How do iron supplements affect your digestive system. What are the common side effects of taking iron pills. How can you minimize nausea when supplementing with iron. What are the best practices for taking iron supplements without discomfort. When should you consult a healthcare provider about iron supplement side effects.

Understanding Iron: Essential Nutrient for Body Function

Iron is a crucial mineral that plays a vital role in various bodily functions. It’s primarily known for its importance in hemoglobin production, the protein in red blood cells responsible for carrying oxygen throughout the body. Without adequate iron, our bodies can’t produce enough healthy oxygen-carrying red blood cells, leading to a condition known as iron deficiency anemia.

Beyond its role in oxygen transport, iron is also essential for:

• Energy production
• Immune system function
• Cognitive development
• Muscle metabolism
• Body temperature regulation

Given its importance, maintaining proper iron levels is crucial for overall health and well-being. While a balanced diet can often provide sufficient iron, certain circumstances may necessitate iron supplementation.

Common Sources of Dietary Iron: Heme vs. Non-Heme

Iron in our diet comes in two forms: heme and non-heme iron. Understanding the difference between these types can help you make informed choices about your iron intake.

Heme Iron Sources

Heme iron is found exclusively in animal products and is more readily absorbed by the body. Some excellent sources of heme iron include:

• Red meat (beef, lamb, pork)
• Poultry (chicken, turkey)
• Fish (especially sardines and tuna)
• Organ meats (liver, kidney)

Non-Heme Iron Sources

Non-heme iron is found in plant-based foods and is less easily absorbed by the body. However, it’s still an important source of iron, especially for vegetarians and vegans. Some good non-heme iron sources include:

• Legumes (lentils, beans, chickpeas)
• Leafy green vegetables (spinach, kale, collard greens)
• Fortified cereals and grains
• Nuts and seeds (pumpkin seeds, cashews, almonds)
• Dried fruits (raisins, apricots)

While a varied diet can often provide sufficient iron, certain factors like pregnancy, heavy menstrual periods, or certain medical conditions may increase iron needs, necessitating supplementation.

Iron Supplements: Types and Formulations

When dietary iron isn’t enough, supplements can help maintain adequate iron levels. Iron supplements come in various forms, each with its own characteristics and absorption rates.

Common Types of Iron Supplements

1. Ferrous sulfate: The most common and often least expensive form
2. Ferrous gluconate: May be easier on the stomach for some people
3. Ferrous fumarate: Contains a higher percentage of elemental iron
4. Iron amino acid chelates: Often better tolerated and may have fewer side effects
5. Carbonyl iron: A form of elemental iron that may be safer in cases of accidental overdose

These supplements are available in various formulations, including tablets, capsules, liquids, and even chewable forms. The choice of supplement and formulation often depends on individual needs, tolerance, and healthcare provider recommendations.

Nausea and Iron Supplements: Understanding the Connection

While iron supplements are essential for many, they can sometimes cause digestive discomfort, with nausea being a common complaint. This side effect can be attributed to several factors:

• Iron’s irritating effect on the stomach lining
• The tendency of iron to cause oxidative stress in the digestive tract
• Individual sensitivity to iron or other ingredients in the supplement
• Taking iron on an empty stomach

Understanding these factors can help in developing strategies to minimize discomfort and ensure consistent iron supplementation.

Strategies to Minimize Nausea from Iron Supplements

If you’re experiencing nausea from iron supplements, several strategies can help mitigate this side effect:

1. Timing of Supplement Intake

Taking iron with food can often reduce nausea. While this may slightly decrease absorption, it’s better than skipping the supplement entirely due to discomfort. Experimenting with different times of day may also help identify when your body tolerates iron best.

2. Gradual Dose Increase

Starting with a lower dose and gradually increasing it can help your body adjust to the supplement. This approach may be particularly useful for those with sensitive stomachs.

