Your red blood cells need iron and folic acid to function properly. If you don't get enough iron or folic acid from your diet, you can take supplements. You can find supplements that combine folic acid with iron, or take the two separately as needed.
You can safely take iron and folic acid at the same time, either in a supplement combining the two or from separate sources. Just know that supplementary iron can cause digestive side effects, and some foods make it less effective.
Iron and Folic Acid
Iron and folic acid are two nutrients your body requires, and you can get synthetic supplements of both iron and folic acid. Folic acid, also called folate, is a B-vitamin that helps your body make red blood cells. It's found in foods like dark green leafy veggies, beans, nuts and some fruits.
Iron is a mineral used in hemoglobin, the protein in red blood cells that helps transport oxygen from your lungs to your organs and tissues. Dietary iron is found in two different forms: Heme iron, from animal products like meat and seafood, and nonheme iron from plant sources.
The Mayo Clinic says that the recommended daily intake of folic acid is 400 micrograms for adults, and that people planning to get pregnant should aim for 400 to 800 micrograms per day. According to the National Institutes of Health, the recommended daily intake of iron is:
- 11 milligrams for men ages 14 to 18
- 15 milligrams for women ages 14 to 18
- 8 milligrams for men ages 19 to 50
- 18 milligrams for women ages 19 to 50
- 27 milligrams for pregnant people
- 9 to 10 milligrams for breastfeeding people* 8 milligrams for adults over 51 years of age
Read more: How Much Is Too Much Iron Supplement?
Iron and Folic Acid Deficiencies
If you have a shortage of iron or folic acid, you might develop anemia. Iron-deficiency anemia is the most common type of anemia, and it can be caused by a lack of iron in the diet, sudden blood loss, a heavy menstrual cycle or conditions like Crohn's disease and celiac disease that make it difficult for your body to absorb nutrients. Iron deficiency affects your red blood cells, limiting the amount of oxygen your body can transport to the places where it's needed.
Johns Hopkins Medicine explains that low levels of folic acid caused by your diet can cause a condition called megaloblastic anemia. People with megaloblastic anemia have larger blood cells that are oval-shaped instead of round. There are also fewer red blood cells overall, and the cells that typically live for about 120 days sometimes die sooner than red blood cells should.
The symptoms of both iron-deficiency anemia and megaloblastic anemia include shortness of breath, weakness, dizziness, fatigue, headaches, feeling cold in your hands and feet, trouble with focus and concentration and pale skin.
Taking Supplemental Iron
According to Michigan Medicine, there are some forms of iron that your body absorbs more easily than others. Ferrous sulfate, ferrous gluconate, ferrous ascorbate and ferric ammonium citrate are easily absorbed.
Each type of iron contains a different amount of "elemental iron" — the amount your body absorbs. Ferrous fumarate contains 33 percent elemental iron by weight, ferrous sulfate contains 20 percent and and ferrous gluconate contains 12 percent.
So, when you're looking for the best supplement to fit your needs, check out what type of iron it contains. For example, ferrous sulphate and folic acid combined, ferrous ascorbate and folic acid tablets or ferrous fumarate and folic acid combined.
The World Health Organization recommends taking a daily iron supplement like ferrous sulfate and folic acid if you're pregnant or planning to become pregnant. They recommend a supplement of 30 to 60 milligrams of elemental iron and 400 micrograms of folic acid.
A daily iron supplement can prevent pregnant people from developing anemia, decreases the likelihood of a premature birth or low birth weight and also helps decrease the likelihood of birth defects such as a neural tube defect or spina bifida.
Combining Iron and Folic Acid
Some supplements combine iron and folic acid to combat low levels of each. You can also get separate supplements. Those with iron are best taken on an empty stomach or with food containing vitamin C to help with absorption.
However, you may find that taking iron supplements on an empty stomach causes side effects like nausea, in which case you can take the supplement with food. Just avoid calcium or caffeine because these can interfere with absorption.
Supplements that combine iron and folic acid come in a variety of formulations:
- One serving of Nutrilite Iron Folic contains 30 milligrams of vitamin C, 200 micrograms of folic acid, 10 milligrams of iron and 35 milligrams of dehydrated spinach.
- One serving of Bronson Vitamins Folic Acid With Iron for Active Women contains 666 micrograms of dietary folate equivalents (DFE) and 18 milligrams of iron.
- One serving of the Vitamin Shoppe MegaFood Blood Builder With Whole Food Iron & Organic Beet Root contains 15 milligrams of vitamin C, 400 micrograms of folate, 30 micrograms of vitamin B12, 26 milligrams of iron and 125 milligrams of beetroot.
Iron Supplement Side Effects
According to Harvard Health, iron supplements can trigger gastrointestinal issues such as nausea, diarrhea and constipation. The site recommends starting with a low dose and slowly increasing it to your preferred amount. If you're taking a combined supplement, like ferrous sulphate and folic acid or ferrous ascorbate and folic acid tablets, you may still experience side effects from the dietary iron.
Read more: Side Effects of Iron Tablets
The Mayo Clinic says that although side effects from taking folic acid are rare, they are possible. If you experience any of the following side effects after taking folic acid or a supplement like ferrous ascorbate and folic acid tablets, be sure to contact your doctor right away:
- Feeling generally weak or uncomfortable
- Shortness of breath
- Feeling itchy, or experiencing a skin rash or reddened skin
- Difficulty breathing
- A tight feeling in your chest
- Harvard Health: "Iron and Your Health"
- Johns Hopkins Medicine: "Folate-Deficiency Anemia"
- National Institutes of Health: Office of Dietary Supplements: "Iron"
- Mayo Clinic: "Folate (Folic Acid)"
- University of Rochester Medical Center: "What Are Red Blood Cells?"
- Amway: "Nutrilite™ Iron Folic"
- Bronson Vitamins: "Folic Acid With Iron for Active Women: Supplement Facts"
- Vitamin Shoppe: "MegaFood: Blood Builder With Whole Food Iron & Organic Beet Root: Supplement Facts"
- University of Michigan: Rogel Cancer Center: "Why Is Iron Important in My Diet?"
- World Health Organization: "WHO Recommendation on Daily Oral Iron and Folic Acid Supplementation"
- Mayo Clinic: "Folic Acid (Oral Route, Injection Route)"