Iron is essential to your health and wellbeing. It plays a vital role in supporting your immune system and helps move oxygen around the body. A lack of iron can cause a host of issues from fatigue to loss of energy.
However, with today’s busy lifestyles getting enough dietary iron can sometimes be a challenge. Vitamin C is proven to aid the absorption of iron and so consuming both together is often recommended.
Iron supplements may be taken as capsules, tablets, chewable tablets, and liquids. The most common tablet size is 325 mg (ferrous sulfate). Other common chemical forms are ferrous gluconate and ferrous fumarate.
Ask your health care provider how many pills you should take each day and when you should take them. Taking more iron than your body needs can cause serious medical problems.
Blood counts return to normal after 2 months of iron therapy for most people. You may need to continue taking supplements for another 6 to 12 months to build up the body’s iron stores in the bone marrow.
TIPS FOR TAKING IRON
Iron is best absorbed on an empty stomach. Yet, iron supplements can cause stomach cramps, nausea, and diarrhea in some people. You may need to take iron with a small amount of food to avoid this problem.
Milk, calcium and antacids should NOT be taken at the same time as iron supplements. You should wait at least 2 hours after having these foods before taking your iron supplements.
Foods that you should NOT eat at the same time as you take your iron include:
- High fiber foods, such as whole grains, raw vegetables, and bran
- Foods or drinks with caffeine
Some doctors suggest taking a vitamin C supplement or drinking orange juice with your iron pill. This can help the iron absorb into your body. Drinking 8 ounces (240 milliliters) of fluid with an iron pill is also OK.
Tell your provider about all the medicines you are taking.
- Iron tablets may cause other drugs you are taking to not work as well. Some of these include tetracycline, penicillin, and ciprofloxacin and drugs used for hypothyroidism, Parkinson disease, and seizures.
- Medicines that reduce stomach acid will impair iron absorption. Your provider may suggest changing these.
- Wait at least 2 hours between doses of these drugs and iron supplements.
Constipation due to iron pills is common. If constipation becomes a problem, take a stool softener such as docusate sodium (Colace).
Nausea and vomiting may occur with higher doses, but they can be controlled by taking the iron in smaller amounts. Ask your provider about switching to another form of iron rather than just stopping.
Black stools are normal when taking iron tablets. Talk to your provider right away if:
- The stools are tarry-looking as well as black
- If the stools have red streaks
- Cramps, sharp pains, or soreness in the stomach occur
Liquid forms of iron may stain your teeth.
- Try mixing the iron with water or other liquids (such as fruit juice or tomato juice) and drinking the medicine with a straw.
- Iron stains can be removed by brushing your teeth with baking soda or peroxide.
Keep tablets in a cool place. (Bathroom medicine cabinets may be too warm and humid, which may cause the pills to fall apart.)
Keep iron supplements out of the reach of children. If your child swallows an iron pill, contact a poison control center right away.
The question of when to take vitamins together or separately is an excellent one and which we address in the “What to Consider When Using” and “Concerns and Cautions” sections of our Reviews of vitamin or mineral supplements. How you take a supplement can be just as important as which product you take — both may impact how much of a nutrient your body actually gets.
A few rules of thumb:
- If you take a large dose of a mineral, it will compete with other minerals to reduce their absorption. The mineral most often taken in large amounts is calcium: The dose is usually several hundred milligrams, compared to doses of just a few milligrams or even microgram amounts (1,000 micrograms = 1 milligram) of most other minerals. So if you take several hundred milligrams of calcium from a supplement, take it at a different time of day than other mineral supplements or a multivitamin/multimineral supplement. Doses of magnesium can also be relatively large and should, ideally, be taken apart from other minerals. If you take high doses of zinc long-term (50 mg or more per day for 10 weeks or longer ), be aware that it can cause copper deficiency, so you may need to supplement with copper as well.
- High doses of calcium or other minerals (including magnesium, certain forms of iron, and zinc) from supplements may decrease the absorption of carotenoids, such as beta-carotene, lycopene and astaxanthin, from foods and/or supplements. It is best to take carotenoid supplements at a different time of day than a supplement or meal containing large amounts of a mineral (e.g., hundreds of milligrams of calcium or magnesium).
- Some vitamins can actually enhance the absorption of other nutrients. Vitamin C, for example, can enhance iron absorption from supplements and plant foods.
- The fat-soluble vitamins (A, D, E, and K) are likely to be better-absorbed if taken with a meal that contains fats. In fact, one study found that taking vitamin D with dinner rather than breakfast increased blood levels of vitamin D by about 50%. However, evidence (mainly from animal and cell studies) suggests that moderate to large doses of fat-soluble vitamins reduce absorption of other fat-soluble vitamins – by about 10 to 50% – due to competition. Absorption of vitamin K appears to be particularly reduced by other fat-soluble vitamins, while vitamin A absorption is least affected and may actually be better absorbed when taken with vitamin E (Goncalves, Food Chem 2015). Taking vitamins D, E, or K several hours before or after other fat-soluble vitamins would seem to maximize their absorption.