3. Alternative Formulations

If tablets cause discomfort, consider trying liquid iron, which may be gentler on the stomach. Some people also find success with slow-release formulations that distribute iron more gradually throughout the digestive tract.

4. Pair with Vitamin C

Vitamin C enhances iron absorption and may help reduce stomach irritation. Consider taking your iron supplement with a glass of orange juice or a vitamin C supplement.

5. Stay Hydrated

Drinking plenty of water throughout the day can help mitigate digestive discomfort associated with iron supplements.

Maximizing Iron Absorption: Tips and Tricks

To get the most benefit from your iron supplement while minimizing side effects, consider these strategies for optimal absorption:

• Take iron supplements on an empty stomach when possible, ideally 1 hour before or 2 hours after meals
• Avoid calcium-rich foods or supplements within 2 hours of taking iron, as calcium can interfere with iron absorption
• Pair iron supplements with vitamin C-rich foods or a vitamin C supplement to enhance absorption
• Avoid coffee, tea, and high-fiber foods when taking iron, as these can inhibit absorption
• If taking multiple supplements, space out iron from other minerals like zinc or magnesium

Remember, while these strategies can help, it’s essential to follow your healthcare provider’s specific recommendations for your individual needs.

When to Consult a Healthcare Provider

While some digestive discomfort is common when starting iron supplements, persistent or severe symptoms warrant medical attention. Consult your healthcare provider if you experience:

• Severe or persistent nausea and vomiting
• Intense abdominal pain
• Black or tarry stools (not caused by iron supplements)
• Signs of an allergic reaction, such as rash, itching, or difficulty breathing

Your healthcare provider can assess your symptoms, adjust your dosage or formulation, or explore alternative treatments if necessary.

Alternative Approaches to Iron Supplementation

For those who struggle with traditional iron supplements, alternative approaches may be worth exploring:

1. Intravenous (IV) Iron

In cases of severe iron deficiency or inability to tolerate oral supplements, IV iron may be recommended. This method bypasses the digestive system, reducing the likelihood of gastrointestinal side effects.

2. Iron-Rich Diet

While not always sufficient for those with significant deficiencies, focusing on iron-rich foods can help maintain iron levels and may be used in conjunction with lower doses of supplements.

3. Transdermal Iron Patches

Although less common, iron patches are being explored as an alternative to oral supplements. These deliver iron through the skin, potentially reducing digestive side effects.

4. Fermented Iron Supplements

Some newer supplements use fermented iron, which may be gentler on the digestive system and better absorbed.

Always consult with a healthcare provider before trying alternative methods of iron supplementation to ensure they are appropriate for your specific needs.

Iron supplementation plays a crucial role in maintaining health for many individuals, particularly those with iron deficiency or increased iron needs. While nausea and other digestive issues can be challenging, various strategies can help minimize these side effects. By understanding the types of iron supplements available, implementing tactics to reduce nausea, and optimizing absorption, most people can successfully incorporate iron supplements into their health regimen. Remember, personalized advice from a healthcare provider is invaluable in navigating iron supplementation effectively and safely.

Taking iron supplements: MedlinePlus Medical Encyclopedia

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Eating iron rich foods is a key part of treating anemia caused by low iron levels. You may also need to take iron supplements as well to rebuild iron stores in your body.

ABOUT IRON SUPPLEMENTS

Iron supplements may be taken as capsules, tablets, chewable tablets, and liquids. The most common tablet size is 325 mg (ferrous sulfate). Other common chemical forms are ferrous gluconate and ferrous fumarate.

Have your health care provider tell you how many pills you should take each day and when you should take them. Taking more iron than your body needs can cause serious medical problems.

Blood counts return to normal after 2 months of iron therapy for most people. You should continue taking supplements for another 6 to 12 months to build up the body’s iron stores in the bone marrow.

TIPS FOR TAKING IRON

Iron is absorbed the best on an empty stomach. Yet, iron supplements can cause stomach cramps, nausea, and diarrhea in some people. You may need to take iron with a small amount of food to avoid this problem.

