Iron deficiency anemia - causes - symptoms, diagnosis, and iron supplements (March 2025):

 

What is Iron, and why does our body require it?

  • Iron is an essential element. It is a component of hemoglobin (in the red blood cells) and many enzymes in the body.

  • Hemoglobin is a protein in red blood cells. It helps the blood carry oxygen from the lungs to all the body‘s tissues and organs and removes carbon dioxide (a waste product).

  • Hemoglobin is the part of red blood cells that gives blood its red color and enables the red blood cells to carry oxygenated blood throughout your body.

  • It is essential for oxygen transport, respiration, and several biochemical functions.

  • Our body needs iron to produce hemoglobin and myoglobin.

  • More than 70% of Iron is stored in the body in the hemoglobin. About one-third of iron is stored as ferritin and hemosiderin in the bone marrow, spleen, and liver. Only a minor fraction (<1%) circulates in transferrin, the plasma iron carrier.

  • Myoglobin is a protein in our muscles and helps supply oxygen to the cells in our muscles.  

How does the body process iron?

  • Iron is present in many foods and absorbed into the body through the stomach.

  • During this process of absorption, oxygen combines with iron and is transported into the plasma portion of blood by binding to transferrin.

  • From there, iron and transferrin are used to produce hemoglobin, which is stored in the liver, spleen, and bone marrow and utilized as needed by all body cells.

What is Iron deficiency anemia?

  • Iron deficiency anemia is a common blood disorder that affects our red blood cells.

  • It occurs due to a low red blood cell count resulting from a lack of iron 

  • When we don’t have enough iron, our bone marrow can’t make hemoglobin.

  • When we don’t have enough hemoglobin, our blood can’t carry oxygen throughout our body.

  • If you aren't consuming enough iron, or your body is not absorbing iron as needed, or you're losing too much iron. It means that your body can't produce enough hemoglobin, and iron deficiency anemia will eventually develop.

What are the symptoms of iron deficiency anemia?

  • Each individual may experience symptoms differently.

  • Initially, iron deficiency anemia can be so mild that it goes unnoticed. But as the body becomes more deficient in iron and anemia worsens, the signs and symptoms intensify.

  • Iron deficiency anemia signs and symptoms may include:

  • Feeling weakness.

  • Lack of energy or tiring easily (extreme fatigue).

  • Abnormal paleness (pallor) or yellowness or lack of color of the skin.

  • Difficulty in breathing or shortness of breath (dyspnea).

  • Chest pain.

  • Fast or irregular heartbeat (tachycardia)

  • Dizziness or lightheadedness..

  • Headaches.

  • Feeling cold (including the sensation that your hands or feet are colder than usual).

  • Infections (caused by problems with your immune system).

  • Pica (craving for things that aren't food, such as dirt, starch, clay, or ice).

  • Restless legs syndrome (a strong urge to move your legs while you’re in bed).

  • Irritability.

  • Muscle cramps.

  • Inflammation, soreness, or a swollen tongue.

  • Enlarged spleen.

  • Brittle, cracked, or spoon-shaped fingernails and toenails (koilonychia).

  • Hair loss.

  • Cracks near the side of your mouth.

  • Poor appetite, especially in infants and children with iron deficiency anemia.              

The symptoms of iron-deficiency anemia may resemble other blood conditions or medical problems. Always consult your doctor for a diagnosis.

What are the complications of Iron Deficiency Anemia?

Mild iron deficiency anemia usually doesn't cause complications. However, left untreated, iron deficiency anemia can become severe and lead to health problems, including the following:

Heart problems:

  • Your heart must pump more blood to compensate for the lack of oxygen carried in your blood when you're anemic. This causes strain, which can lead to heart failure, irregular or rapid heartbeat, an enlarged heart, or a heart murmur.

  • Giving iron by IV can improve heart failure symptoms. But taking iron by mouth doesn't help. 


Problems during pregnancy:

In pregnant women, severe iron deficiency anemia has been linked to premature births and low-birth-weight babies. However, the condition is preventable in pregnant women who receive iron supplements as part of their prenatal care.


Breath-holding attacks:

Many children who have breath-holding attacks have low iron levels. Taking iron orally reduces the number of breath-holding attacks in children.


Memory and thinking skills (cognitive function):

Taking iron orally might help improve thinking, learning, and memory in children and adolescents with low iron levels.


Restless Legs Syndrome ( RLS):

  • A disorder that causes leg discomfort and an irresistible urge to move the legs (restless legs syndrome or RLS).

  • Taking iron orally or by IV decreases symptoms of RLS, such as leg discomfort and sleep problems.  


Growth problems:

In infants and children, severe iron deficiency can lead to anemia as well as delayed growth and development. Additionally, iron deficiency anemia is associated with an increased susceptibility to infections.

 

Other miscellaneous problems:

  • Brain fog.

  • Depression.

  • A higher risk of infection. This is because your immune system may not be working properly.

  • Motor problems.

What are the causes of Iron deficiency anemia?

Many factors lower the iron supply to the body. Some are listed below:

Blood loss:

Blood loss can lead to iron deficiency anemia because blood holds iron within red blood cells. The more blood you lose, the more iron you lose.

We can lose blood in many ways, including:

  • Heavy bleeding during monthly periods (menstrual bleeding) or childbirth -

Women with heavy periods can become low in iron because they lose blood during their cycle. Heavy periods mean losing blood over a longer period, which can reduce your storage of iron. This iron loss also happens if you have endometriosis, a condition where tissue grows outside of the uterus and can cause heavy bleeding during your period. 

