How Many Mg of Iron Do I Need if I Am Anemic?

You can treat iron deficiency anemia by taking iron pills, available over the counter. Your doctor will recommend the best dosage for you based on how serious your anemia is, but the American Society of Hematology recommends between 150 and 200 milligrams of elemental iron per day.

Liver is a great source of iron. Credit: Elena_Danileiko/iStock/GettyImages

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The correct daily iron dosage for anemia is the one recommended by your doctor. It is likely in the range of 2 to 5 milligrams of iron per kilogram of body weight.

Read more: Types of Iron Supplements

What Is Anemia?

The Mayo Clinic describes anemia as a condition where you don't have enough healthy red blood cells in your body to transport oxygen adequately to your muscle tissues.

Iron deficiency anemia is caused by inadequate levels of iron in your body, while vitamin deficiency anemia is caused by a lack of folate and vitamin B12. Anemia can also be caused by bone marrow diseases, inherited conditions like sickle cell anemia and chronic diseases like Crohn's and HIV/AIDs.

Iron deficiency anemia happens when your body lacks enough iron to create the necessary levels of hemoglobin, a substance that helps red blood cells transport oxygen. According to the National Heart, Lung and Blood Institute, symptoms of iron deficiency anemia include:

  • Brittle nails
  • Cracks at the sides of your mouth
  • A swollen or sore tongue
  • Fatigue
  • Dizziness
  • Chest pain
  • Feeling cold in the hands and feet
  • Trouble concentrating
  • Headaches
  • An irregular heartbeat (typically a sign of severe iron-deficiency anemia)
  • Pica, which is when you feel a craving to eat nonfood items like ice or dirt

You are at an increased risk for iron deficiency anemia if you:

  • Menstruate (especially with heavy periods)
  • Are pregnant or breastfeeding
  • Have recently undergone surgery or experienced blood loss from a physical trauma
  • Suffer from celiac disease, ulcerative colitis, peptic ulcer disease or Crohn's disease
  • Have undergone a bariatric procedure like a gastric bypass operation
  • Eat a diet low in iron-rich foods

Read more: The Difference Between Iron Deficiency Anemia & Vitamin Deficiency Anemia

Iron Deficiency and Diet

According to the American Society of Hematology, your body absorbs only a small amount of dietary iron. Cells lining your gastrointestinal tract absorb iron from food and release it into your bloodstream, where a protein called transferrin attaches to it. The iron then travels to your liver, where it is stored as ferritin and released when needed to create new red blood cells.

The Academy of Nutrition and Dietetics recommends a diet rich in iron to prevent iron deficiency. The academy says that your body absorbs two to three times more iron from animal sources than it does from plant-based sources, but eating foods rich in vitamin C with plant-based iron can increase absorption rates. Some sources of dietary iron are:

  • Chicken liver. A 3-ounce serving of cooked chicken liver provides 142 calories, 21 grams of protein and almost 10 milligrams of iron.
  • Beef liver. A 3-ounce serving of braised beef liver contains 162 calories, almost 25 grams of protein and 6 milligrams of iron.
  • Oysters. A 3-ounce serving of Pacific oysters, served raw, provides 69 calories and over 5 milligrams of iron.
  • Fortified breakfast cereal. A 1-cup serving of fortified wheat cereal provides 44 calories and almost 4 milligrams of iron.
  • Clams. A 3-ounce serving of cooked clams provides 126 calories, almost 22 grams of protein and almost 3 milligrams of iron.
  • Spinach. A 1-cup serving of raw spinach provides 7 calories and almost 1 milligram of iron.

The recommended daily iron intake varies depending on your age and sex:

  • Men ages 14 to 18 should consume 11 milligrams of elemental iron daily
  • Women ages 14 to 18 should consume 15 milligrams of elemental iron daily
  • For men ages 19 to 50, 8 milligrams per day are recommended
  • Women ages 19 to 50 should consume 18 milligrams per day
  • Pregnant people should consume 27 milligrams per day
  • Breastfeeding people should consume 9 to 10 milligrams per day
  • Adults over 50 should aim for 8 milligrams each day

Read more: The Best Types of Iron Supplements if Iron Upsets Your Stomach

Iron Supplements for Anemia

Your doctor may recommend iron pills to treat iron deficiency anemia. Iron supplements for anemia are typically available over the counter, and come as pills, liquids or salts. These iron supplements contain different forms of iron, including ferrous sulfate, ferric citrate, ferrous gluconate and ferric sulfate.

According to the Cleveland Clinic, the iron in your body is called "elemental iron," and iron pills contain different dosages of elemental iron. The higher the dosage of the iron supplements, the more iron your body will absorb. "For the treatment of iron deficiency anemia in adults, 100 to 200 milligrams of elemental iron per day has been recommended," the Cleveland Clinic states.

The National Institutes of Health Office of Dietary Supplements explains that ferrous fumarate contains 33 percent of elemental iron by weight, compared to 20 percent in ferrous sulfate and 12 percent in ferrous gluconate.

Read more: How Much Is Too Much Iron Supplement?

Iron Pill Side Effects

Common side effects of iron pills include diarrhea, constipation and nausea. According to the Mayo Clinic, some people may also experience chills, chest pain, dizziness, headaches, a metallic taste in their mouth, abdominal cramps and an increased heartbeat.

Johns Hopkins Medicine recommends taking iron supplements on an empty stomach to increase absorption. However, this can worsen the gastrointestinal side effects, so some people prefer to take their iron supplements with a snack or a small meal. You should avoid taking them with milk, calcium supplements, antacids or caffeine because this can make the iron supplements less effective.

Read more: Can Taking Iron Supplements Make You Gain Weight?

If iron supplements for anemia cause long-lasting side effects, you can speak with your doctor about trying a different form of iron. Some iron pills are available in "gentle" or "slow-release" forms, which may be easier on your stomach and make you less likely to experience diarrhea or constipation.

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