Milk, calcium and antacids should not be taken at the same time as iron supplements. You should wait at least 2 hours after having these foods before taking your iron supplements.

Foods that you should not eat at the same time as you take your iron include:

• High fiber foods, such as whole grains, raw vegetables, and bran
• Foods or drinks with caffeine

Some doctors suggest taking a vitamin C supplement or drinking orange juice with your iron pill. This can help the iron absorb into your body. Drinking 8 ounces of fluid with an iron pill is also OK.

Tell your provider about all the medicines you are taking.

• Iron tablets may cause other drugs you are taking to not work as well. Some of these include tetracycline, penicillin, ciprofloxacin, and drugs used for Parkinson’s disease and seizures.
• Medicines that reduce stomach acid will impair iron absorption and may cause iron deficiency. Your provider may suggest changing these.
• Wait at least 2 hours between doses of these drugs and iron supplements.

SIDE EFFECTS

Constipation and diarrhea are very common. If constipation becomes a problem, take a stool softener such as docusate sodium (Colace).

Nausea and vomiting may occur with higher doses, but they can usually be controlled by taking the iron in smaller amounts. Ask your provider about switching to another form of iron rather than just stopping.

Black stools are normal when taking iron tablets. Talk to your provider right away if:

• The stools are tarry looking as well as black
• If they have red streaks
• Cramps, sharp pains, or soreness in the stomach occur

Liquid forms of iron may stain your teeth.

• Try mixing the iron with water or other liquids (such as fruit juice or tomato juice) and drinking the medicine with a straw.
• Iron stains can be removed by brushing your teeth with baking soda or peroxide.

Keep tablets should in a cool place. (Bathroom medicine cabinets may be too warm and humid, which may cause the pills to fall apart.)

Keep iron supplements out of the reach of children. If your child swallows an iron pill, contact a poison control center right away.

Brittenham GM. Disorders of iron homeostasis: iron deficiency and overload. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 36.

Camaschella C. Microcytic and hypochromic anemias. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier ; 2020:chap 150.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

How to Take Iron Pills Without Getting Sick

Iron is one of your body’s most vital nutrients.

We get iron from our food so a healthy balanced diet should ensure we have sufficient iron in our diets. In some cases, like during pregnancy or due to a restricted diet, it may be necessary to take an iron supplement to keep up our iron levels.

However, some people find it difficult to take iron supplements without feeling sick, often experiencing stomach irritation and nausea.

But how can you make sure that supplementing with iron doesn’t make you feel sick?

This is the question we’re going to be answering in this article, but first of all, there’s a few things we need to cover:

• Why you need iron
• Where you will find iron in your diet
• How you can maximize iron absorption
• How you can ensure that taking iron pills, doesn’t make you feel sick

Active Iron has a scientifically developed formula which ensures it works in perfect harmony with your body, while also being kind on your stomach and highly effective. Click this link to visit our store and purchase Active Iron.

Let’s get right into it.

Why Do You Need Iron?

Healthy iron levels support your overall health. Iron contributes to normal cognitive function and energy yielding metabolism, so when your body has enough iron, you feel more energized and alert.

Maintaining healthy iron levels helps reduce tiredness and fatigue in the body and can help improve immune system function.

Your body also needs iron to produce hemoglobin – a protein that carries oxygen from the lungs to the rest of the body.

Naturally, this means the people who are most likely to benefit from iron supplements are:

• Pregnant women
• Women during their period
• People over the age of 65
• Active Exercisers
• Vegetarians

How Can You Get More Iron In Your Diet?

There are two types of iron:

• Heme iron, which is most commonly found in meat, fish and poultry.
• Non-heme iron, which is found in plant-based foods such as legumes, nuts and vegetables.

Your body absorbs heme iron way more easily than non-heme iron.

If you eat more meat, you will likely boost your iron levels higher than if you mostly consume non-heme iron from other sources.