  • Medications -  Nonsteroidal anti-inflammatory drugs (NSAIDs) may cause gastrointestinal tract bleeding. Gastrointestinal bleeding is often caused by the frequent use of certain pain relievers like aspirin. 

  • Some conditions can make you bleed inside your body, including:

  • Peptic ulcer

  • Hiatal hernia

  • Uterine fibroids

  • Colon polyps

  • Inflammatory bowel disease,

  • Celiac disease.

  • Surgeries and traumatic injuries.

  • Bleeding in your urinary tract.

  • Gastrointestinal conditions like esophageal reflux disease.

  • Injuries -  Any injury that causes you to lose blood can cause iron deficiency anemia.

  • Frequent blood donations - Giving blood often can remove iron from your body. If you donate more than 2-3 units a year, you're considered a frequent blood donor. 

  • End-stage kidney failure - If your kidneys aren't working the right way, they can't make erythropoietin, a hormone made by kidneys that helps with producing red blood cells. Having fewer red blood cells affects the ability to carry oxygen throughout your body, which can lead to anemia. Also, if you're getting dialysis for end-stage kidney failure, you can lose blood. Some people with end-stage kidney failure also take medications that can cause iron-deficiency anemia.


Issues with absorbing iron (malabsorption):

Some health conditions and medications can decrease your body’s ability to absorb iron. These may include:

  • Rare genetic disorders that block your intestines from absorbing iron.

  • Endurance sports cause athletes to lose iron through their gastrointestinal tracts.

  • Intestine and stomach surgeries, including weight loss surgery

(Gastrointestinal tract abnormalities) -

  • Iron malabsorption is common after some forms of gastrointestinal surgery. Most of the iron taken in by foods is absorbed in the upper small intestine. Any abnormalities in the gastrointestinal (GI) tract could alter iron absorption and result in iron-deficiency anemia.

  • Surgery such as gastric bypass, which removes part of your intestines, and medicines used to lower stomach acid can also affect your body's ability to absorb iron.

  • Medications: It is found that taking a mix of histamine-2 receptor antagonists and calcium carbonate can also lead to iron deficiency anemia. Proton pump inhibitors, used to control acid reflux, can also prevent your body from absorbing enough iron.

However, more research is needed to confirm the facts.

  • Chronic health conditions: People who have certain long-term conditions involving inflammation can develop Anemia of Chronic Disease (ACD). Such conditions can destroy too many red blood cells. Some chronic conditions that lead to ACD are: 

  • Cancer, including Hodgkin's disease and lymphoma.

  • Autoimmune conditions and inherited blood cell disorders such as rheumatoid Arthritis, Lupus, Ulcerative colitis, Crohn's disease, Celiac disease,  Cystic fibrosis, and chronic pancreatitis can make it harder for the body to absorb iron.

  • Long-term bacterial infections of the stomach, HIV/AIDS, hepatitis B, hepatitis C, or osteomyelitis (a bone infection). 

  • An intestinal or digestive condition such as autoimmune gastritis or inflammatory bowel disease.

  • Anemia can lead to a higher risk of death if you have congestive heart failure.


Body changes such as growth, pregnancy, and lactation:

  • An increased iron requirement and increased red blood cell production are required when the body is going through changes, such as growth spurts in children and adolescents, or during pregnancy and lactation.

  • Pregnancy - When you’re expecting, you need extra iron to nourish your growing baby as well as provide enough for you and the increase in your blood volume. If you don't get enough iron from your diet or supplements, you can become deficient.

  • Also, babies and young children may become iron deficient if they were born prematurely or with a low birth weight and don't get enough iron from breast milk, formula, or foods.


Cancer:

  •  It is found that iron deficiency is common in people with cancer such as Colorectal cancer.


Diets low in iron:

  • Our body gets iron regularly from the foods we eat. If you consume too little iron, over time, your body can become iron deficient.

  • How much iron you need depends on your age and sex. 

  • Iron is obtained from foods in our diet; however, only 1 mg of iron is absorbed for every 10 to 20 mg of iron ingested.

  • Iron deficiency anemia can also happen if our diet doesn't have enough iron.

  • For proper growth and development, infants and children need iron from their diets, too.


Genetics:

  •  A rare condition called iron-refractory iron deficiency anemia is a form of anemia that you can inherit from your parents. Babies with this condition are born with a gene mutation that causes low iron.

  • Congenital dyserythropoietic anemia is a blood disorder that you can inherit that affects your body's ability to make red blood cells, which also can lead to anemia.





Stages of iron-deficiency anemia:

Normally, our body absorbs iron from the foods we eat, and it stores iron so it’s available to make hemoglobin.

Iron-deficiency anemia develops when our body uses the iron stores faster than they can be replaced or when the flow of iron into your system slows.


This occurs in three stages:

First stage -

  •  In the first stage, the iron our body is taking in is less than our body needs. Our iron stores that are needed to make new hemoglobin and red blood cells are being used up.  Iron stores decrease, but our low iron supply hasn’t yet affected our red blood cells.

Second stage -

  •  In the second stage, we develop iron-deficient erythropoiesis. When iron stores are low, our body alters the way it processes red blood cells. Our bone marrow makes red blood cells without enough hemoglobin.


Third stage - 

  • In the third stage, our hemoglobin levels will be below the normal range because we don't have enough iron to make hemoglobin. Our symptoms of iron deficiency anemia would begin at this stage.


