Iron supplements are commonly prescribed to raise low plasma levels of iron and prevent iron deficiency anemia. Anemia is a condition in which the red blood cells cannot transport sufficient iron to meet all the needs of the body. Several factors may reduce the effectiveness of iron supplements as a treatment. If iron levels do not respond to the supplement, underlying health conditions, drug interactions or side effects may be responsible.
Effects
Your doctor should perform blood tests to monitor your red blood cell count, hemoglobin and ferritin levels. In most cases, blood hemoglobin increases within two to three weeks of beginning iron supplementation. The high doses of iron in supplements should raise your hemoglobin level by 0.7 to 1.0 g per dL per week. New red blood cell production should be detected within 7 to 10 days after beginning the supplement. Your plasma ferritin level correlates with the amount of total iron stores in your body. A serum ferritin level of 50 micrograms per dL indicates that the treatment has been effective.
Absorption
Iron supplements are most effective when taken on an empty stomach. Take each dose with a glass of water or fruit juice, and time the doses so they fall one hour before or two hours after a meal. Caffeine, calcium-rich foods and calcium supplements impair the absorption of iron. Certain medications may also block absorption including antacids, H-2 receptor blockers and proton pump inhibitors. In contrast, foods rich in vitamin C improve absorption of iron.
Compliance
The main cause of iron therapy failure is poor patient compliance. More than 25 percent of patients taking iron pills experience side effects. Gastrointestinal distress is among the most common and may include nausea, vomiting, constipation, diarrhea and dark colored stools. Approximately 20 percent of patients discontinue the treatment as a result of side effects. Talk to your doctor about ways to manage or reduce the side effects of iron supplements. A different dosing regimen or a different formulation of iron may improve your symptoms. In addition, intravenous injections are an option for individuals who cannot tolerate oral iron supplements. Talk to your doctor before beginning or discontinuing iron supplementation.
Dosing
A typical therapeutic dose of supplemental iron is 50 to 100 mg of elemental iron three times daily. Doses are often split so you take a small amount several time per day. Because the absorption of iron decreases with higher amounts, this type of dosing schedule should improve your levels faster. The amount of elemental iron in your supplement is the key measurement and will vary among different formulations. For example, 1 g of ferrous gluconate contains 120 mg of elemental iron, while 1 g of ferrous sulfate provides 200 mg of elemental iron.
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