- 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.