Who is prone to Iron deficiency anemia?


Anyone can develop iron-deficiency anemia, although the following groups or conditions have a higher risk:

  • Women: Women in general are at greater risk of iron deficiency anemia as below:

  • Menstruating women (especially if you have heavy periods).

  • Pregnant, after delivery, and breastfeeding women.

  • Frequent blood donors: Low hemoglobin related to blood donation may be a temporary problem remedied by eating more iron-rich foods.

  • A history of major surgery (especially gastrointestinal or weight loss surgery)

  • People who have kidney failure (especially if they are on dialysis) have trouble making red blood cells.

  • Premature babies, infants with low birth weights, and children:

  • Infants, especially those who were low birth weight or born prematurely,

  • Infants who are only breastfed or who drink formula that's not fortified can get anemia. Those who drink a lot of cow's milk also develop it.

  • Children need extra iron during growth spurts. If your child isn't eating a healthy, varied diet, he or she may be at risk of anemia.


  • Vegetarians: People who don't eat meat may have a greater risk of iron deficiency anemia if they don't eat other iron-rich foods.

  • People with certain cancers or heart failure.

  • Age: Children ages 6 months to 2 years, teens, and adults over the age of 65 are most at risk.

  • Lifestyle: This can include exercising a lot (including endurance sports) and not eating enough foods rich in iron.

  • Lead: Lead from water or environmental sources can cause problems in the way of making red blood cells.

  • Family history and genetics: Two inherited diseases, hemophilia and von Willebrand disease, can cause you to bleed more and lose iron.

  • Gender: Girls and women who have heavy periods or are pregnant or breastfeeding need more iron.


How is Iron deficiency anemia diagnosed?

Iron deficiency anemia may be suspected from general findings on a complete medical history and physical examination, such as complaints of tiring easily, abnormal paleness or lack of color of the skin, or a fast heartbeat (tachycardia).


A healthcare provider (doctor or medical specialist) may order one or more of the following blood or other tests to find out if you have iron deficiency anemia.

  • Complete Blood Count (CBC):

The CBC (Complete Blood Count) test provides important information about the blood components, including red blood cells (RBCs), white blood cells (WBCs), and platelets. It is often used as a screening tool to assess overall health, detect various medical conditions, and monitor the effectiveness of treatments.

Human blood comprises components like red blood cells (RBCs), white blood cells (WBCs), and platelets, which are essential for various physiological processes in your body. RBCs are the abundant cells in the blood that consist of a protein called hemoglobin, which helps transport oxygen throughout the body. WBCs form the part of the immune system that helps protect the body against infections and other diseases. Platelets are tiny blood cells that help form clots to stop bleeding after an injury. 


Test components of CBC include:

  • Red Blood Cell (RBC):  The Red Blood Cell Count test measures the total number of red blood cells in your blood. RBCs are the most abundant cells in the blood, with an average lifespan of 120 days. These cells are produced in the bone marrow and destroyed in the spleen or liver. Their primary function is to help carry oxygen from the lungs to different body parts. The normal range of RBC count can vary depending on age, gender, and the equipment and methods used for testing.

  • Mean Corpuscular Volume (MCV) : The Mean Corpuscular Volume test measures the average size of your red blood cells, which carry oxygen through your body. This test tells whether your RBCs are of average size and volume or whether they are bigger or smaller.

  • Mean Corpuscular Hemoglobin (MCH): An MCH test measures the average amount of hemoglobin in a single red blood cell (RBC). Hemoglobin is an iron-containing protein in RBCs, and its major function is to transport oxygen from the lungs to all body parts. This test provides information about how much oxygen is being delivered to the body by a certain number of RBCs.

  • Hemoglobin:  An Hb (Hemoglobin) test measures the concentration of hemoglobin protein in your blood. Hemoglobin is made up of iron and globulin proteins. It is an essential part of RBCs and is critical for oxygen transfer from the lungs to all body tissues. Most blood cells, including RBCs, are produced regularly in your bone marrow. This test shows the amount of this protein in your blood. If you have anemia, your hemoglobin will be low.

  • Peripheral blood smear - This test looks at the size and shape of your red blood cells. In iron deficiency anemia, red blood cells are smaller than usual.

  • Hematocrit - The Hematocrit test measures the proportion of red blood cells (RBCs) in your blood as a percentage of the total blood volume. It is a crucial part of a complete blood count (CBC) and helps in assessing your blood health. The hematocrit test provides valuable information about your blood's oxygen-carrying capacity.

Higher-than-normal amounts of RBCs produced by the bone marrow can cause the hematocrit to increase, leading to increased blood density and slow blood flow. On the other hand, lower-than-normal hematocrit can be caused by low production of RBCs, reduced lifespan of RBCs in circulation, or excessive bleeding, leading to a reduced amount of oxygen being transported by RBCs. Monitoring your hematocrit levels is essential for diagnosing and managing various blood-related disorders.

  •  Reticulocyte count -  This test shows how many reticulocytes (immature red blood cells) you have in your blood. If you have iron deficiency anemia, your reticulocyte count is usually low because you’re not making many new red blood cells.


  • Iron studies including:

  • Serum iron -  An Iron Serum test determines iron levels in the blood and can help diagnose conditions like anemia or iron overload in the body.

