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Is your iron low? Oral Iron replacement options

  • See our blogs about Iron Deficiency in Women.
  • Iron is absorbed very poorly, even from iron pills. The “bioavailability” is low: we only absorb about 5-30%. So use it regularly until your ferritin (stored iron in your blood) is > 30.
  • Side effects from the iron pills?
    • Constipation: ensure that you increase your fluid and fibre intake and/or use stool softeners such as Colace.
    • Taking the iron at bedtime may help some of the other stomach side effects.
  • Vit C: 250-500mg taken with the iron from the non-heme group (see below), can help increase the iron absorption in the small intestines.
  • Taking iron every second day may help overall absorption of iron. (based on small studies)
  • Liquid iron or pills? No real difference, possibly a marketing strategy. But liquid ferrous sulphate or ferrous fumarate is a good option if you can’t swallow pills easily.
  • Severe iron deficiency: If your ferritin is very low, I recommend taking a heme iron supplement in the morning, and a non-heme iron supplement with Vit C, at bedtime.
  • Too much iron? Always monitor the ferritin level: too much iron is bad, it can increase inflammation, cause liver damage and disturb your protective gut organisms


2 types of iron replacement:


Heme iron is made from animal sources such as beef, so may be better absorbed.

Use heme iron replacement in the morning.


  • Optifer or Proferrin in the morning


Non heme iron: Made from plant sources or various iron salt compounds.

Use at Bedtime: (may help decrease stomach side effects.)


  • Ferrous Ascorbate (EBMFER has Vit C already)


  • Ferrous Polysaccharide (eg. Polyride Ultra (includes Vit C) or Feramax (add Vit C)


  • Ferrous Fumarate 300mg with Vit C 500mg at bedtime (eg. Palafer or Eurofer: (Eurofer is cheaper and the same)


  • Ferrous sulphate and ferrous gluconate have lower amounts of elemental iron and some women tolerate them well.


  • Floridex: women often ask about this. It contains one of the lowest amount of iron, so that is why it may be better tolerated.


  • Do not take these with Calcium or dairy products (blocks iron absorption).
  • Vitamin C helps with iron absorption.

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