For many reasons, mental health clinicians are involved at times in recommending iron supplements. We may identify iron deficiency during:
– Routine laboratory testing
– Evaluation of restless legs syndrome
– Evaluation of antipsychotic-induced akathisia
– Evaluation of unexplained fatigue.
– Evaluation of hair loss, before concluding it is due to a medication that we prescribed
Of course, we must also refer these patients to their primary care clinician in evaluating and treating the underlying condition.
In recommending iron supplements, so many different instructions need to be given that I thought that it might be helpful to just list them in one place. Below, we’ll cover everything I know about the WHEN and the HOW of taking an iron supplement.
WHEN to take iron supplements
1. Take the iron supplement on alternate days.
This is now recommended because it can improve tolerability AND, paradoxically, lead to more iron being absorbed compared to if the iron is being taken daily.
2. Ideally, take the iron supplement on an empty stomach.
Iron is better absorbed on an empty stomach. But, because there are so many things that are best avoided around the time that the iron supplement is taken (as listed below), taking the iron supplement at the ideal time and in the ideal way can be confusing. Here is a simple way to think about when to take the iron supplement:
– In between any two meals that are at least 4 hours apart.
– Closer to the second of those two meals (because of the next instruction below).
– Of those two meals, at least two hours after the first AND at least one hour before the second.
– With nothing else (food, beverage, or medication) being taken between the two meals except for the beverage and vitamin C source that is being taken with the iron supplement as described below.
If the iron supplement bothers your stomach when taking it on an empty stomach, here are some things that you could do:
– If not already doing so, take the iron supplement on alternate days.
– Switch to a form of iron supplement that is less likely to bother your stomach. One good choice may be iron protein succinylate. The brand of iron protein succinylate tested and approved by Consumer Lab is the following:
– Lower the dose. Side effects of iron supplementation are generally dose-related.
– If these options don’t work or are not feasible, you can switch to taking the iron supplement with food. But, if you do this, make sure to avoid or minimize taking it with foods and beverages that can reduce its absorption (see below).
HOW to take iron supplements
While taking the pills
1. Take iron supplement pills with a full glass of water (or orange juice) to make sure they get completely washed down into the stomach
2. With 150 to 500 mg of vitamin C (if the iron is not being taken along with a vitamin-C-containing beverage), even though it is not clear how much this improves absorption of the iron.
3. After taking an iron supplement, to reduce the risk of acid reflux, don’t lie down for at least 30 to 60 minutes after taking the iron.
Before and after taking the pills
For at least 2 hours before and after taking an iron supplement, avoid taking any of the following foods, beverages, and medications that can interfere with the absorption of iron:
– Milk or other dairy products
– Antacids that contain calcium
– Caffeine-containing beverages, including coffee, tea, so-called “energy drinks”, soda, chocolate
– High-fiber foods like whole-grain cereals and raw vegetables.
Disclosure: The link above is an Amazon affiliate link. Buying products from Amazon.com using links on this website helps to support this website at no additional cost to the purchaser. But, we still want to be fully transparent about this.
Copyright © 2021, Simple and Practical Medical Education, LLC. All rights reserved. May not be reproduced in any form without express written permission.
Disclaimer: The content on this website is provided as general education for medical professionals. It is not intended or recommended for patients or other laypersons or as a substitute for medical advice, diagnosis, or treatment. Patients must always consult a qualified health care professional regarding their diagnosis and treatment. Healthcare professionals should always check this website for the most recently updated information.