  • Ferritin - The Serum Ferritin test measures the concentration of ferritin in the blood. Ferritin is a protein found in cells, particularly in the liver, spleen, and bone marrow, that stores iron in a soluble or nontoxic form. When the body needs iron for essential functions like producing red blood cells and carrying oxygen, it releases iron from ferritin into the blood. The Serum Ferritin test provides valuable information about the body's iron storage levels. Low ferritin levels may indicate iron deficiency, a condition where the body lacks enough iron to function properly. In contrast, elevated ferritin levels can indicate iron overload, a condition known as hemochromatosis. Iron overload can lead to organ damage if not adequately managed, making early detection crucial.

  • Total Iron Binding Capacity (TIBC) - The Total Iron Binding Capacity test measures the ability of your blood to bind and transport iron and, therefore, reflects your body's iron stores. TIBC correlates with the amount of transferrin, a protein, in your blood that helps bind iron and facilitates its transportation in the blood. Usually, about one-third of the transferrin measured is being used to transport iron, and this is called transferrin saturation.

  • Transferrin Saturation  - This test determines an individual’s iron status by using the ratio of serum iron concentration and total iron binding capacity (TIBC) as a percentage. The test tells us how much iron in the blood is bound to transferrin, the main protein in the blood that binds to iron and transports it throughout the body. Under normal conditions, transferrin is one-third saturated with iron, so about two-thirds of its capacity is held in reserve. This test is often employed alongside others to evaluate iron levels and diagnose conditions like iron deficiency anemia if transferrin saturation is low or hemochromatosis (an iron overload disorder) if transferrin saturation is higher than normal.

  • Unsaturated Iron Binding Capacity (UIBC) -  An Unsaturated Iron Binding Capacity test determines the reserve capacity of transferrin, i.e., the portion not yet saturated with iron. The iron-binding capacity of our body can be segregated into two parts – Total Iron Binding Capacity (TIBC) and Unsaturated Iron Binding Capacity (UIBC). UIBC refers to the capacity of transferrin, a protein that transports iron, to bind with additional iron. In easy terms, it represents the available "slots" on transferrin to carry iron molecules. Unlike iron saturation, which assesses the occupied slots, UIBC measures the unoccupied ones.


If blood tests show you have iron deficiency anemia, you might need other tests to see what's causing it. These tests include:


  • Bone marrow aspiration and/or biopsy -  A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells. This test is usually not necessary. 

  • Pelvic ultrasound or uterine biopsy - If you bleed a lot during your monthly periods, this test can find the cause.

  • Upper and/or lower abdomen endoscopy or colonoscopy- These tests may help rule out a source of blood loss. Your doctor uses a tube with a camera on one end to look inside your esophagus or colon. Endoscopy can find bleeding in your GI tract from ulcers, polyps, or other growths.

  • Fecal occult blood test - This test looks for tiny amounts of blood in your poop to check for cancer and other causes of bleeding in your intestines.

  • Urine test - Your doctor may recommend a urine test to see if hemoglobin or blood is in your pee.

A healthcare provider (doctor or medical specialist) can diagnose the problem with the help of levels of these parameters. 


What is the treatment for Iron deficiency anemia?

Specific treatment for iron-deficiency anemia will be determined by your doctor based on:

  • Your age, overall health, and medical history.

  • Extent of the anemia.

  • Cause of the anemia.

  • Your tolerance for specific medications, procedures, or therapies.

  • Expectations for the course of the anemia.

  • Your opinion or preference.


Iron deficiency anemia can be treated by adopting an Iron-rich diet and/or taking iron supplements or IV iron infusion.

Iron-rich diet:

  • We can find iron naturally in many foods. Many food products have also been fortified with iron. 

  • Our body absorbs more iron from meat than it does from other sources.

  • Our body can absorb iron from plant foods better when you eat it with meat, poultry, seafood, and foods that are high in vitamin C.

  • If you choose not to eat meat, you may need to increase your intake of iron-rich, plant-based foods to absorb the same amount of iron as does someone who eats meat.

  • Choose foods containing vitamin C to enhance iron absorption. We can enhance our body's absorption of iron by drinking citrus juice or eating other foods rich in vitamin C at the same time that you eat high-iron foods. 

  • The following foods are high in vitamin C:

  • Oranges

  • Potatoes

  • Red and green peppers.

  • Strawberries

  • Broccoli

  • Grapefruit

  • Kiwi

  • Leafy greens

  • Melons

  • Tangerines

  • Tomatoes


The following foods are rich in iron:

Meat:

Including red meat, lean meat, beef, pork, lamb, liver, and other organ meats.

Poultry:

Including eggs, chicken, duck, turkey (especially dark meat), etc.

Seafood and Fish:

Including salmon, shellfish, sardines, shrimp, clams, mussels, oysters, anchovies, etc.

Vegetables:

Including dark leafy green vegetables, spinach, string beans, potatoes, tomatoes, sweet potatoes, and the cabbage family, such as broccoli, kale, turnip greens, and collards. 

Legumes:

Including lima beans, green peas, dry beans, white beans, kidney beans, peas, pinto beans, black-eyed peas, lentils, canned baked beans, tofu, and tempeh.

Iron-fortified foods, Iron-enriched cereals and other grains:

Including yeast-leavened whole-wheat bread, Whole wheat bread, iron-enriched white bread, rye bread, rolls, pasta, rice, bran cereals, and cereals.

Nuts and dried fruits:

Including peanuts, walnuts, dates, prunes, cashews, apricots, figs, and raisins.


Iron supplements:

  • Iron Deficiency Anemia (IDA) or non-anemic Iron Deficiency (ID)  are managed by oral (and in specific cases intravenous) iron replacement therapy. 

