Iron Supplements

Iron supplements are used in medicine to treat iron-deficiency anemia.

First, it must be clear that iron deficiency and not another factor (e.g. chronic, low-grade, undetected blood loss such as fecal occult blood) causes the anemia. Preventive measures must be discussed with the patient.

Another indication for giving extra iron is the second and third trimester of pregnancy, generally in association with folic acid. Indeed, in some condition like growth, menstruation and pregnancy, the body’s need for iron is increased. Supplements may be needed to reach RDA life goals.

Iron can be supplemented using various pharmacological forms, such as iron(II) sulphate or sulfate (this is the most common and cheapest salt, e.g. Feratab, Fer-Iron, Slow-FE,…) and in complex with gluconate, dextran, carbonyl iron, and other salts. Sometimes ascorbic acid is added for better absorption.

Generally, iron supplementation therapy is an oral therapy, and parenteral iron therapy (intravenously or intramuscular) is only given when resorption is seriously compromised (by illnesses, or when the patient cannot swallow) and benefit from oral therapy cannot be expected. It is more expensive and less healthy.

Since iron stores in the body are generally depleted, and there is a limit to what the body can process (about 100mg per day) without iron poisoning, this is a chronic therapy which may take 3-6 months. In some conditions (e.g. after gastrectomy), in which there is production ofintrinsic factor by the parietal cells of the stomach is complicated), even permanent iron substitution is necessary.

Patients at risk of acute complications may be candidates for transfusion. Patients with anemia of chronic disease may benefit fromerythropoietin.

Side effects of therapy with iron are most often diarrhea or constipation and epigastric abdominal discomfort. Taken after a meal, side effects decrease but there is an increased risk of interaction with other substances. Side effects are dose-dependent, and the dose may be adjusted.

The patient may notice that his/her stools become black. This is completely harmless, but patients must be warned about this to avoid unnecessary concern. When iron supplements are given in a liquid form, teeth may reversibly discolor (this can be avoided through the use of a straw). Intramuscular injection can be painful, and brown discoloration may be noticed.

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