However, eating a lot of meat isn’t the only option for increasing your iron intake – taking an iron supplement can be a helpful addition to a well-balanced diet.

Here is a list of iron-rich foods you can start implementing in your diet right now:

• Beef
• Eggs
• Pork
• Chicken
• Shrimp
• Tuna
• White bread
• Tofu
• Spinach
• Kale

How Is Iron Absorbed In The Body?

When iron enters the stomach, it’s exposed to stomach acid and changed into a Fe+3 form. This will need to be converted back into Fe+2 by the body so that it can be absorbed.

The majority of iron is absorbed in the small intestine, specifically the duodenum. As iron enters the mucosal sites of the duodenum (the first part of the small intestine) this is where most of its absorption takes place.

If you are supplementing with iron, it is best to find a supplement that is designed to release at the body’s natural site of absorption than one that breaks down completely in the stomach.

That’s why if you want to take iron without getting sick, you have to do your best to ease the iron absorption process.

Here are a few tips that will help you increase your iron absorption and lessen the chances of getting sick after taking an iron supplement:

• If you don’t experience any stomach problems, take iron in the morning on an empty stomach.
• If you have a sensitive stomach, take iron along with a little food, so it doesn’t make you nauseous.
• When you take iron with food, do NOT eat milk, calcium or antacids, and don’t drink tea or coffee because they will lower your ability to absorb iron.
• Take iron with a Vitamin C supplement or with orange juice to increase the absorption.

Is That The Only Way To Take Iron Without Getting Sick?

You can follow all of the above tips, OR if you are looking for an easier option, you can just start taking Active Iron – the iron supplement that revolutionizes iron absorption and is gentle on your stomach. Providing 2X better iron absorption than other iron supplements*, and decreasing the likelihood of side effects by 6X**,  Active Iron is recommended by health professionals and loved by consumers.

Will Active Iron Tablets Make You Feel Sick?

No they should not, Active Iron has a ground-breaking formula that is kind on your gut. Our iron pills are specifically designed to help reduce side effects e.g. feel sick, nauseated, constipated.

Active Iron is a very tolerable and easy-to-absorb iron supplement.

Active Iron will increase the amount of iron you absorb and reduces the chances of making you feel sick because it works in tune with your body by targeting your natural site of absorption in the small intestine.

Active Iron reduces unwanted side effects that are typically associated with taking iron pills, such as nausea, cramping, constipation, flatulence, and stomach irritation.

Conclusion: If You Want To Optimise Your Chance Of Not Feeling Sick Due To Iron Pills, Choose Active Iron

Maintaining healthy iron levels will go a long way to promoting a better lifestyle and a healthier body.

If you regularly feel tired or fatigued, try taking an iron supplement to see if it boosts your energy levels.*

When you need an iron supplement that won’t make you feel sick, the best option is Active Iron. By reducing gut irritation from iron, Active Iron limits the potential side effects of iron including nausea.

It has a scientifically proven formula that works in tune with your body to improve your absorption and increase your iron levels and reduces the chances of making you feel sick.

Making Active Iron a part of your daily routine is a guaranteed way to reap all the benefits of an increased iron intake.

Iron supplements should not be used as a substitute for a varied balanced diet and a healthy lifestyle.

*These symptoms maybe signs of other conditions, you should contact a health care profession if they persist

*Wang et al. 2017, Acta Haematological, 138: 223-232
**Ledwidge et al. Data on file.

Taking iron supplements once, twice or thrice a week to prevent anemia and its consequences in menstruating women

What is the problem?

