Oral iron supplementation is commonly used to treat iron-deficiency anemia. In Australia, as in many other countries, there are several types of oral iron supplements available. The effectiveness of an iron supplement is largely determined by its ability to increase iron levels in the body, while tolerability refers to how well patients can take the medication without experiencing side effects.
Commonly prescribed oral iron supplements in Australia include:
- Ferrous sulfate: This is one of the most commonly prescribed forms of oral iron. It’s effective, but gastrointestinal side effects (like constipation, nausea, and stomach upset) can be a concern for some people.
- Ferrous fumarate: This is another commonly prescribed form of iron. It generally offers a similar profile to ferrous sulfate in terms of efficacy and tolerability.
- Ferrous gluconate: Compared to ferrous sulfate and ferrous fumarate, ferrous gluconate typically contains less elemental iron per tablet. This might make it more tolerable for some individuals, but larger or more frequent doses might be required to achieve the same iron intake.
- Iron polymaltose complex (Maltofer): This is a type of complexed iron that is generally better tolerated than ferrous salts, with fewer gastrointestinal side effects. Its absorption might be less affected by food, allowing for more flexible dosing. However, it may be less effective at rapidly replenishing iron stores than ferrous salts.
- Liposomal iron: This is a newer form of iron supplementation that’s designed to improve absorption and reduce gastrointestinal side effects. Some studies have shown that liposomal iron is better tolerated than traditional iron supplements.
When choosing an iron supplement, the decision often comes down to balancing efficacy and tolerability. For many people, starting with a standard preparation like ferrous sulfate is effective. However, if they experience side effects, they might switch to another formulation, like iron polymaltose or liposomal iron.
Vitamin C
When vitamin C is taken together with iron supplements, it promotes the conversion of iron to the ferrous form (Fe^2+), which is more soluble and better absorbed in the intestines than the ferric form (Fe^3+). This is particularly relevant for oral iron salts, such as ferrous sulfate, ferrous gluconate, or ferrous fumarate.
For individuals who are taking iron supplements to address iron-deficiency anemia or another medical condition, consuming the supplement with a source of vitamin C (like orange juice or a vitamin C tablet) can optimize iron absorption.
However, it’s essential to consider the following:
- Stomach Upset: Some individuals might find that taking iron supplements with orange juice (a common source of vitamin C) increases stomach upset, a common side effect of iron supplements. In such cases, they might prefer to take vitamin C in another form or separate the iron supplement and vitamin C intake.
- Interactions: Both iron supplements and vitamin C can interact with other medications or supplements. It’s important to be aware of potential interactions and consult with a healthcare provider or pharmacist.
- Balanced Intake: While vitamin C can improve iron absorption, excessive intake isn’t necessarily better. Taking very high doses of vitamin C can lead to side effects and may not provide added benefits in terms of iron absorption.