijsen S , Naulaers G , Daniels H , Vanhole C , Devlieger H Source J Clin Pharmacol, 40(12 Pt 2): 1447-51 � 2000 Abstract: The more widely used divalent forms of iron (Fe2+) supplementation often lead to gastrointestinal symptoms in preterm infants although little is known about the use of nonionic trivalent iron preparations (FeIII) in these patients. It is especially under this nonionic form that dietary iron is available. For this reason, a randomized controlled study was undertaken to compare the efficacy and the extent of possible side effects in two groups of preterm infants. In one group, the elemental iron was given in the Fe2+ form, while the other group received a nonionic trivalent iron (FeIII) complexed with polysaccharides of low molecular weight. Both groups received 7.5 mg elemental iron daily. Measured parameters in the two study groups did not differ significantly throughout the study period of 14 weeks. Both forms of iron supplementation were well tolerated. However, vomiting, diarrhea, or constipation occurred slightly more often in the group receiving iron supplementation in the Fe2+ form without reaching statistical difference. The authors found a nonionic trivalent polysaccharide-iron complex given as iron supplementation as effective as the generally more favored ferrous sulphate. Since iron therapy is mandatory in the preterm infant, the use of trivalent iron complexes can be considered as a good alternative.Title: Side effects of iron supplements in blood donors: superior tolerance of heme iron. Author: Frykman E , Bystrom M , Jansson U , Edberg A , Hansen T Source J Lab Clin Med, 123(4): 561-4 � 1994 Abstract: Regular blood donors were enrolled in a double-blind, parallel group study to evaluate the side effects of two iron supplements, one containing both heme iron and non-heme iron (Hemofer, 2 tablets = 18 mg iron/day), the other non-heme iron only (Erco-Fer; 1 tablet = 60 mg iron/day). No differences were found between the two alternatives in regaining predonation iron status as measured by serum ferritin and hemoglobin levels. Despite this therapeutic equivalence, participants' symptom diaries showed substantial differences in the side effects for the two treatments. The frequency of constipation (p < 0.05) and the total incidence of all side effects (p < 0.01) were significantly higher for non-heme iron when compared with the heme iron-non-heme iron combination and a placebo. The study demonstrates that a low-dose iron supplement containing both heme iron and non-heme iron (Hemofer) has fewer side effects when compared with an equipotent, traditional non-heme iron supplement. AuthorsLiguori L.InstitutionSurgical Division B, Ospedale Maggiore, Largo Nigrisoli, Bologna, Italy.TitleIron protein succinylate in the treatment of iron deficiency: controlled, double-blind, multicenter clinical trial on over 1,000 patients.SourceInternational Journal of Clinical Pharmacology, Therapy, & Toxicology. 31(3):103-23, 1993 Mar.Local MessagesHSL has complete holdings.AbstractA prospective, controlled, double-blind, double-dummy, multicenter clinical trial was made to assess the efficacy and tolerability of iron-protein-succinylate (ITF 282) in comparison with a well known iron preparation in the treatment of iron deficiency or iron deficient anemia. One thousand and ninety-five patients affected with iron deficiency or overt iron deficient anemia were randomized to receive either two ITF 282 tablets/day (60 mg iron each) or a commercially available ferrous sulphate controlled release tablet (one tablet containing 105 mg iron/day). Five hundred and forty-nine patients received ITF 282; 546 patients were treated with ferrous sulphate. Both treatments lasted 60 days. The treatment outcome was checked by evaluating special hematology, symptomatology, safety hematology and hematochemistry. After two months of treatment, the normalization of the main hematologic parameters in both groups was detected. Although in the first month the reference treatment appears to provide somewhat faster results, at the end of the observation, the values of hematocrit, hemoglobin and ferritin were greater in the ITF 282 group, indicating a more progressive and steady therapeutic effect. The overall clinical rating was significantly in favor of ITF 282, with 78.9% of favorable results vs 67.6%. By dividing the patient population according to pathological conditions (iron deficiency or overt anemia), or according to the etiopathogenesis of the iron deficiency (increased requirement, or increased loss in adults and in the elderly), separate analyses on the treatment outcome were made (and have been included). The general tolerability, although favorable with both treatments, was significantly more favorable with ITF 282. With this medication, 63 patients (11.5%) complained of 69 adverse reactions (25 heartburn, 19 constipation, 25 abdominal pain) vs 141 events reported by 127 patients (26.3%) with the reference medication (33 heartburn, 31 epigastric pain, 23 constipation, 32 abdominal pain, 8 skin rash, 14 nausea). These observations confirm that, although the most modern preparations of ferrous sulphate exhibit a relatively low frequency of adverse events of limited clinical concern, it is nevertheless possible to decrease both the prevalence and the duration of such events without prejudice for the clinical efficacy, with the use of more "physiological" preparations in which the iron is reversibly bound to a protein carrier, thus effectively removing one of the main obstacles to the correct compliance with treatments that must be administered for prolonged periods of time.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 

