Q: My granddaughter just started taking iron tablets, 325 mg each morning. Every time she takes one, she gets sick. Does it have to do with the iron? I take them and I don’t get sick. If she stops taking them, she is fine.
A: Iron is a mineral necessary for transporting oxygen and carbon dioxide, and for a number of other purposes. My guess is that your granddaughter is iron deficient and may even have iron deficiency anemia, a condition in which there are not enough red blood cells to carry sufficient oxygen throughout her body. Supplements are available in tablets, capsules, chewable tablets and liquid forms, with the most common strength being 325 mg.
Iron is absorbed best by many individuals when taken on an empty stomach; however, some individuals develop stomach cramps, diarrhea and nausea when following this protocol. If she falls into this category, she might try to take the supplement with a small amount of food. Also, she should not drink milk, take antacids or calcium at the same time and should wait at least two hours before taking an iron supplements. Food may impair absorption of nonheme iron but this effect may be minimized by concurrent administration of vitamin C. Liquid Feosol is a liquid that might be attempted in small amounts until her symptoms are acceptable.
There are a number of reasons why a person may be iron deficient. She may experience heavy menstrual cycles, be a vegan, or a vegetarian. Vegetarian diets are low in heme iron; however careful planning of her meals can increase the amount of absorbed iron. If she is taking an excess amount of antacids for acid reflux or peptic ulcer disease, this will also reduce amount of absorbed iron in her system.
Signs of iron deficiency include difficulties maintaining body temperatures, glossitis (tongue inflammation), fatigue, weakness, and having low immune function that increases a person’s susceptibility to infection. Constipation and diarrhea are rather common when an iron supplement is taken, as are dark stools. Diagnosis is made through lab work that might include a complete blood count, serum ferritin, hematocrit, and heoglobin.
There are two forms of dietary iron – heme and non-heme. Heme iron comes from hemoglobin, the protein in red blood cells that transports oxygen to cells. Heme iron is found in red meats, fish, and poultry. Plant-based iron, on the other hand is known as non-heme iron and is contained in oatmeal, beans, tofu canned spinach, raisins, bread and a host of other products. Heme iron is absorbed better in the system than is non-heme. The key to boost her levels is to eat a healthful diet that includes fresh fruits and vegetables high in vitamin C, whole grains, lean meats, fish, eggs, nuts, and to drink fat-free or non-fat milk. The C will help her body absorb the non-heme iron foods she eats. I don’t know how old your granddaughter is but females between the ages of 14 and 18 should consume 15 mg of iron daily; those between the ages of 19 and 30 should consume 18 mg daily. Food sources high in iron include one ounce of fortified cereal at between 1.8 to 21.1 mg, a packet of instant breakfast cereal at between 4.9 and 8.1 mg per serving, one half cup spinach at 3.2 mg, one tablespoon blackstrap molasses 3.5 mg, and while not everyone’s favorite, one ounce of canned clams contain a whopping 23.89 mg.
She should speak with her physician to determine if incorporating some of the foods mentioned above might help bring her iron level back to normal without having to take a supplement. In this way she won’t experience the symptoms she is.
Other readers who would like related information can order Dr. Gott’s Health Report “Vitamins and Minerals” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
