Iron

Iron Supplements in Australia

Overview

Iron is an essential mineral needed for many vital functions in the body. It is part of the hemoglobin protein that carries oxygen from the lungs to tissues. Iron is also required for energy production, immune function, and cognitive development.

The recommended daily intake (RDI) for iron differs for men and women according to the Nutrient Reference Values for Australia and New Zealand [[1]].

Recommended Dietary Intakes

Infants

Age	AI
0-6 months	0.2 mg/day

Age	EAR	RDI
7-12 months	7 mg/day	11 mg/day

Children & Adolescents

Age	EAR	RDI
1-3 years	4 mg/day	9 mg/day
4-8 years	4 mg/day	10 mg/day

Boys

Age	EAR	RDI
9-13 years	6 mg/day	8 mg/day
14-18 years	8 mg/day	11 mg/day

Girls

Age	EAR	RDI
9-13 years	6 mg/day	8 mg/day
14-18 years	8 mg/day	15 mg/day

Adult Men

Age	EAR	RDI
19-30 years	6 mg/day	8 mg/day
31-50 years	6 mg/day	8 mg/day
51-70 years	6 mg/day	8 mg/day
Over 70 years	6 mg/day	8 mg/day

Adult Women

Age	EAR	RDI
19-30 years	8 mg/day	18 mg/day
31-50 years	8 mg/day	18 mg/day
51-70 years	5 mg/day	8 mg/day
Over 70 years	5 mg/day	8 mg/day

Pregnancy

Age	EAR	RDI
14-18 years	23 mg/day	27 mg/day
19-30 years	22 mg/day	27 mg/day
31-50 years	22 mg/day	27 mg/day

Lactation

Age	EAR	RDI
14-18 years	7 mg/day	10 mg/day
19-30 years	6.5 mg/day	9 mg/day
31-50 years	6.5 mg/day	9 mg/day

For adult men aged 19-70+ years, the RDI is 8 mg/day. For women aged 19-50 years, the RDI is 18 mg/day, dropping to 8 mg/day for women over 50 years. During pregnancy, the RDI rises to 27 mg/day to support increased blood volume and fetal development.

Iron Deficiency

Iron deficiency is one of the most prevalent nutritional deficiencies globally. In Australia, around 20% of women of childbearing age do not get adequate iron [[2]].

Signs of iron deficiency include fatigue, weakness, pale skin, shortness of breath, dizziness, headaches, brittle nails, and rapid heartbeat. If untreated, it can progress to iron deficiency anemia with symptoms like extreme fatigue, chest pain, and an inflamed tongue.

Causes

Causes of iron deficiency include:

• Inadequate intake of iron-rich foods like red meat, poultry, beans, lentils, and spinach over time
• Blood loss through heavy periods, frequent donations, or internal bleeding
• Increased iron needs during pregnancy and growth spurts
• Impaired absorption due to digestive disorders like celiac disease

Iron Supplementation

Iron supplements may be recommended for those at higher deficiency risk:

• Women of childbearing age, especially with heavy periods
• Pregnant women
• Infants and small children
• Vegetarians and vegans
• Athletes, particularly female endurance athletes
• People with conditions affecting absorption like celiac disease
• Those diagnosed with iron deficiency anemia

Always consult a doctor before taking iron supplements.

Types of Supplements

Ferrous sulfate, ferrous fumarate, and ferrous gluconate are forms of ferrous salts used in iron supplements. Ferrous sulfate has the highest elemental iron content per dose and is often the recommended form.

Heme iron supplements contain iron bound to a porphyrin ring, similar to the heme structure in animal foods. Heme iron may be better absorbed than non-heme iron from plants.

Choosing a Supplement

Consider the following when selecting an iron supplement:

• Elemental iron content - Check the label for the mg of elemental iron per dose. Higher elemental iron means more absorption.
• Form - Tablets, capsules, liquids and gummies are available. Tablets are typically the most cost-effective. Liquids may be easier to take for some people.
• Side effects - Iron can cause constipation, nausea, stomach pain and dark stools. Ferrous bisglycinate formulas may be gentler.
• Dose - Carefully follow dosing instructions. Take on an empty stomach where possible for maximum absorption. Discuss correct dosage with your doctor.
• Interactions - Iron can interact with some medications. Always check with your doctor or pharmacist about potential interactions.

Some well-known iron supplement brands in Australia include Floradix, Spatone, Maltofer, Ferro-grad and Ferro-tab. Consult your pharmacist for the best option for your needs.

Benefits and Side Effects

Benefits

When taken as directed, iron supplements can:

• Increase hemoglobin and ferritin levels in iron deficiency anemia
• Reduce fatigue and improve concentration
• Boost energy and exercise performance
• Support healthy fetal development during pregnancy
• Strengthen immune function

However, iron supplements should only be taken if recommended by a doctor.

Potential Side Effects

Iron supplements can cause:

• Constipation
• Nausea
• Stomach discomfort
• Dark colored stools
• Metallic taste

They can also interfere with absorption of some medications. Excess intake can be toxic and damage organs. Iron should be stored safely out of children's reach.

Absorption and Usage

Maximising Absorption

Take iron supplements:

• On an empty stomach
• With vitamin C-rich foods to enhance absorption
• Avoid calcium-rich foods at the same mealtime as they can hinder absorption

It can take 3-6 months to restore iron levels. Energy improvements may occur in 1-2 months. Always finish the full course prescribed by your doctor.

Iron can interact with medications like antacids, calcium supplements, and thyroid medications. Check with your doctor or pharmacist about potential interactions. Separate dosing times may be recommended.

Eat vitamin C-rich foods like citrus fruits, strawberries, and broccoli to improve iron absorption. Avoid high-calcium foods like milk and yogurt at mealtimes with iron supplements.

Good iron supplement options include Maltofer, Spatone, Floradix, Ferro-Grad C and Ferro-tab. Talk to your pharmacist about the best choice for your needs. Carefully follow all dosing instructions provided.

Frequently Asked Questions

Who might need iron supplements?

Iron supplements may be recommended for those at higher risk of deficiency, including women of childbearing age, pregnant women, infants/children, vegetarians/vegans, athletes (especially females), and those with conditions affecting absorption like celiac disease. Those diagnosed with iron deficiency anemia may also need iron supplementation to replenish stores.

When should I take iron supplements?

Take iron supplements on an empty stomach where possible to maximize absorption. Avoid taking with foods high in calcium like milk and yogurt, as calcium can interfere with iron absorption. Take iron supplements at least 1-2 hours before or after meals for best results.

How long does it take for iron supplements to work?

It can take 3-6 months for iron supplementation to fully replenish iron stores in the body. Improvements in energy, fatigue, and concentration may be noticed within 1-2 months. Always finish the full course of supplements prescribed by your doctor.

What iron supplement is gentlest on the stomach?

Some iron supplements made with ferrous bisglycinate are designed to be gentler on the stomach than traditional ferrous salts like ferrous sulfate. Speak to your pharmacist about the best iron supplement options if you have a sensitive stomach. Start with a low dose taken with food and slowly increase as tolerated.

Can I take iron supplements long term?

Iron supplementation is usually recommended for limited periods to treat deficiency. Excess iron can be toxic. Long term use should be monitored by your doctor to ensure iron levels do not get too high. Once iron-rich foods are reintroduced to the diet and stores are replenished, ongoing supplements may not be needed.

What medications should not be taken with iron?

Iron can interfere with absorption of some medications like levothyroxine, antacids, and certain antibiotics like tetracyclines and quinolones. Always check with your doctor or pharmacist before taking iron supplements with other medications. Separate dosing times may be recommended.