In the world, approximately one in three non-pregnant women of reproductive age is anemic, i.e. has fewer red blood cells or a lower concentration of hemoglobin (the red substance that binds to oxygen and carries it around the body) in each red blood cell than normal. Despite the existence of a number of reasons for the development of anemia, it is very often due to long-term iron deficiency. The standard practice for preventing or treating anemia in women is to give iron supplements daily (sometimes in combination with folic acid and other vitamins and minerals) for three months. However, this regimen is often associated with the development of side effects such as nausea or constipation. Intermittent administration (i.e., dosing once, twice, or three times per week on non-consecutive days) has been suggested as an effective and safe alternative to daily dosing.

Why is this important?

Women with anemia may have lower physical performance and a higher susceptibility to infectious diseases. The majority of women in the world are anemic at the time of pregnancy, putting them at increased risk of having low birth weight babies and other birth complications.

According to some scientists, taking iron supplements several times a week instead of daily can improve the well-being of women with anemia and increase their hemoglobin levels without causing many side effects. With fewer side effects, women are more likely to take iron supplements more regularly and for longer.

What evidence did we find?

We reviewed the evidence in February 2018. The review included 25 randomized controlled trials (a type of experimental study in which participants are randomly assigned to one or more treatment groups) involving 10,996 women. The review included studies that compared intermittent iron supplementation with no intervention, placebo (dummy pills), or daily intake of the same iron supplements. Most of the research was conducted in academic settings and funded primarily by international organizations, universities, and ministries of health at the national level. Approximately one-third of the included studies did not provide sources of funding.

Studies have shown that women who took intermittent iron supplements (alone or in combination with folic acid or other micronutrients) were less likely to develop anemia compared with women who did not take iron supplements or took a placebo. They also had higher concentrations of hemoglobin and ferritin (an iron-carrying protein). In addition, the intermittent regimen of iron supplementation reduced the risk of developing iron deficiency. These findings suggest that intermittent iron supplementation was comparable to daily iron supplementation in reducing anemia and increasing hemoglobin concentrations, and was associated with fewer side effects. This mode of administration did not affect the increase in ferritin concentrations.

We found little evidence of the effect of intermittent iron supplementation versus placebo or daily iron supplementation on iron deficiency anemia, all-cause morbidity, disease outcomes, treatment adherence, cost-effectiveness, and performance.

What does this mean?

Intermittent iron supplementation in menstruating women may be an effective intervention to reduce the risk of anemia and increase hemoglobin concentrations when compared with no intervention, placebo, or daily supplementation of the same supplement. Intermittent dosing may be associated with fewer side effects compared to daily dosing. The results of the intervention were effective regardless of whether the drugs were taken once or twice a week, for less than or more than three months, whether they contained less or more than 60 mg of elemental iron per week, and whether the intervention was carried out in populations with varying degrees of anemia at baseline. level (baseline for comparisons). The evidence base was generally of low quality.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

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Translation notes:

Translation: Vinichenko Yulia Viktorovna. Editing: Yudina Ekaterina Viktorovna. Project coordination for translation into Russian: Cochrane Russia – Cochrane Russia on the basis of Kazan Federal University. For questions related to this translation, please contact us at: cochrane. [email protected]; [email protected]

Ferinject – a new word in the treatment of iron deficiency conditions

Iron preparations are the basic therapy for latent iron deficiency and iron deficiency anemia (IDA), regardless of its cause and severity. Doctors pay great attention to the elimination of risk factors and disorders of internal organs, however, without saturation of the body with iron, these measures will not be effective.

To replenish the reserves of the microelement in IDA, 3 variants of preparations are used :

● Tablets for oral use.

● Solutions for intramuscular injections.

● Solutions for intravenous injections.

Each of the methods of treatment has advantages and disadvantages, which we will discuss today. We will also tell you about an innovative drug for the treatment of IDA, which is devoid of most of the disadvantages and has every chance of becoming the “gold standard” of injectable therapy for iron deficiency.

Iron tablets

Oral iron preparations are the first line of treatment for mild to moderate IDA. This is the best treatment option for people who do not have problems swallowing pills, are responsible for treatment and do not forget to take their medicine on time. Tableted iron avoids painful injections, which is why it is often prescribed to patients.

