Iron Supplements Linked to Constipation: Exploring Research Findings
In some cases, people who take iron supplements may experience constipation. This condition is characterised by hard stools that are difficult to pass and fewer than three bowel movements a week [1]. If you find yourself in this situation, it is essential to consult a doctor for advice and potential treatment options.
The Food and Drug Administration (FDA) has noted that iron supplements may cause constipation [2]. The reason behind this side effect is not fully understood, but it's believed that iron's difficulty in absorption and the unabsorbed iron in the gut can disrupt digestive motility and feed harmful bacteria, leading to constipation [1][2][3].
Fortunately, there are strategies to manage iron-induced constipation. One approach is to change the iron formulation. Switching from ferrous sulfate (higher elemental iron) to forms like ferrous gluconate (lower elemental iron) can help reduce constipation severity [1].
Another option is to reduce the dose. Taking smaller doses may lessen gastrointestinal side effects while still improving iron status [1]. Additionally, considering slow-release iron formulations may reduce constipation, although it might also lower absorption effectiveness because iron release occurs beyond the primary absorption site in the duodenum [1].
Beyond adjusting the iron formulation, general approaches such as increasing dietary fiber, adequate hydration, and physical activity are commonly recommended to alleviate constipation caused by medications, including iron supplements [5]. If oral iron causes intolerable GI symptoms, intravenous iron can be an alternative to avoid constipation and other GI side effects [2].
It's important to remember that everyone's health history is unique, and tailored adjustments can balance iron absorption needs and side effect management. For example, depending on an individual's health history, doctors may recommend biofeedback therapy or surgery for constipation [6].
The daily upper limit of iron from all sources for adults should not be exceeded [7]. Eating more fiber, staying physically active, and drinking plenty of water may help manage constipation [8].
It's worth noting that people with certain medical conditions, such as hemochromatosis, should not take iron supplements [9]. Pregnant or nursing people may take iron supplements under a doctor's guidance, but should seek further advice if they become constipated [10].
Lastly, it's crucial to remember that gastrointestinal side effects, such as constipation, abdominal pain, and bloating, may occur in up to 60% of people who take iron supplements [11]. If you experience constipation after starting iron supplements, consult your healthcare provider for advice and potential treatment options.
References:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135463/ [2] https://www.fda.gov/drugs/drug-safety-and-availability/iron-supplements-what-consumers-should-know [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707625/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073750/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7135463/ [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073750/ [7] https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/ [8] https://www.mayoclinic.org/diseases-conditions/constipation/in-depth/constipation/art-20047872 [9] https://www.mayoclinic.org/diseases-conditions/hemochromatosis/symptoms-causes/syc-20366155 [10] https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/iron-supplements-during-pregnancy/faq-20068099 [11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073750/
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- Strategies to manage iron-induced digestive disorders include adjusting the iron formulation and general approaches such as increasing fiber, adequate hydration, and physical activity.
- Intravenous iron can be an alternative to avoid constipation and other gastrointestinal side effects caused by oral iron supplements.
- Tailored adjustments, based on an individual's health history, can balance iron absorption needs and side effect management, including biofeedback therapy or surgery for constipation.
- The daily upper limit of iron from all sources for adults must not be exceeded to avoid potential health issues.
- Increasing fiber, staying physically active, and drinking plenty of water may help manage constipation caused by various factors, not just iron supplements.
- People with specific medical conditions like hemochromatosis should avoid taking iron supplements.
- Pregnant or nursing individuals may take iron supplements under a doctor's supervision, but they should seek additional advice if constipation occurs.
- Gastrointestinal side effects, including constipation, abdominal pain, and bloating, are common in up to 60% of people who take iron supplements.
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