Why do iron supplements cause nausea. How can you take iron pills without feeling sick. What are the best ways to maximize iron absorption. When should you take iron supplements for optimal results.

The Importance of Iron in Your Body

Iron plays a crucial role in maintaining overall health and well-being. This essential mineral is vital for various bodily functions, including:

• Oxygen transport through hemoglobin production
• Energy production and metabolism
• Immune system support
• Cognitive function and brain development
• Muscle function and physical performance

Despite its importance, iron deficiency remains one of the most common nutritional deficiencies worldwide. When the body lacks sufficient iron, it can lead to anemia, fatigue, weakness, and other health issues.

Who is at Risk for Iron Deficiency?

Certain groups are more prone to iron deficiency and may require supplementation:

• Pregnant women
• Menstruating women with heavy periods
• Vegetarians and vegans
• Endurance athletes
• People with certain digestive disorders
• Individuals who have undergone weight loss surgery

Common Sources of Dietary Iron

Before resorting to supplements, it’s essential to understand the natural sources of iron in our diet. Iron-rich foods can be categorized into two types: heme and non-heme iron.

Heme Iron Sources

Heme iron, found in animal products, is more easily absorbed by the body. Some excellent sources include:

• Red meat (beef, lamb)
• Poultry (chicken, turkey)
• Fish (tuna, salmon)
• Organ meats (liver, kidney)

Non-Heme Iron Sources

Non-heme iron, primarily found in plant-based foods, is less readily absorbed but still contributes significantly to iron intake. Some good sources are:

• Leafy green vegetables (spinach, kale)
• Legumes (lentils, beans)
• Fortified cereals and grains
• Nuts and seeds
• Dried fruits (raisins, apricots)

Understanding Iron Supplements

When dietary iron intake is insufficient, supplements may be necessary. Iron supplements come in various forms, including:

• Ferrous sulfate
• Ferrous gluconate
• Ferrous fumarate
• Iron amino acid chelates

These supplements are available as tablets, capsules, liquid formulations, and even as intravenous treatments in severe cases.

Recommended Dosage

The recommended daily allowance (RDA) for iron varies based on age, sex, and other factors. For adults, it typically ranges from 8 to 18 mg per day, with higher amounts recommended for pregnant women and those with diagnosed deficiencies.

Side Effects of Iron Supplements

While iron supplements can be beneficial, they often come with side effects, particularly when taken in high doses or on an empty stomach. Common side effects include:

• Nausea and vomiting
• Stomach cramps and abdominal pain
• Constipation or diarrhea
• Dark stools
• Metallic taste in the mouth

These side effects can be uncomfortable and may discourage people from continuing their iron supplementation regimen.

Strategies to Minimize Iron Supplement Side Effects

Fortunately, there are several strategies you can employ to reduce the likelihood of experiencing side effects from iron supplements:

1. Take Iron with Food

While iron is best absorbed on an empty stomach, taking it with a small amount of food can help reduce gastrointestinal discomfort. Choose foods that don’t interfere with iron absorption, such as those rich in vitamin C.

2. Start with a Lower Dose

Begin with a lower dose of iron and gradually increase it over time. This allows your body to adjust and may help minimize side effects.

3. Choose a Gentle Iron Formulation

Some forms of iron, such as iron amino acid chelates or carbonyl iron, may be easier on the stomach. Consult with your healthcare provider about switching to a gentler formulation if you’re experiencing significant side effects.

4. Consider Liquid Iron Supplements

Liquid iron supplements may be better tolerated by some individuals and allow for more precise dosing.

5. Take Iron at Bedtime

Taking iron supplements before bed may help reduce nausea and other gastrointestinal symptoms.

Maximizing Iron Absorption

To get the most benefit from your iron supplements and minimize the need for high doses, it’s crucial to optimize absorption. Here are some tips:

Pair Iron with Vitamin C

Vitamin C significantly enhances iron absorption. Consider taking your iron supplement with a glass of orange juice or a vitamin C-rich food like strawberries or bell peppers.

Avoid Calcium-Rich Foods and Supplements

Calcium can interfere with iron absorption. Avoid taking iron supplements with dairy products, calcium-fortified foods, or calcium supplements. Wait at least two hours between consuming calcium and iron.

Be Mindful of Phytates and Tannins

Certain compounds found in foods like whole grains, legumes, tea, and coffee can inhibit iron absorption. Try to separate the consumption of these foods from your iron supplement intake.

Consider Splitting the Dose

Taking smaller doses of iron throughout the day, rather than one large dose, may improve absorption and reduce side effects.

When to Take Iron Supplements

The timing of iron supplementation can significantly impact its effectiveness and tolerability. Consider the following guidelines:

• Take iron on an empty stomach if possible, about 1 hour before or 2 hours after meals
• If stomach upset occurs, try taking iron with a small amount of food
• Avoid taking iron with calcium-rich foods or antacids
• Space iron supplements at least 2 hours apart from other medications
• For optimal absorption, take iron supplements at a different time than multivitamins containing zinc

Monitoring Iron Levels and Supplement Use

Regular monitoring of iron levels is crucial when taking supplements to prevent iron overload, which can be harmful. Your healthcare provider may recommend periodic blood tests to check your iron status and adjust your supplementation regimen accordingly.

Signs of Iron Overload

While iron deficiency is more common, it’s important to be aware of the signs of iron overload, which can occur with excessive supplementation:

• Joint pain
• Fatigue
• Abdominal pain
• Irregular heart rhythm
• Skin color changes

If you experience any of these symptoms, consult your healthcare provider immediately.

Alternative Approaches to Boosting Iron Levels

For those who struggle with iron supplements or prefer natural alternatives, there are other ways to increase iron levels:

Dietary Modifications

Increasing the consumption of iron-rich foods, particularly heme iron sources for non-vegetarians, can help boost iron levels naturally. Combine iron-rich foods with vitamin C sources to enhance absorption.

Cooking in Cast Iron

Using cast iron cookware can increase the iron content of foods, especially when cooking acidic dishes like tomato-based sauces.

Herbal Remedies

Some herbs, such as yellow dock root and nettle leaf, are believed to support iron absorption and red blood cell production. However, always consult with a healthcare provider before using herbal remedies.

Address Underlying Causes

In some cases, iron deficiency may be due to underlying health conditions or excessive blood loss. Identifying and addressing these root causes can help improve iron levels without relying solely on supplements.

Iron supplementation can be a crucial part of maintaining optimal health for many individuals. By understanding the potential side effects and implementing strategies to minimize them, you can ensure that you’re getting the iron you need without unnecessary discomfort. Remember to consult with your healthcare provider before starting any new supplement regimen and to monitor your iron levels regularly. With the right approach, you can effectively manage your iron intake and support your overall well-being.

Taking iron supplements: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus.gov/ency/article/007478.htm

To use the sharing features on this page, please enable JavaScript.

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.

Donate

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.