- Taking certain supplements with food can reduce gastrointestinal side-effects. For example, taking magnesium with food can reduce the occurrence of diarrhea, and taking iron with food can reduce the chance of stomach upset.
- Be aware that vitamins and minerals can also affect the absorption and effectiveness of medications. You’ll find more specific information about this in the “Concerns and Cautions” section of each of our Reviews.
Keep in mind that these issues are not of significant concern when consuming a multivitamin providing up to the recommended daily intakes (RDAs) of vitamins and minerals — as long as it does not contain more than 250 mg of either calcium or magnesium.
The Relationship Between Vitamin C and Iron Absorption
How do vitamin C and iron work together? Simply put, the combination of iron and vitamin Chelps your body to absorb more of this vital mineral.
Dietary iron comes from two main sources. Heme iron is found in animal foods such as red meat, chicken and fish. And non-heme iron is abundant in plant-based foods, including whole grains, beans, fruits and vegetables.
Non-heme iron tends to be more easily absorbed by the body than animal sources of heme iron.
Vitamin C helps the body to dissolve and absorb iron. Drinking a glass of orange juice with your steak, or drizzling lemon juice over salads will help to increase your iron absorption. But that alone is unlikely to be enough.
Nowadays, our hectic lifestyles can make it difficult to get sufficient iron from our diet alone. And many people do not realise that some daily habits like drinking tea or coffee after meals can inhibit iron absorption. Iron supplementation can be a convenient way to ensure your body gets enough iron.
If you take an iron supplement that needs to be converted into the correct form for absorption, then taking a vitamin C supplement will increase absorption. Drinking a glass of orange juice or similar at mealtimes is not enough. However, Active Iron is in the correct form for absorption and travels protected in its protein matrix to the lower gut where is it absorbed, and so a vitamin C supplement is not needed when you take Active Iron.
Should You Take Vitamin C and Iron Together?
Eating vitamin C and high-iron foods together is perfectly safe. Experts suggest that the source of vitamin C doesn’t impact the amount of iron absorbed. So, supplements work just as well as eating lots of foods rich in vitamin C.
However, some people find it difficult to tolerate the high doses found in some vitamin C supplements. In a few cases, it can cause nausea or diarrhoea.
For some people, iron and vitamin C supplements cause no issues. The benefits of getting enough iron and feeling full of energy and zest outweigh the low risks involved.
Alternative Ways to Support Iron Absorption & Ensure You Get Enough
Eating high iron and vitamin C foods is the number one way to support iron absorption. Later on, we identify what foods to include in your diet to maximise vitamin C and iron absorption.
Just as important is knowing what foods to avoid and when. As we have seen, drinking that cup of tea or coffee after your meal may adversely affect iron absorption. Similarly, eggs, wholegrain cereals, and dietary fibre can also impact the body’s ability to absorb iron. You don’t have to eliminate these foods altogether. Just have your cuppa between meals instead.
Some studies suggest that calcium also hinders iron absorption. If you want to increase iron levels, it’s worth considering avoiding eating calcium-rich foods (milk, cheese etc.) with high iron foods.
Foods High in Vitamin C and Iron
We have already identified sources of dietary iron, but what about foods high in vitamin C and iron? Fruits and vegetables are the best sources of Vitamin C. Here are some food choices that will tick both boxes at once.
- Spinach – this superfood supplies an abundance of iron and vitamin C in one power-loaded hit.
- Broccoli – eat raw in a tasty salad and score highly for both iron and vitamin C.
- Leafy greens – cooked kale or Swiss chard contain high levels of iron plus a good dose of vitamin C.
- Potatoes – the humble potato also packs a punch with lots of iron and vitamin C. Best served with the skins on as this contains the most nutrients.
You could also consider pairing vitamin C-rich sources with high iron foods. Why not add delicious, chopped strawberries to your oatmeal breakfast. Combine sweet red peppers with spinach leaves and a lemon vinaigrette for a nutritious meal on its own or to accompany red meat.
The options are almost endless, so let your culinary juices run wild.
Conclusion: Iron and Vitamin C
When it comes to health and wellbeing, there is no doubt that iron and vitamin C make a powerful combination. This is especially so if you are a vegetarian or follow a plant-based diet. Eating iron and vitamin C together will increase non-heme iron absorption, which is harder for the body to do on its own. As part of a balanced diet, consider incorporating foods high in vitamin C and iron to enhance your health and wellbeing.
If you find it hard to get enough iron from diet alone, then Active Iron supplements could be the answer. They are also a good option if you want to maintain your iron levels.
Our ground-breaking iron supplements are clinically proven to enhance iron absorption. As Active Iron is released lower in the gut, at the site of natural iron absorption in the body, the DMT-1, it does not rely on Vitamin C for absorption. Active Iron is kind enough to take on an empty stomach, has clinically proven x 2 absorption and fewer unwanted side effects such as constipation, nausea, and reflux.