However, tablets have a number of disadvantages :

● their absorption depends on the functional state of the gastrointestinal tract, so the effect of treatment may be much lower than expected;

● give a slow saturation of the body with iron and are not suitable for people with severe symptoms of iron deficiency – with optimal absorption of drugs, an increase in hemoglobin by 10 g / l takes about 1 month;

● give a persistent gray tint to tooth enamel;

● stain feces black;

● often cause constipation, nausea and vomiting;

● can cause exacerbations of digestive diseases (stomach ulcers, ulcerative colitis).

The above symptoms cause poor adherence of patients to therapy, due to which the treatment of anemia is ineffective. Therefore, physicians are using injection therapy options that have become a kind of next step in the evolution of IDA therapy.

Injectable iron preparations

This includes drugs for intramuscular and intravenous iron injections. Parenteral administration of drugs is indicated in such cases :

● poor tolerance of iron tablets;

● severe forms of IDA;

● the need for rapid saturation of the body with iron;

● Violation of iron absorption due to inflammatory and atrophic diseases of the gastrointestinal tract;

● presence of gastric ulcer and some other ulcerative-erosive diseases of the gastrointestinal tract;

● inability to swallow a tablet;

● personal choice of the patient.

For injections, complexes with iron are used, which are divided into 4 groups according to their physicochemical properties. The first 2 types are highly stable and are used for intravenous injections, while complexes 3 and 4 are not stable enough and are suitable for intramuscular injections. Intravenous administration is used much more often than intramuscular, due to the rapid and stable therapeutic effect, the ability to use more modern drugs.

Advantages of intramuscular iron preparations over tableted :

● devoid of negative effects on the gastrointestinal tract and do not depend on the state of absorption in the intestine;

● May be used in patients unable to swallow a tablet.

Disadvantages of preparations for intramuscular administration :

● reactions at the injection site – pain, redness, formation of sterile abscesses, necrosis of the skin and soft tissues;

● The rate of saturation does not have significant advantages over taking drugs by mouth, which determines the long duration of the injection course of 10-15-30 injections performed daily, or with a weekend break, or every other day.

Thus, tablet and injectable forms do not always fully meet the interests of the patient and the attending physician, which makes it possible for the widespread use of intravenous IDA therapy.

Iron preparations for intravenous use are devoid of all the disadvantages of tablet forms and solutions for intramuscular injection. The effectiveness of therapy does not depend on intestinal absorption, the presence of gastrointestinal diseases, does not cause side effects from the gastrointestinal tract, there are no infiltrates and abscesses at the injection site, and the iron saturation rate is on average 3 times higher than that of tablets and intramuscular agents. Thus, an increase in hemoglobin by 10 g/l on average is achieved after 5 droppers of traditional solutions of iron hydroxide, performed at intervals of 1 day.

However, intravenous forms of drugs are not without disadvantages, which include :

● anaphylactoid reactions – shortness of breath, angioedema, urticaria, collapse;

● systemic side effects – heart rhythm disturbances, muscle and joint pain, urine discoloration.

Nevertheless, the benefits of iron infusions are much higher and more important than possible adverse reactions, so such drugs are actively used in therapeutic practice. In this regard, the development of new, less toxic and more effective medicines is an important task.

What is the difference between Ferinject

Ferinject is an intravenous drug that contains a molecule called iron carboxymaltose. In terms of chemical structure, such a substance is as close as possible to serum ferritin, a natural molecule responsible for storing iron reserves in the body.

4 main advantages of Ferinject compared to previous generation injectables :

1. Extremely rarely causes allergic reactions, unlike iron preparations containing dextran.

2. Allows you to administer a dose of up to 1000 mg in 15 minutes – this treatment regimen is the most comfortable for the patient.

3. Quickly replenishes iron stores in the body – an increase of 10 g / l is achieved after the first infusion, therefore it is suitable for severe forms of anemia.