Iron

Effects and Benefits

Core Identification

Common Names:
- Iron
- Ferrous iron
- Ferric iron

Latin Name: Fe (Ferrum)

Category: Mineral

Uses

Traditional Uses

• Blood tonics and strengthening remedies - Various cultures throughout history
• Iron-rich foods prescribed for weakness and pallor - Ancient medical traditions
• Cast-iron cookware used to increase dietary iron intake - Historical practice

Modern Uses

• Iron-deficiency anemia treatment - Restores hemoglobin levels and red blood cell production | Research quality: Strong
• Key findings: Iron supplementation effectively corrects iron-deficiency anemia within 3-6 months; supplements should continue 6 months after correction to replenish body stores

• Source citations: Merck Manual Home Health Handbook; Brewer, TDT Encyclopedia of Vitamins

• Pregnancy support - Prevents maternal anemia and supports fetal development | Research quality: Strong

• Key findings: Iron requirements approximately double during pregnancy; supplementation from 28th week significantly improves iron status of both mother and infant

• Source citations: Brewer, TDT Encyclopedia of Vitamins

• Immune function support - Maintains white blood cell activity against pathogens | Research quality: Moderate

• Key findings: Iron deficiency impairs immunity and increases susceptibility to infections including recurrent thrush and herpes simplex; can occur even before frank anemia develops

• Source citations: Brewer, TDT Encyclopedia of Vitamins

• Cognitive function and energy - Supports oxygen delivery to brain and muscles | Research quality: Moderate

• Key findings: Iron deficiency associated with fatigue, difficulty concentrating, and reduced cognitive ability; correction improves energy levels
• Source citations: Behan, The Baby Food Bible; Moline, The Doctors Book of Natural Health Remedies

Active Compounds

Primary Active Ingredients:
- Ferrous iron (Fe²⁺) - The absorbable form of iron; essential for hemoglobin synthesis
- Heme iron - Found in animal sources; absorbed 10 times more efficiently than non-heme iron
- Non-heme iron - Found in plant sources; absorption enhanced by vitamin C

Dosage Information

Standard Dosage:
- Form: Tablet, capsule, or liquid
- Amount: 14-18 mg per day (EC RDA: 14 mg for adults)
- Frequency: Once daily

Therapeutic Dosage:
- Form: Ferrous sulfate, ferrous gluconate, or ferrous fumarate tablets
- Amount: 20-40 mg elemental iron per day for mild deficiency; higher doses as prescribed
- Purpose: Correction of iron-deficiency anemia
- Duration: 3-6 months to correct anemia, plus additional 6 months to replenish stores

Maximum Safe Dosage:
- Daily maximum: Do not exceed prescribed amounts without medical supervision
- Warning threshold: Iron toxicity can occur with excessive supplementation; keep away from children as even small amounts can be fatal

Bioavailability Notes:
- Ferrous forms (ferrous sulfate, gluconate, fumarate) absorbed better than ferric forms
- Heme iron from meat absorbed up to 10 times better than non-heme plant iron
- Only about 20% of dietary iron is typically absorbed
- Ferrous fumarate and ferrous gluconate generally better tolerated than ferrous sulfate
- Liquid iron tonics (like Floradix) may be absorbed twice as well as solid supplements

How to Take It

Timing:
- Best absorbed on an empty stomach, 30 minutes before meals or 2 hours after meals
- If stomach upset occurs, may take with small amount of food
- Late evening/bedtime can be effective due to peak gastric acid production at night
- Allow 2 hours between iron and calcium supplements

Synergies - What It Works Well With

Complementary Supplements:
1. Vitamin C - Keeps iron in the absorbable ferrous form; significantly enhances non-heme iron absorption | Take 100-500 mg vitamin C with iron supplement
2. Copper - Works together for proper iron metabolism and red blood cell formation | Found together in many multi-mineral formulas
3. Vitamin B12 and Folate - All three nutrients essential for healthy red blood cell production | Address together when treating anemia

Avoidance - What NOT to Combine With

Supplement Interactions:
1. Calcium supplements - Significantly reduces iron absorption | Take at different times of day
2. Zinc supplements - Iron given alone can decrease zinc absorption | Take as part of balanced multi-mineral formula
3. High-tannin herbs - Agrimony, green tea, uva ursi, white willow bark interfere with iron absorption | Avoid within 2-3 hours of iron supplementation

Drug Interactions:
1. Antacids - Reduce iron absorption by decreasing stomach acid | Severity: Moderate
2. Proton pump inhibitors - Decrease gastric acid needed for iron absorption | Severity: Moderate
3. Tetracycline antibiotics - Mutual interference with absorption | Severity: Moderate
4. Levodopa - Iron may reduce drug absorption | Severity: Moderate

Food Interactions:
- Coffee - Can reduce iron absorption by up to 39-80% if consumed within an hour of eating
- Tea - Polyphenols and tannins significantly inhibit iron absorption
- Dairy products - Calcium content reduces iron absorption
- High-fiber foods with phytates (bran, whole grains) - Interfere with iron absorption
- Oxalate-rich foods (spinach, Swiss chard, chocolate) - Inhibit iron absorption

Safety Information

Contraindications:
- Hemochromatosis (hereditary iron overload disorder)
- Non-iron-deficiency anemias (unless specifically indicated)
- Regular blood transfusion recipients
- Chronic alcoholism (increases iron absorption risk)
- Men and post-menopausal women without documented deficiency

Side Effects:
- Common: Constipation, stomach upset, nausea, dark/black stools (harmless)
- Less common: Diarrhea, heartburn
- Rare: Allergic reactions, intestinal damage from overdose

Long-Term Use:
- Should only be taken long-term under medical supervision with periodic blood tests
- Excess iron accumulation can damage organs including heart, liver, and pancreas
- Most men and post-menopausal women do not need ongoing iron supplementation
- Regular monitoring of ferritin levels recommended for long-term users

Special Precautions:
- Pregnancy: Generally recommended but under medical guidance
- Children: Keep supplements out of reach; even small amounts can be fatal to children
- Verify iron deficiency with blood tests before supplementing
- Hereditary hemochromatosis screening recommended for those with family history

Primary Uses At-a-Glance

Primary: Iron-deficiency anemia, pregnancy support, fatigue from iron deficiency

Secondary: Immune support, cognitive function, athletic performance support, heavy menstruation support

Sources

Local Library:
- Merck - The Merck Manual Home Health Handbook
- Brewer, Sarah - TDT Encyclopedia of Vitamins
- Gaby, Alan R. - A-Z Guide to Drug-Herb-Vitamin Interactions 2nd Ed
- Moline, Peg - The Doctors Book of Natural Health Remedies
- Mars, Brigitte - The Country Almanac of Home Remedies
- Balch, Phyllis - Prescription for Herbal Healing
- Moyad, Mark - The Supplement Handbook
- Gehring, Abigail - The Illustrated Encyclopedia of Natural Remedies
- Behan, Eileen - The Baby Food Bible
- Weil, Andrew - Eating Well for Optimum Health
- Davies, Jill - The Complete Home Guide to Herbs

General Knowledge:
- Clinical nutrition references and established medical guidelines