  • The first line of treatment involves oral iron supplementation.

  • Iron supplements can be taken over several months to increase iron levels in the blood.

  • Iron supplements can irritate the stomach and cause discoloration of bowel movements.

  • They should be taken on an empty stomach or with orange juice to increase absorption.

  • They are much more effective than dietary interventions alone.

  • In addition to eating foods that are rich in iron, you may have to take an oral iron supplement.

  • The benefit of an oral iron supplement is that it treats your symptoms by increasing the levels of iron and hemoglobin in your body.

  • The iron in your body is called "elemental iron." Oral iron supplements contain different amounts of elemental iron. When you choose a supplement, be sure to check the label to see how much elemental iron it contains. A greater amount of elemental iron means your body will absorb more iron.

  • Your doctor may treat your iron deficiency anemia in different ways.

  • Only a healthcare provider (doctor or specialist) can recommend a dose based on your iron levels and other health conditions. Taking vitamin C-rich food or supplements along with Iron supplements helps your body absorb the iron.

  • The simplest, least expensive, and most commonly prescribed drug is ferrous sulfate, while other ferrous salts and ferric complexes with polysaccharides or succinylated milk proteins are also widely used.

  • In recent years, novel iron formulations have been developed, such as the lipophilic iron donor ferric maltol or nanoparticle encapsulated sucrosomial® iron.

  • Oral iron supplementation is usually efficacious in correcting iron-deficiency anemia and replenishing iron stores but causes gastrointestinal side effects that reduce compliance.

  • Iron supplements can cause constipation, nausea, vomiting, diarrhea, heartburn, and dark-colored poop.

  • When oral iron supplementation is not suitable due to contraindications, malabsorption, or intolerance, you might need a transfusion of red blood cells. Or, if you have an ulcer, tumor, or other growth, it may need to be treated with medicines or surgery.

  • Intravenous iron therapy can rapidly achieve therapeutic targets without gastrointestinal complications.


Can iron deficiency anemia be prevented?

Yes, you may be able to prevent iron-deficiency anemia if it’s detected and treated early enough. If you’ve already developed iron-deficiency anemia, a healthcare provider can easily correct the condition with treatment.

How can iron deficiency anemia in infants be prevented?

To prevent iron deficiency anemia in infants, feed your baby breast milk or iron-fortified formula for the first year. Cow's milk isn't a good source of iron for babies and isn't recommended for infants under 1 year. After 6 months, start feeding your baby iron-fortified cereals or pureed meats at least twice a day to boost iron intake. After one year, be sure children don't drink more than 20 ounces (591 milliliters) of milk a day. Too much milk often takes the place of other foods, including those that are rich in iron.

What is the best way to take iron supplements?

Only a health care provider (doctor or specialist) can tell you correctly.

Generally, it may be best to take the iron supplement in two or more doses each day.

This way, your body absorbs the greatest amount of iron.

However, it may be advised to take extended-release iron products once a day. 

Which are the best iron supplements?

Only a healthcare provider (a doctor or specialist)  will help you decide what the best iron supplement is for you. 

How much iron supplement is needed to cure the deficiency?

It will depend on the condition of an individual. Only a healthcare provider (a doctor or specialist) can tell the correctly. 

How should I take iron supplements?

  • If your healthcare provider has recommended an iron supplement, use it only as directed.

  • You should take the supplement on an empty stomach. Take your medication at least one hour before or two hours after you eat a meal. Although the supplement works best on an empty stomach, you may want to take it with food so it doesn’t upset your stomach.

  • If you’re using a tablet form, swallow the tablet whole. Don’t try to crush, chew, or break it. 

  • If you’re using a liquid form, measure the medicine carefully. Use a dosing syringe, not a kitchen spoon. Without a measuring spoon, you may not get an accurate dose of the medication.

  • Your healthcare provider may recommend a special diet while you’re taking ferrous sulfate. Follow their instructions precisely.

  • You shouldn't take iron supplements with milk, caffeine, antacids, or calcium supplements.

  • Try to take your iron supplement with vitamin C (for example, a glass of orange juice) to increase absorption.

  • Store the supplement at room temperature, and keep it out of reach of children.

What are the possible ineffectiveness of oral supplements:

It may be ineffective in the following cases:

  • Athletic performance: Taking iron orally doesn't improve athletic performance.

  • Child growth: Taking iron orally does not help a child grow faster.

  • Preterm birth: Taking iron during pregnancy doesn't seem to reduce the risk of preterm birth. It might increase the risk in areas where malaria is common.


What are the common salts used in Iron supplements?

Iron products are preparations of iron taken either by mouth or given by injection to correct iron deficiency in humans.

Various iron salts are used as iron supplements. They include:

Ferrous sulfate,  ferric sulfate, or Ferrous sulfate systemic (Pro):

Brand names include Fe Caps, Feosol Original, Fer-In-Sol, Feratab, Ferrousal, Slow Fe, and Slow Release Iron.


Iron sucrose systemic (Pro):

Brand name: Venofer


Ferric carboxymaltose systemic (Pro):

Brand name: Injectafer


FErumoxytol systemic (Pro):

Brand name: Feraheme


Ferrous fumarate systemic:

Brand names: Ferretts Iron, Hemocyte


Heme iron polypeptide systemic:

Brand name: Proferrin-ES


Ferrous gluconate systemic:

Brand names: Ferate, Fergon.


