Iron Pills & Calcium Pills

Iron and calcium are essential minerals that need to be consumed in adequate amounts. Iron is essential for the formation of red blood cells and delivery of oxygen to cells. Calcium is integral for bone and teeth, hormone function, and nerve impulses. If adequate iron and calcium cannot be obtained through dietary sources, then supplemental forms may be needed.

Iron Requirements

According to the Centers for Disease Control and Prevention (CDC), iron deficiency is the most common nutritional deficiency in the United States. Many populations are at risk for iron deficiency including adolescent girls, pregnant and breastfeeding women, and women of child-bearing age. The Institute of Medicine's (IOM) recommended dietary allowance for these high risk populations is 18 mg of iron daily. Due to the large amount of iron needed for high-risk populations, a supplement may be beneficial, but should not exceed the IOM's tolerable upper intake level (UL) of 45 mg a day.

Iron Supplements

Iron supplements are available in three forms: ferrous sulphate, ferrous gluconate, and ferrous fumerate. Iron is available in many different forms including capsules, elixirs, tablets, chewable, and extended release tablets. On the label, elemental iron is the actual amount of iron available for absorption. Iron fumerate typically contains the largest amount of elemental iron and is the least constipating.

Iron Interactions

In order to naturally increase the absorption, iron should be consumed with a vitamin C rich food, juice, or supplement. Due to risk of binding and excretion, foods high in oxalates (plants and teas), tannins (teas and wine), and calcium supplements should not be consumed with iron supplements. Iron should be consumed at least two hours apart from any calcium supplements. The combination of iron and some medications can cause serious side effects. Unless under the supervision of a physician, iron supplements should not be consumed with antibiotics, fosamax, levodopa, methyldopa, penicillamine, and drugs used to treat thyroid conditions.

Calcium Requirements

Between the ages of 25 and 30, individuals begin to lose bone mass. If calcium is not consumed in adequate amounts, osteoporosis can result. The IOM's Adequate Intake for calcium includes 1,300 mg a day for adolescents, 1,000 mg for 19 to 50 years old, and 1,200 mg for adults older than 50. Adolescents need increased calcium for critical bone development while older adults have decreased absorption capabilities. For individuals that do not consume three to four servings of dairy products daily, calcium intake may be less than these recommendations. Due to risk of constipation, bloating, renal damage, and negative calcium deposits, consumers should not consume more than the IOM's UL of 2,500 mg a day.

Calcium Supplements

Calcium supplements are available in multivitamins or sold separately. Forms include calcium carbonate, citrate, citrate malate, phosphate, gluconate, and lactate. Supplements are typically available in doses ranging from 250 to 1000 mg of elemental calcium. Most calcium supplements also contain added vitamin D for optimal bone health. For optimal absorption, the National Institute of Health recommends consuming calcium citrate in doses of 500 mg or less in between meals. Supplement labeling can be misleading because the amount of elemental calcium may not be listed. Consumers can assume carbonate is 40 percent elemental, citrate is 21 percent, lactate is 13 percent, and gluconate is nine percent.

Calcium Interactions

Calcium supplements can interfere with a variety of medications including salicylates, biphosphonates, tetracyclines, thyroid hormones, ciprofloxacin, and sotalol. On the other hand; medications such as anticonvulsants, cholestyramine, corticosteroids, mineral oil, and laxatives can interfere with calcium levels. Fiber components including phytic acid from wheat products and oxalic acid in spinach can interfere with calcium absorption. Calcium competes with fluoride, iron, zinc, and magnesium for absorption; thus should always be consumed in safe levels and not with other supplements.