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I've generally heard that iron is constipating, although alot of pregnant woman have constipation that may be from other things as well.Docusate sodium is the most commonly used stool softener, and I dunno if that would have any effect on diarrhea or not. I'd think it would be alot less likely to cause problems than a laxative would.Here is what I found trying to see if iron causes constipation (and like everything else your mileage may vary). It seems like constipation is seen as a side effect in some studies with some types of iron supplementation.Title: Side effects of alternative iron supplementation: a pilot study. Author: Roth JL , Pugh LC Source Pa Nurse, 53(6): 16-8 � 1998 Abstract: Iron deficiency anemia is a significant health problem for women. An intervention utilizing home visits by a nurse and the intake of alternate iron supplements was examined. Outcome measures of hematocrit levels and side effects are reported in this manuscript. Ten African-American inner city homeless women in transitional housing agreed to participate in this longitudinal study. Each participant was encouraged to take the alternate iron supplements for a three month period. Hematocrit values increased from recruitment through the third month. A paired t-test was significant (t value -5.39; df, 9; p < .0001). In addition, the side effect of fatigue decreased from recruitment through the third month. A paired t-test was significant (t value 3.18: df, 7: p = .015). During the weekly and monthly visits, when the subjects were asked if the supplements had any effect on their feelings of well-being, two women stated they had "little effects." In terms of side effects there were no complaints of nausea, stomach ache, or black tarry stools. Of the approximately 12 visits to each subject, constipation was reported only two times by two subjects. While the women did not report black stools they did offer that the vitamins seemed to color their stools green (three reported it one time and two subjects reported it three times). The benefits and the lack of side effects may have far-reaching implications for client populations such as the elderly and pregnant women who typically have difficulty with anemia and constipation alike. The weekly visits by the nurse may have added to the compliance and success of this program. Title: Iron supplementation in preterm infants: a study comparing the effect and tolerance of a Fe2+ and a nonionic FeIII compound. Author: Naude S , Clijsen S , Naulaers G , Daniels H , Vanhole C , Devlieger H Source J Clin Pharmacol, 40(12 Pt 2): 1447-51 � 2000 Abstract: The more widely used divalent forms of iron (Fe2+) supplementation often lead to gastrointestinal symptoms in preterm infants although little is known about the use of nonionic trivalent iron preparations (FeIII) in these patients. It is especially under this nonionic form that dietary iron is available. For this reason, a randomized controlled study was undertaken to compare the efficacy and the extent of possible side effects in two groups of preterm infants. In one group, the elemental iron was given in the Fe2+ form, while the other group received a nonionic trivalent iron (FeIII) complexed with polysaccharides of low molecular weight. Both groups received 7.5 mg elemental iron daily. Measured parameters in the two study groups did not differ significantly throughout the study period of 14 weeks. Both forms of iron supplementation were well tolerated. However, vomiting, diarrhea, or constipation occurred slightly more often in the group receiving iron supplementation in the Fe2+ form without reaching statistical difference. The authors found a nonionic trivalent polysaccharide-iron complex given as iron supplementation as effective as the generally more favored ferrous sulphate. Since iron therapy is mandatory in the preterm infant, the use of trivalent iron complexes can be considered as a good alternative.Title: Side effects of iron supplements in blood donors: superior tolerance of heme iron. Author: Frykman E , Bystrom M , Jansson U , Edberg A , Hansen T Source J Lab Clin Med, 123(4): 561-4 � 1994 Abstract: Regular blood donors were enrolled in a double-blind, parallel group study to evaluate the side effects of two iron supplements, one containing both heme iron and non-heme iron (Hemofer, 2 tablets = 18 mg iron/day), the other non-heme iron only (Erco-Fer; 1 tablet = 60 mg iron/day). No differences were found between the two alternatives in regaining predonation iron status as measured by serum ferritin and hemoglobin levels. Despite this therapeutic equivalence, participants' symptom diaries showed substantial differences in the side effects for the two treatments. The frequency of constipation (p < 0.05) and the total incidence of all side effects (p < 0.01) were significantly higher for non-heme iron when compared with the heme iron-non-heme iron combination and a placebo. The study demonstrates that a low-dose iron supplement containing both heme iron and non-heme iron (Hemofer) has fewer side effects when compared with an equipotent, traditional non-heme iron supplement. AuthorsLiguori L.InstitutionSurgical Division B, Ospedale Maggiore, Largo Nigrisoli, Bologna, Italy.TitleIron protein succinylate in the treatment of iron deficiency: controlled, double-blind, multicenter clinical trial on over 1,000 patients.SourceInternational Journal of Clinical Pharmacology, Therapy, & Toxicology. 31(3):103-23, 1993 Mar.Local MessagesHSL has complete holdings.AbstractA prospective, controlled, double-blind, double-dummy, multicenter clinical trial was made to assess the efficacy and tolerability of iron-protein-succinylate (ITF 282) in comparison with a well known iron preparation in the treatment of iron deficiency or iron deficient anemia. One thousand and ninety-five patients affected with iron deficiency or overt iron deficient anemia were randomized to receive either two ITF 282 tablets/day (60 mg iron each) or a commercially available ferrous sulphate controlled release tablet (one tablet containing 105 mg iron/day). Five hundred and forty-nine patients received ITF 282; 546 patients were treated with ferrous sulphate. Both treatments lasted 60 days. The treatment outcome was checked by evaluating special hematology, symptomatology, safety hematology and hematochemistry. After two months of treatment, the normalization of the main hematologic parameters in both groups was detected. Although in the first month the reference treatment appears to provide somewhat faster results, at the end of the observation, the values of hematocrit, hemoglobin and ferritin were greater in the ITF 282 group, indicating a more progressive and steady therapeutic effect. The overall clinical rating was significantly in favor of ITF 282, with 78.9% of favorable results vs 67.6%. By dividing the patient population according to pathological conditions (iron deficiency or overt anemia), or according to the etiopathogenesis of the iron deficiency (increased requirement, or increased loss in adults and in the elderly), separate analyses on the treatment outcome were made (and have been included). The general tolerability, although favorable with both treatments, was significantly more favorable with ITF 282. With this medication, 63 patients (11.5%) complained of 69 adverse reactions (25 heartburn, 19 constipation, 25 abdominal pain) vs 141 events reported by 127 patients (26.3%) with the reference medication (33 heartburn, 31 epigastric pain, 23 constipation, 32 abdominal pain, 8 skin rash, 14 nausea). These observations confirm that, although the most modern preparations of ferrous sulphate exhibit a relatively low frequency of adverse events of limited clinical concern, it is nevertheless possible to decrease both the prevalence and the duration of such events without prejudice for the clinical efficacy, with the use of more "physiological" preparations in which the iron is reversibly bound to a protein carrier, thus effectively removing one of the main obstacles to the correct compliance with treatments that must be administered for prolonged periods of time.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html
 

