When we think about the classic vitamins and minerals the public is encouraged to supplement in case of deficiency, we think of micronutrients like calcium, vitamin D, and iron supplementation. Iron is vital to blood as it plays an important role in hemoglobin formation and production in red blood cells. However, iron supplements may come with a side effect — constipation. In this article, we'll explore the link between iron supplements and constipation: why it may happen, strategies for relieving symptoms, and other ways to increase and maintain adequate iron intake levels.
Understanding iron and its benefits
Iron is what is considered an 'essential mineral' in the human body. It helps carry oxygen throughout the body and is involved in the maturation of red blood cells. The two main naturally occurring forms of iron are heme and non-heme iron. In the human body, however, iron is stored as ferritin and hemosiderin. Ferritin and hemosiderin are primarily stored in the liver, spleen, and bone marrow, the latter of which is where we begin to understand how critical iron is to overall health.
Within the bone marrow, elemental iron is critical to the body's synthesis of hemoglobin. Hemoglobin is a protein found in red blood cells, responsible for transporting oxygen throughout the body and for transporting carbon dioxide for removal, a waste product that may cause toxicity if left to linger in the bloodstream. Hemoglobin does this by transporting the carbon dioxide to the lungs.
Different populations may experience iron deficiency for different reasons. Iron can be absorbed into the body by the intake of foods such as red meat, beets, dark green leafy vegetables, and certain nuts and seeds, with the deficiency occurring with the lack of such foods in the diet. However, not all iron deficiency is diet-related. As a solution to deficiency or anemia, iron supplements — both in pill or liquid form — are often recommended.
Without adequate amounts of iron, the bone marrow cannot produce enough hemoglobin, leading to a condition known as iron deficiency anemia. This condition results in decreased oxygen transport, potentially causing fatigue, weakness, and in some cases severe complications if left unmanaged.
Iron deficiency anemia: why an iron supplement might be needed
Iron deficiency happens when your body doesn't absorb enough iron from the regular diet. When there is not enough iron in the body, red blood cells are poorly produced. People with iron deficiency may experience potential symptoms like pale skin, restless leg syndrome, fatigue, lower blood pressure, and dizziness. Iron deficiency can be discovered using a blood test and can affect anyone, but certain groups are more susceptible due to increased physiological demands or reduced dietary intake.
Individuals experiencing these symptoms are usually recommended to take iron in the form of dietary supplements to manage iron deficiency anemia. Unfortunately, not all iron supplements are created equally, and more iron doesn't necessarily mean fewer symptoms; some iron supplements may have gastrointestinal side effects in some people.
Constipation as a side effect of iron supplements
Iron supplements may cause constipation and gastrointestinal system discomfort — including stomach cramps, stool hardening, and bloating — when the excess iron is not absorbed properly by the body. Oral iron supplementation often means consuming ferrous sulfate, one of two types of recommended iron supplements. Ferrous sulfate supplementation is widely understood to be the optimal way for those with iron deficiency anemia to get iron. It may be taken as iron tablets or as a liquid iron supplement.
It is typically recommended to take ferrous sulfate iron supplements on an empty stomach. When you take oral iron supplements on a full stomach, certain dietary components may inhibit the absorption rates of iron by reducing its solubility and bioavailability. Because of it, iron may linger in the gut and may potentially negatively impact your bowel movement. This excess iron can slow down the movement of food through the gastrointestinal tract and potentially harden the stool.
Certain symptoms may occur from iron supplementation, especially oral iron supplements, which include reduced regularity of passing stool, stomach cramps, muscle straining, hardened or painful stool, and bloating.
Who's more at risk?
Groups most at risk for iron deficiency, or potentially in need of a higher iron intake, include:
- Individuals of childbearing age
- People who are menstruating
- Those who experience regular blood loss
- Children undergoing rapid growth that requires higher levels of iron for tissue and red blood cell development
- People with gastrointestinal issues that may prevent iron absorption
- Individuals with certain chronic conditions, such as Chron's disease or cancer
- People who follow vegetarian diets that are not diversified enough to make up for the absence of animal-based nutrients
Finding relief: strategies for addressing constipation
Individuals taking iron supplements can do a number of things to support iron intake and reduce the risk of constipation. Dietary adjustments and exercise regimens may help alleviate the potential stomach issues associated with managing anemia. Speak with your doctor to determine which adjustments are suitable for you.
