What do you need to know about iron supplements?

If someone is pale, tired, weak, or has a headache, iron deficiency is often the cause of the symptom (s). In addition to the above warning signs, fragmentation of the nails, hair loss, or susceptibility to infectious diseases may also indicate iron deficiency. Iron deficiency is more common in women than in men due to bleeding due to menstrual bleeding. Pregnancy and breast-feeding, even in women with normal iron levels, may lead to a lack of reserves, which may require iron replacement.

The cause of iron deficiency is that hemoglobin, whose central metal ion is iron, is responsible for transporting oxygen in the blood, red blood cells. In the absence of this key trace element, iron deficiency anemia (anemia) develops.
If someone suspects an iron deficiency, a simple blood test can reveal the actual condition of their iron household. Indeed, the revealing parameters of blood test results (eg hemoglobin level, red blood cell count, serum iron content, transferrin and serum ferritin levels, etc.) make it soon apparent that someone needs iron supplementation.

How much iron is needed to get into the body?

In cases of non-iron deficiency, it is recommended that men need 10 mg daily and women 15 mg daily. The loss of blood due to menstruation in women explains the greater need in their case. During pregnancy, women’s daily iron requirements increase to 30 mg, and increased iron requirements after childbirth persist during the months of breastfeeding. An iron intake of 20 mg daily is recommended for breast-feeding mothers.

How to fill iron warehouses in case of iron shortage?

Ideally, iron enters the body through food. Meat dishes, especially red meats, offal (eg liver), fish eggs contain high concentrations of iron. The iron content of vegetables and fruits is significantly lower, so iron deficiency is much more common in vegetarians than in mixed foods.
From the point of view of iron supplementation, food of animal origin is preferred. There is ten times more iron in beef liver than in beets.
Animal-derived so-called “hemvas” is better absorbed and utilized in the body than plant-derived so-called “non-hemvas”. As an example, the iron content of beets and beef liver, which are known to have exceptionally high iron content among plants, can be compared: 100 g of beet is approx. It contains 0.8 mg of iron, while 100 g of beef liver contains 8.8 mg. The difference is more than ten times! From a kitchen point of view, it is important that heat treatment, so neither long-term frying nor cooking, reduces the iron content of food.

Iron replacement drugs

In the case of iron deficiency, dietary changes are often inadequate and medication may need to be supplemented with medication. Iron is usually present in the form of iron sulphate (possibly iron ascorbate or iron fumarate) in iron replacement compositions. The dosage forms are various: film-coated tablets, chewable tablets, capsules, syrups or drops.

Babies and young children are usually prescribed drops by the doctor and older ones by syrup; it is easier for adults to choose the formulation and they do not have difficulty swallowing / taking. In addition to the above, iron supplementation can also be performed in the form of injections in a hospital setting, e.g. gastric disease with bleeding or significant blood loss for any reason.

In the case of drug therapy, the dose of iron is about 100 to 200 mg per day (this is several times what is recommended for non-iron deficient people as a daily intake). Some iron supplements that contain larger amounts of iron (about 100 to 110 mg) are available on prescription. Drugs containing lower doses (about 10 to 20 mg) of iron are available without a prescription. Some iron supplements contain folic acid in addition to iron.

If someone needs iron replacement and starts taking medication, don’t be impatient!

The effect of iron therapy does not appear immediately, the treatments last for at least eight weeks, and the effect of iron replacement drugs and the settlement of iron reserves can be detected only after a few months. Meanwhile, repeated blood samples are usually taken every four weeks to monitor the improvement in iron homeostasis.

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What to look for in case of iron replacement?

  • It is recommended to be taken on an empty stomach and with vitamin C.

The drug should be taken on an empty stomach if possible to maximize iron absorption; half an hour before breakfast recommends several medications in the package leaflet. Since the metallic taste as a side effect bothers many, this inconvenience in the morning – breakfast is approx. After 2 hours – but can be suppressed somewhat by ingestion on an empty stomach. Vitamin C is known to promote the absorption of iron from the small intestine. It is recommended to use iron preparations together with vitamin C.

  • Gastric acid sequestrant, fiber foods, spinach, green tea – not to be taken with these

To avoid interactions with other medicines and food supplements, the intake should not coincide with the intake of gastric acid binders (in other words, antacids). Foods high in fiber (such as whole grains) inhibit the absorption of iron due to their fiber content and spinach due to its oxalate content. Foods and beverages with a high polyphenol content (eg green tea) inhibit the utilization of iron through the chemical binding of polyphenols and iron, so their simultaneous consumption should be avoided.

  • The concomitant use of many antibiotics (eg doxycycline, ofloxacin, ciprofloxacin) and iron is prohibited, as iron prevents the absorption of the antibiotic, so the expected antibacterial effect is not achieved.
  • In addition, bisphosphonates used to treat osteoporosis (eg, alendronate, risedronate), levothyroxine used in thyroid hormone replacement therapy, and levodopa used in Parkinson’s disease should be taken a few hours (at least two hours) apart from iron salts.

Side effects of iron replacement drugs

A side effect of iron replacement can be a metallic taste, which can be unpleasant. Taking iron supplements can cause constipation and black stools, as well as allergic skin reactions and stomach pain and bloating.

In children, iron replacement syrup taken without dilution may cause transient black discolouration of the teeth. Some of the side effects can be kept under control: it is recommended to eat dried fruits and jams to prevent / reduce constipation. Don’t let the black stool scare anyone, it’s not a pathological change!

Dr. Budai Marianna PhD,
Dr. Lívia Budai PhD

Source: Patika Magazin Online by www.patikamagazin.hu.

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