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Of course prenatal vitamins are constipating--this ain't rocket science, just ask anyone who has ever been pregnant!!! In addition to the vitamins being constipating, the further into pregnancy you get, the slower your system is, and that compounds the constipation. None of the prenatal vitamins I took had a stool softener in them, but the ob/gyn recommended ducolex (sp?) when the constipation became too bad. Drink lots and lots of water.
 

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Of course prenatal vitamins are constipating--this ain't rocket science, just ask anyone who has ever been pregnant!!! In addition to the vitamins being constipating, the further into pregnancy you get, the slower your system is, and that compounds the constipation. None of the prenatal vitamins I took had a stool softener in them, but the ob/gyn recommended ducolex (sp?) when the constipation became too bad. Drink lots and lots of water.
 

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I've also heard/read, over and over, that iron can be constipating (not necessarily "is" but "can"). A friend of mine can verify that in her case. More than that, I've been reading how too much iron, esp. in supplements, can prove toxic. "Experts" often advise to avoid vitamin/mineral supplements with iron in them (it's sometimes hard to do) - esp. if your iron levels are already within range.Sorry, party, I've digressed a bit here...
 

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I've also heard/read, over and over, that iron can be constipating (not necessarily "is" but "can"). A friend of mine can verify that in her case. More than that, I've been reading how too much iron, esp. in supplements, can prove toxic. "Experts" often advise to avoid vitamin/mineral supplements with iron in them (it's sometimes hard to do) - esp. if your iron levels are already within range.Sorry, party, I've digressed a bit here...
 
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