Taking iron supplement? This is how to get more of it into your body (with fewer gastric complaints)

I recently found myself on the other side of the consultation table when I was diagnosed with iron deficiency.

This happened to me 3 months ago! Being a vegetarian, I always have one or the other deficiency going on, despite being on supplements meant to recuperate my RDA (recommended daily allowance) of basic nutrients.

Also, my first sign of iron deficiency was quite vague- Leg cramps. Not exactly the symptom you’d expect.

https://www.youtube.com/shorts/aOilrxt2xMs

I ignored it for over a month. Then all of a sudden (no exaggeration here), I was seeing way-more-than-100-hairs-a-day shedding, fatigue and (something I only noticed in hindsight) pallor over my lateral cheeks and lips.

Turns out my iron was 5.6, and Ferritin 8.

My levels were, in fact, really low. And yes, this happened despite taking a general supplement that contained iron.

So, like any responsible adult, I started high dose iron supplements, and my symptoms improved in the following order: calf pain (within 1 week), hair fall (6 weeks), pallor (8 weeks).

Also, the “glow” in my case was just more oxygen to my skin cells.😛

So, long story short, if you’re dealing with unexplained fatigue, hair fall, cramps or pallor, especially women, don’t just brush it off. Get your levels checked- iron, vitamin D, vitamin B12, ferritin, and thyroid hormones.

How to Increase Iron Supplement Absorption

1. Check the form of iron

Different formulations contain different amounts of elemental iron and have different GI tolerability.

Ferrous salts are commonly used and generally well absorbed:

• Ferrous sulfate → effective, inexpensive, but GI side effects are relatively common.

• Ferrous fumarate → higher elemental iron content per tablet; can also cause GI symptoms.

• Ferrous gluconate → lower elemental iron content, but may be better tolerated by some people.

  
  

Then there’s iron bisglycinate, a chelated form that can offer good absorption with potentially fewer GI side effects than conventional ferrous salts.

And then we have liposomal/sucrosomial iron (what I took), where iron is incorporated into or surrounded by a lipid-based or phospholipid-associated structure. These formulations are designed to improve delivery and GI tolerability and may be useful when conventional oral iron isn't tolerated well.

When should you take it?

For absorption, an empty stomach is best.

But empty-stomach iron can also mean nausea, abdominal discomfort or constipation.

So my rule is:

Start for 2 weeks after breakfast → If no gastric distress → Try it on an empty stomach → If gastric distress happens → Switch back to post breakfast.

What NOT to take with Iron?

Avoid the following 2 hours before/after iron supplements:

1. Tea & coffee (have polyphenols that substantially reduce iron absorption)

2. Calcium supplements (calcium competes with iron for absorption in the intestine)

3. Milk or any dairy products (because of the calcium thingy)

4. Antacids (raise stomach pH, make iron less soluble + harder to absorb)

5. Levothyroxine (iron binds to thyroid hormone in the stomach, blocks levothyroxin absorption)

   
   

What about vitamin C?

Vitamin C and Iron are like Pikachu and Ketchup! Eternal lovers.

Vit C enhances absorption of non-heme iron by helping keep iron in a more absorbable form.

Taking iron with a source of vitamin C (orange juice) helps.

And even better if you can get your hands on a iron+vit C supplement in one!

And what about taking it every day?

Depends on your iron and ferritin levels, honestly. Leave this decision to your treating physician.

But, fun fact: Oral iron increases hepcidin (a lesser known hormone that temporarily reduces intestinal iron absorption).Alternate-day dosing has been studied to improve fractional iron absorption and tolerability compared with taking iron on consecutive days.

But, but but...the exact regimen should depend on your degree of deficiency, formulation, elemental iron dose, response, and clinical situation.

What about liposomal iron (the one I took)?

Liposomal iron packages iron within lipid structures to protect it from the GI tract and facilitate delivery.

Advantages include:

• Better GI (gastro-intestinal) tolerability

• Useful option when conventional ferrous salts cause significant GI symptoms

  
  

But...and it's a big BUT!

No self-diagnosis or self-treatment, plz! The aforementioned are just screening tests. Let your physician make a proper management plan.