Iron polysaccharide systemic:

Brand names: Ezfe, Ferrex-150, Hematex, Myferon 150, NovaFerrum 50, NovaFerrum Pediatric, Nu-Iron 150, Poly Iron, ProFe, etc.


Sodium ferric gluconate complex systemic (Pro):

Brand name: Ferrlecit


Ferric derisomaltose systemic (Pro):

Brand name: Monoferric


Carbonyl iron systemic:

Brand names: Feosol Natural Release, Icar, Iron Chews, Wee Care


Iron protein succinylate systemic:

Brand name: Ferretts IPS


Iron dextran systemic (Pro):

Brand name: Infed


Ferrous fumarate/folic acid systemic:

Brand names: Ed Cyte F, Hematinic with Folic Acid.


Ferric pyrophosphate systemic:

Brand names: Triferic, Triferic AVNU


Ferric maltol systemic:

Brand name: Accrufer


Multivitamin with iron and fluoride systemic (Pro):

Brand names: Escavite, MyKidz Iron FL, Poly-Vi-Flor with Iron, Quflora FE


Ferrous ascorbate.

Ferric citrate.

What are the different types of ferrous sulfate?

Ferrous sulfate comes in tablet or liquid form:

  • Tablets: The most common tablet size is ferrous sulfate 325 milligrams (mg). Tablets come in standard or delayed (extended) release formats.

  • Liquid: You can also take ferrous sulfate as a liquid iron supplement. The liquid comes as an elixir or as drops.

Side effects may include constipation, stomach cramps, and other digestive issues.

Only take an iron supplement as directed.

What are Carbonyl iron and heme iron?

  • Carbonyl iron and heme iron polypeptide offer additional options for oral iron supplementation.

  • Carbonyl iron is a form of elemental iron that is generated from vaporized iron pentacarbonyl complexes and is commonly used as a food additive. It is solubilized at a slow rate by gastric fluid, resulting in prolonged absorption.

  • Heme iron polypeptide is produced by enzymatic hydrolysis of bovine hemoglobin.

  • The rationale for its commercialization is the better absorption of heme versus inorganic iron.

  • While pure heme cannot be utilized as an iron supplement because it aggregates into insoluble polymers in the gastric environment, peptides and amino acids produced during the hydrolysis of hemoglobin maintain heme solubility.

What are the side effects of iron supplements?

Taking the appropriate dosage of iron is unlikely to cause any side effects.

Iron supplementation might cause a metallic taste in your mouth or gastrointestinal side effects.

In some instances, however, people taking iron supplements may experience

 the following symptoms:

  • Flatulence

  • Nausea

  • Heartburn.

  • Loss of appetite.

  • Stomach cramps.

  • Diarrhea.

  • Dark poop (stool).

  • Constipation

  • Dark bowel movements

  • Diarrhea

  • Vomiting


Iron supplements can cause constipation, so drink plenty of water. You may need to take a stool softener along with the supplement.

In most cases, these side effects will subside once the body adjusts to the supplement. If someone experiences these side effects and has concerns about them, they can speak to a healthcare professional. They may be able to reduce them by adjusting your iron dosage or regimen.


Having too much iron in the body can also be problematic, as given below:

  • Hemochromatosis, or iron overload disorder, causes iron to build up in the body. Without treatment, iron overload disorder can damage the body’s organs, including the heart, liver, and pancreas.

  • If someone takes more than the recommended dosage of iron supplements, they may develop iron poisoning.

  • If someone suspects that they have taken too much iron, they should seek professional medical advice as soon as possible.


Pregnancy and breastfeeding: 

Iron is likely safe to use while pregnant and breastfeeding in doses below the UL of 45 mg of elemental iron by mouth daily. But iron is likely unsafe when taken by mouth in high doses. If you do not have iron deficiency, don't take more than 45 mg daily. Higher doses can cause stomach side effects such as nausea and vomiting and may even increase the risk for preterm birth.


Children:

Iron is likely safe when taken by mouth in doses below the UL of 40 mg of elemental iron daily. However, high doses of iron are likely unsafe for children. Iron is the most common cause of poisoning deaths in children. Doses as low as 60 mg/kg can be fatal.


Diabetes: 

High iron intake in the diet might increase the risk of heart disease in females with type 2 diabetes. If you have diabetes, discuss your iron intake with your healthcare provider.


Hemodialysis:

Iron from supplements might not be absorbed well in people on hemodialysis.


Hemoglobin diseases:

Taking iron might cause iron overload in people with these conditions. If you have a hemoglobin disease, do not take iron unless directed by your healthcare provider.


Hereditary Hemorrhagic Telangiectasia (HHT):

An inherited disorder that affects the formation of blood vessels.  Taking iron might increase the risk of nosebleeds in patients with HHT. Use with caution.


Premature infants: Giving iron to premature infants with low blood levels of vitamin E can cause serious problems. Low levels of vitamin E should be treated before giving iron. Talk with your healthcare provider before giving iron to a premature infant.


Physical training: 

Iron might not be absorbed as well in young females participating in physical training.


Traumatic Brain Injury: A sudden injury that causes damage to the brain. Iron might worsen swelling of the brain in people with recent brain damage due to injury.


Special precautions and warnings when taken by mouth:

Iron is likely safe for most people when used in doses below the tolerable upper intake level (UL) of 45 mg of elemental iron daily. It can cause side effects such as stomach upset, nausea, and vomiting. Taking iron supplements with food seems to reduce side effects. But food can also reduce how well the body absorbs iron. Doses above the UL should only be used while under medical supervision.

