Oral iron supplementation

Ask the Pharmacist

By Jason E Cridge R.Ph. B.Sc. (Pharm)

Iron is an important element for our bodies. It's used in a protein called hemoglobin which is responsible for delivering oxygen from your lungs to the rest of your body. Low iron can mean a reduction in hemoglobin which in turn means reduced oxygen carrying capacity in your blood. This can result in fatigue, depression, impaired cognitive function, pale skin...etc.

Iron deficiency is the most common nutritional disorder in Canada, affecting up to 11% of women and 4% of men. If you suspect that you may have iron deficiency talk to your doctor; a simple blood test can confirm your suspicion.

There are two main types of iron that our body can absorb: heme iron and non heme iron. Heme iron is found in animals, and the iron molecules are surrounded in protein. This is the easiest iron for our bodies to absorb and is primarily found in liver, lean red meats, oysters, clams, tuna, salmon, sardines and shrimp. Non-heme iron is found primarily in plants (legumes, grains, nuts, vegetable, etc). Non-heme iron is harder for our bodies to absorb, which usually leads to vegetarians and vegans having lower stores of iron than omnivores.

If you have been diagnosed with iron deficiency you will most likely need to take an iron supplement to return your iron to its normal levels. Although iron rich foods can be good at maintaining your iron at appropriate levels, they aren't usually potent enough to correct a deficiency.

When starting iron supplementation, the target dose is between 100mg-200mg of elemental iron per day. The three main groups of iron supplements are

Iron Salts- ferrous gluconate, ferrous fumarate, and ferrous sulfate

Advantages to these irons are they are by far the least expensive. Disadvantages are that some may have to be taken 2 – 3x per day to achieve the 100mg-200mg daily recommended dosage, and they must be taken on an empty stomach. However, they may cause nausea, constipation and black stools

Feramax (Iron polysaccharide)

Feramax is a unique iron supplement in that it lies somewhere between non-heme and heme iron. Each molecule of iron is surrounded by a layer of sugar which makes it easier for your body to absorb. Each capsule has 150mg of elemental iron which is well within the recommended range of 100mg-200mg per day. Feramax also has a lower incidence of intestinal upset, and constipation than the iron salts. The downside to Feramax is that it is much more expensive than the iron salts.

Proferrin

Proferrin is the only oral heme iron supplement available over the counter. Each tablet contains 11mg of heme iron. The recommended daily dose for Proferrin is 1 tablet three times per day. This is lower than the recommended 100mg-200mg of elemental iron per day, but the theory is that your body is absorbing a higher percentage of iron in Proferrin, and therefore you're not having to take as much orally as you would a non-heme iron.

Should you have any further questions iron or other supplements please contact your local pharmacist or physician.

The James Bay Beacon receives monthly contributions from the following pharmacists:

Jason Cridge - Cridge Family Pharmacy;
Stefani Tagg - Thrifty Foods Pharmacy; and
Robert Wojtas - James Bay Pharmasave