Iron Pills — 7 Crucial Things to Know
Iron deficiency is the most common nutritional deficiency around the world. Meats, fish, beans, spinach, and cereal have small amounts of this essential mineral.
The best-known function of iron in our body is the formation of hemoglobin. If your body is deficient in iron, your red blood cells won’t have enough hemoglobin. This condition, called anemia, prevents your blood from carrying enough oxygen to the cells and tissues of your body.
Look for these signs to know if you have anemia:
- A pale look
- Constant tiredness
- Breathlessness after small effort
Iron is a part of several enzyme systems, and many cells and tissues are affected by iron deficiency. You may have a poor appetite, tiredness, and lack of energy in the early stages of iron deficiency, even before anemia develops.
How Much Iron Do You Need?
Most men and non-menstruating women lose about 1 milligram of iron from their bodies a day. The human body guards its iron, only losing minute amounts in the sweat, urine, and the cells shed from the skin. Iron losses during menstruation and pregnancy are much greater.
While you lose only a tiny amount each day, you need much more iron in your diet to maintain an iron balance. Under normal circumstances, your intestines only absorb 10% to 15% of the iron in your food. Surprisingly, this proportion is not constant. If you’re iron-deficient, your intestines will absorb more of the iron available.
Non-vegetarian diets usually provide 10-15 milligrams of iron a day. Your body will absorb enough to maintain enough iron in its stores. Vegetarian diets often do not provide adequate iron.
Ferrous or Ferric Iron?
The iron molecule exists in two forms, and different salts are available. The ferrous form is better absorbed, and more salts (ferrous sulfate, ferrous fumarate, ferrous bis-glycinate, etc.) are used as therapy. Iron in the ferric form is absorbed only after conversion to the ferrous form. Consequently, fewer ferric salts (ferric hydroxide, ferric ammonium citrate, etc.) are used.
Heme or Non-Heme Iron?
Heme iron is found in hemoglobin and myoglobin in animal-origin food. Non-heme iron is found in plant-based foods, and is also used to fortify food and infant formulas. Heme iron has an easier pathway to absorption.
Some iron supplements or treatments contain hemoglobin. Remember, this hemoglobin doesn’t get inserted into your red blood cells. If you consume hemoglobin, your intestines will break it down, releasing the iron.
Moreover, one gram of hemoglobin contains only about three milligrams of iron, making it a poor choice for iron therapy.
Your Body Isn’t Fussy
You’ll hear a lot of arguments about which salt is best. Arguments about the benefits of ferrous sulfate over ferrous gluconate can get ugly. What’s more, ferrous fumarate has diehard fans.
The fact is, it’s the absolute amount of iron that’s important. Your doctor considers the elemental iron content of the tablet or capsule before prescribing.
Help and Hindrance
Some substances help your gut absorb more iron. The best known is vitamin C (ascorbic acid). It converts ferric iron to the ferrous form, facilitating absorption. Hence, vitamin C is often included in iron tablets. If your tablets don’t have it, simply gulp them down with orange juice for the same benefit. Animal tissues in the diet also help inorganic iron absorption.
Some substances in your food bind to iron and prevent absorption. These are mostly organic compounds like phytates, phosphates, and polyphenols. Drugs like proton pump inhibitors and calcium supplements also retard iron absorption. Avoid tea and coffee with meals and iron tablets, as they reduce iron absorption.
Which Iron Pill Is Best Tolerated?
The one that has the least iron. The supplements to be taken when you’re healthy have a few milligrams of iron and are easily tolerated.
If you are anemic, your doctor will prescribe pills with higher amounts of iron. You may suffer side-effects like abdominal discomfort, nausea, diarrhea, or constipation.
Iron tolerance is personal. If you can tolerate iron well, any preparation will suit you.
How Can You Reduce the Side-Effects?
If you’re anemic, your doctor will prescribe you higher doses of iron than you take as supplements. Some strategies to reduce the side-effects:
- Take your iron pill(s) with food.
- Ask your doctor for preparations like carbonyl iron or iron polysaccharide complex, which are less irritant.
- Your doctor may also prescribe slow-release preparations of iron.
- Instead of a single pill with the daily dose, consider pills with lesser amounts, two or three times a day.
Beware the Add-Ons
If you are a competitive athlete, make sure your pills do not contain banned substances. Manufacturers won’t deliberately put performance-enhancing substances into iron pills. Nevertheless, it’s rare for a tablet to contain only iron. Most will also have folic acid, vitamin B12, and other substances, some of which may be on the banned list in your discipline.
What if you can’t tolerate oral iron at all? If you are severely iron deficient, your doctor can calculate your iron requirement and give it to you as an intravenous infusion. For safety, such treatment is done in a hospital.