Tailor your diet
Eating fiber-rich foods and whole grains can act as a stool softener and support regular bowel movements. Outside of taking it on an empty stomach, iron is best absorbed alongside vitamin C. Vitamin C-rich foods like orange juice, citrus, or other fruits alongside iron intake can help manage iron deficiency anemia, while dietary fiber may help in managing constipation symptoms that come from the additional iron in your gut.
Daily hydration
Drinking plenty of water is important for digestion and preventing dehydration, which can naturally worsen constipation. To avoid constipation,
take iron supplements with water. Some people may consider liquid iron supplementation. Generally, it is recommended to aim for 6–8 cups or glasses of fluid per day; however, the recommendations may vary depending on physical activity, environment, and individual needs.
Regular exercise
Regular physical activity may support digestion. You don't have to have a complicated gym regimen. Running, yoga, and walking may all help manage the constipation you might experience from taking the supplements.
Laxatives and stool softeners
If there are no other options, some people may consider taking gentle prescription or over-the-counter laxatives under the guidance of a healthcare professional for potential short-term relief. Some might prefer natural laxatives instead. These may include prune juice or psyllium husk dietary supplements. Natural laxatives may be gentler on the stomach.
Avoid pairing with dairy
Calcium supplements are known for blocking the likelihood of absorbing oral iron and reducing its potential effects. Avoid dairy or calcium supplements at the same time as taking iron supplements. It's crucial for individuals experiencing severe or persistent constipation to talk to a healthcare professional before making further changes to their diet or oral supplementation.
Final word
Iron is crucial for overall health, but taking it as an oral supplement may potentially disrupt your gut microbiota, harden the stool, and increase the risk of constipation and stomach cramping. It is also important to explore different ways to include iron naturally. This amazing mineral occurs in a variety of foods.
Additionally, different brands of supplements may have different effects on individuals. If you think you should take iron supplements, consult with your doctor first and make sure you're being proactive about potential symptoms of constipation that tend to be associated with iron supplementation.
FAQ
Why take iron supplements?
Iron is important for the development of hemoglobin in the blood. When people have low levels of iron in their body, they may experience symptoms like fatigue, dizziness, restless legs, and paleness. Often, iron supplements in the form of ferrous sulfate may be taken as tablets or in liquid form to manage potential symptoms.
Does iron affect bowel movements?
In some instances, oral iron supplements taken to manage iron deficiency anemia may cause constipation. When not properly absorbed by your body, iron may harden the stools and result in stomach cramps and muscular straining.
How do I avoid constipation when taking iron supplements?
Start by considering your diet. Eat fiber-rich foods such as fruits, vegetables, nuts, and whole grains. Regular aerobic exercises like swimming, running, and cycling, along with drinking plenty of water, can also help. If these strategies don't work, consider consulting with your healthcare provider. Additionally, avoid taking iron supplements with foods rich in calcium.
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Iron is a mineral vital to blood health. It plays an important role in the formation and production of hemoglobin. Hemoglobin is a protein found in red blood cells that is primarily responsible for transporting oxygen throughout the body and helping to remove carbon dioxide.
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To combat iron deficiency, iron supplements in the form of liquid or tablet ferrous sulfate are recommended.
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One potential side effect of taking ferrous sulfate supplements is constipation. This happens when iron is not correctly absorbed into the body and instead lingers in the intestines. Symptoms include stomach cramps, straining, and gastrointestinal discomfort.
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To avoid constipation caused by iron supplements, you can adjust your diet to include fiber-rich foods and vitamins that help with iron absorption, introduce gentle exercise into your routine, or take over-the-counter or natural laxatives to soften your stool.
4 resources
- National Library of Medicine. Iron supplementation.
- MDPI. Oral iron supplementation—gastrointestinal side effects and the impact on the gut microbiota.
- Missouri Medicine. Constipation: evaluation and management.
- National Library of Medicine. Constipation.
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