What is the interaction behavior of iron supplements?

Interactions with the following medication may be experienced. You should be cautious with the following medications:

  • Antibiotics (Quinolone antibiotics) interact with Iron:
    Iron can decrease how much of the quinolone antibiotic the body absorbs from the stomach. Taking iron along with these antibiotics might decrease the effects of these antibiotics. To avoid this interaction, take iron 2 hours before or 2 hours after taking antibiotics.

  • Antibiotics (Tetracycline antibiotics) interact with Iron:
    Iron might decrease how much tetracycline antibiotics the body can absorb from the stomach. Taking iron along with these antibiotics might decrease the effects of these antibiotics. To avoid this interaction, take iron 2 hours before or 4 hours after taking tetracyclines.

  • Bisphosphonates interact with Iron:
    Iron can decrease how much bisphosphonate the body absorbs from the stomach. Taking iron along with bisphosphonate can decrease the effects of bisphosphonate. To avoid this interaction, take bisphosphonate at least two hours before iron or later in the day.

  • Levodopa interacts with Iron:
    Iron might decrease how much levodopa the body absorbs. Taking iron along with levodopa might decrease the effects of levodopa. Do not take iron and levodopa at the same time.

  • Levothyroxine (Synthroid, others) interacts with Iron:
    Levothyroxine is used for low thyroid function. Iron can decrease how much levothyroxine the body absorbs. Taking iron along with levothyroxine might decrease the effects of levothyroxine.

  • Methyldopa (Aldomet) interacts with Iron:
    Iron can decrease how much methyldopa the body absorbs. Taking iron along with methyldopa might decrease the effects of methyldopa. To prevent this interaction, take iron at least two hours before or after taking methyldopa.

  • Mycophenolate mofetil (CellCept) interacts with Iron:
    Iron might decrease how much mycophenolate mofetil the body absorbs. Taking iron along with mycophenolate mofetil might decrease the effects of mycophenolate mofetil. But it's not clear if this is a big concern. Until more is known, take iron at least 4 hours before or 2 hours after taking mycophenolate mofetil.

  • Penicillamine (Cuprimine, Depen) interacts with Iron:
    Iron might decrease how much penicillamine the body absorbs. This might decrease the effects of penicillamine. To avoid this interaction, take iron 2 hours before or 2 hours after taking penicillamine.

  • Dolutegravir (Tivicay) interacts with Iron:
    Dolutegravir is a drug used to treat HIV infection. Iron can reduce how much dolutegravir the body absorbs from the stomach. To avoid this interaction, take dolutegravir at least 2 hours before or 6 hours after taking iron.

  • Medications for HIV/AIDS (Integrase inhibitors) interact with Iron:
    Taking iron along with integrase inhibitors might decrease blood levels of these drugs. This might decrease their effects. Talk to your healthcare provider if you are using integrase inhibitors and want to start taking iron.

  • Chloramphenicol interacts with Iron:
    Iron is important for producing new blood cells. Chloramphenicol might decrease the number of new blood cells. Taking chloramphenicol for a long time might decrease the effects of iron on new blood cells. But most people only take chloramphenicol for a short time, so this interaction isn't a big problem.

How soon after treatment will I feel better?

Once your iron levels go up, you should start to feel better.

It depends on the treatment you receive and how low your iron is to begin with. People who take iron supplements may notice a difference in about two to three weeks. If you have iron infusions, you might start to feel better a little sooner.

What’s the Outlook / Prognosis for people with iron-deficiency anemia?

  • The outlook is good with treatment, but your healthcare provider will need to address any underlying conditions that cause iron-deficiency anemia.

  • Iron supplementation is only a temporary fix because it doesn’t address the actual cause.

  • Suddenly becoming iron-deficient might point to conditions like stomach ulcers or colon polyps.

  • In some cases, it can be a sign of gastrointestinal cancer. It’s important to figure out why you’re iron-deficient so you can get the right treatment.

Can iron deficiency anemia be treated naturally?

Eating fortified, iron-rich foods will help to treat iron deficiency anemia.

But if the iron level is too low in the body, it is necessary to consult the healthcare provider to diagnose and recommend iron supplements.

What steps should be taken by people taking a vegan or vegetarian diet to avoid iron deficiency?

If you follow a vegan or vegetarian diet, look for iron-fortified breads and cereals. There are several options for boosting your iron intake, like beans, tofu, dried fruits, and dark leafy greens.

You can also try iron supplements. Always talk to your healthcare provider before adding any supplement to your regimen.

What is the difference between iron deficiency and anemia?

Iron deficiency is having low iron storage in your body that doesn't meet the level that your body needs.

Iron deficiency can cause anemia, which occurs when your body doesn't have enough iron to make healthy red blood cells or hemoglobin.

You can have iron deficiency without being anemic, where your hemoglobin level is normal but your iron is low. 


Summary:

Iron is an important mineral. Most of the iron in the body is found in red blood cells and muscle cells.

Food sources rich in Iron include meat, fish, beans, spinach, and cereal.

Iron helps red blood cells carry oxygen from the lungs to cells all over the body. Iron also plays a role in many important functions in the body.

The amount of iron that someone needs per day varies depending on different factors.

The main causes of iron deficiency anemia are losing blood, having a diet low in iron, being pregnant, and being unable to absorb iron.

Without enough iron, our body can't produce enough of a substance (hemoglobin) in red blood cells that enables them to carry oxygen. As a result, iron deficiency anemia may develop.

