Supplements in practice - iron

Question 1

Iron

Answer 1

Ferrous salts (ferrous fumarate, ferrous sulphate, and ferrous gluconate) are the best absorbed iron supplements.

Question 2

Iron Forms: Ferrous citrate:

Answer 2

Well absorbed and generally tolerated well.

Question 3

Iron Forms: Ferrous fumarate:

Answer 3

Well absorbed but may inhibit the absorption of vitamin E.

Question 4

Iron Forms: Ferrous sulphate:

Answer 4

Orthodox version of iron; most studied form.
Can cause nausea and constipation.
May interfere with vitamin E absorption.
Higher dosages may be given than other forms.

Question 5

Iron Forms: Ferrous bisglycinate:

Answer 5

Chelated iron that is claimed by its manufacturers to be highly bioavailable and without the adverse effects of ferrous sulphate (gut).

Question 6

Iron Forms: Ferrous lactate (Iron II lactate):

Answer 6

Derived from the action of lactic acid on iron fillings; can be vegan or animal derived. In fortified foods and baby formula.

Question 7

Caution:

Answer 7

• Overdosing iron is toxic in children; can be fatal.
• Has pro-oxidant effects —can cause free radical damage. It also feeds bacteria ― avoid in GI bacterial overgrowth.
• Always check serum ferritin and transferrin levels before supplementing. With males, beware of haemochromatosis.
• A minor overload of manganese can exacerbate iron deficiency. Having too little can also cause problems. Consider levels of other minerals before supplementing.

Question 8

Drugs interactions:

Answer 8

• Thyroxine, levodopa, tetracyclines, fluoroquinolones, penicillamine.

Always check your drug / herb / nutrient interactions guide. www.theanp.co.uk/herb-drug-nutrient

Question 9

Adverse reactions:

Answer 9

Iron adverse reactions include:
* Nausea, diarrhoea, constipation, heartburn, upper gastric pain.
* Taking with food seems to decrease adverse effects.
* Toxicity: Organ damage and death.
* Toxicity is more common in conditions such as:
o Haemosiderosis: Overload of iron in organs or tissues.
o Haemochromatosis (iron overload) ― often genetic condition causes the body to absorb more than normal.
o Thalassaemia and sideroblastic anaemias.