Restless Legs Syndrome (RLS) Discussion Board

I began taking oral iron in July, taking 2 of the 65mg elemental iron (325 ferrous sulfate) with 500mg of vitamin C. Originally, I was taking at breakfast with other vitamins, but, based upon a post on this forum, have switched to taking it on an empty stomach, 2 hours after a meal and 1 hour before the next meal. For me the best time for this empty stomach window is when I first wake up in the morning. Started doing this in mid August. I am also taking ropinirole, having settled in at 1mg after much experimentation on the dosage.

(As an aside - Been doing a bunch of traveling, so my routine has been messed up and I have not been able to really know if the oral iron has reduced my symptoms. Also, measured 40 blood ferritin in June; won’t have another blood test for a few more months)

MY QUESTION is: when is the best time of day to take the oral iron? With RLS symptoms only occurring in the evening, would I be better off taking the iron in the afternoon? Also, is it better to take one pill in the morning and one in the afternoon? The root answer revolves around an understanding of how long does the iron stay in my system. Does it have a short “half life” or does it buildup and stay in your system? I know things like caffeine wear off after 5 hours or so, making coffee in the morning not affecting my sleep. And ropinirole only seems to be effective (on me) for about 4 hours or so. But I have heard of other medications that take some time to build up in your system, then tend to stay there.

Does anyone have a recommendation or experience with this?

meiatflask, when I first was diagnosed with RLS my ferritin level was 42. I was taking iron twice a day and scheduled these at mid-morning and mid-afternoon. I did that until my iron went to about 100 and then dropped the afternoon dose.

Unfortunately, I am part of the group that did not benefit from increasing serum ferritin as it up to about 650 with once a day after several years.

As for the best time of day, iron is something that builds up in your system, so you don't need to worry about half life like many of the medications. It is either there or it isn't. It just takes time for it to build up, often many weeks or months and many (if not most) people cannot get their ferritin levels up to 100 with oral iron. That is why you see so many discussion threads about intravenous iron treatments.

Incredible that oral iron raised you as high as 100.

No idea if this is true but I've heard that it's best to take all of the oral iron at once because you'll be able to absorb more. When your blood iron concentration is low, you absorb more, when it's high you absorb very little, so taking it twice or three times a day might keep the blood concentration elevated enough to reduce absorption. I went from taking it two or three times a day to bunching it up all at once and that grossly coincides with an increase in my serum ferritin over the years but I have no idea if the two are related.

I also heard it's best at night, but I forget why. Simply going by the above, you;d think it would be best to take in the morning, long after any iron you ate from food sources.

I improved my ferritin concentrations from under 24 to over 200 using oral iron but the effect probably had to do with something else too - - like healing of leaky gut or something similar.