If you have any symptoms of iron deficiency anemia, which can include fatigue or weakness, hair loss, fast heartbeat, dizziness, cold extremities, or brittle nails. You are required to consult with a health care provider (a doctor or a specialist) for diagnosis and treatment. 

Iron deficiency anemia is one condition that will require iron supplements.

People experiencing less severe forms of iron deficiency due to pregnancy or blood loss may also need to take iron supplements.

There are 3 stages of iron deficiency anemia.

In the first stage, the iron that your body is taking in is less than what your body needs, but your red blood cells are not yet affected.

In the second stage, you develop iron-deficient erythropoiesis, during which your bone marrow makes red blood cells but without enough hemoglobin.

In the third stage, your hemoglobin levels will be below the normal range because you don't have enough iron to make hemoglobin. Your symptoms would begin at this stage.

Some treatment options include iron supplements or infusions or eating foods rich in iron.

People commonly use iron supplements for preventing and treating different types of anemia caused by low iron levels.

IV (Intra Venous infusion) products can only be given by a healthcare provider.

Iron supplements are also used for heart failure, memory and thinking skills, child development, fatigue, to enhance sports performance, Attention Deficit Hyperactivity Disorder (ADHD), and many other conditions, but there is no good scientific evidence to support most of these other uses.

Some other diseases or health conditions may have similar symptoms. Therefore,  medications without the recommendation of a specialist may be harmful. It is always better to consult and follow the guidelines of a healthcare provider (doctor, specialists, etc).

If your provider recommended you start on iron supplements, make sure to follow their guidance closely.

Iron supplements should be taken as long as your provider instructed. Taking more iron than your body needs can cause serious health issues.

The most common oral iron supplements are ferrous salts with sulfate, fumarate, or gluconate.

Others include ferrous glycine sulfate, bisglycinate, ascorbate, carbonate, tartrate, iodine, chloride, sodium citrate, aspartate, or succinate.

Vitamin C helps the body absorb iron more efficiently, so some manufacturers of iron supplements will add vitamin C to the formulation.

Taking iron supplements may cause some minor side effects while the body is adjusting.

Iron is a vital mineral, but too much of it in the body can lead to poisoning and severe health problems. Iron poisoning is a medical emergency, and if someone suspects that they have taken too much iron, they should seek professional medical help as soon as possible.

IDA (Iron Deficiency Anemia) and non-anemic ID (Iron Deficiency) are the most common pathologies worldwide and remain leading contributors to the global burden of disease.

They cause fatigue and, in severe cases, immunological, developmental, or neurocognitive defects.

ID, with or without anemia, is the most prevalent nutritional deficiency.

ID and IDA primarily affect women of reproductive age or pregnant women, but also children and vulnerable populations in low- and middle-income countries.

In most patients, ID and IDA are etiologically linked to blood loss, except in pregnant women, in whom the causes are the extraordinarily high iron need of the growing fetus and the increase in blood volume (hemodilution).

ID and IDA are also associated with Inflammatory Bowel Disease (IBD), Chronic Kidney Disease (CKD), and bariatric surgery.

In patients with IBD or CKD, ID is often combined with “functional ID”, a condition in which significant quantities of body iron remain sequestered within tissues and cannot be efficiently utilized to support physiological erythropoiesis. This is caused by chronic inflammatory processes, including the induction of hepcidin.


Disclaimer:

The best efforts are made to provide authentic and updated information on Iron Deficiency Anemia. This blog is prepared from the data compiled from various websites, including those mentioned in the blog.

The information given in this blog is only for educational purposes. It is not intended to serve as medical advice and can not replace medical advice in any form.

Always keep in mind that the particular medications and their dosages are decided by the health care provider (doctor or specialist) as per the needs of the individual. It varies from one person to another.

I am not a health professional, and this blog is not AI-generated, instead, it is manually written. Therefore, I do not take any responsibility (legal or otherwise) for its typographical error, correctness, completeness, consequences, etc.

Before following anything from this blog, it is strongly requested to consult a specialist, doctor, or healthcare provider.

https://www.mayoclinic.org

https://my.clevelandclinic.org

https://www.webmd.com

https://www.medicalnewstoday.com

https://www.drugs.com/

https://www.medicalnewstoday.com

https://pmc.ncbi.nlm.nih.gov

https://www.1mg.com

The last line:

  • Take an iron-rich diet as per the need of the body.

  • Iron need varies from one person to another.

  • In case of any suspected symptoms, consult with a healthcare provider.

  • Always follow the healthcare provider's guidelines. Please don't start or stop taking iron supplements on their own.

  • Eat healthy and be happy. 

==The End==


Comments

Popular posts from this blog

USA - Ukraine minerals deal. What is going on? Know all about here:

France - a golden hub for international jobseekers and business creators. How to get a work visa? Know all about here (February 2025):

Health Insurance policies in India. Know, compare, select, and purchase the best and latest for everyone.

Pregnancy - Know about diet, care, and precautions:

India - Personal loan - online with instant disbursal.

Jimmy Carter, U. S. president (1977-1981) - a true human rights supporter to make the world a better place:

Parkinson's Disease [PD]- its symptoms, diagnosis, and treatment (February 2025):

Deepseek- V3 and R1 AI (Artificial Intelligence) assistant chatbot model by China: Why is it a breakthrough for all and a setback to the USA? (February 2025):

Germany - An ultimate destination for international job seekers (2025):