Warning: may not cause constipation.

October 4, 2010 1:45 PM

My iron supplement is giving me diarrhea. WTF and what do I do? (semi-grossness inside)

I've been taking iron (ferrous sulphate) supplements for the past week due to iron deficient anemia. My doctor warned me that it would probably cause constipation. I wasn't too worried since I am a fairly prolific crapper already - I eat a healthy vegetarian diet, so lots of fiber, am physically active and like my coffee - but instead I have had diarrhea for the past week. As in, floaty not very solid crap like 8 times a day. This is no fun.

According to Google this can be a side effect of iron supplements. I know YANAD but I have questions:
1. Should I go back to my doctor about this? I would have to pay and want to avoid this if I can. Will the diarrhea affect my absorption of the iron?

2. My doctor said the constipation would go away once my body got used to the iron. Will this happen with the diarrhea too?

3. What can I do to stop crapping in the meantime? Would taking Immodium/Pepto-Bismal/Tylenol #1 be a bad idea? Are there any (vegetarian) changes to my diet that could slow things down?

BTW, if it matters, I'm taking the iron pill every morning right before breakfast with a glass of orange juice, as my doctor recommended. Also, not taking the iron is not an option (my anemia is making me exhausted and miserable and my doctor said supplements will get my iron levels back up much faster than just dietary changes) nor is eating meat (I've been vegetarian for so long the thought of eating it disgusts me).

Thanks!

posted by anonymous to Health & Fitness (13 answers total)

Is it OTC iron or prescription iron? If it's not a special Rx iron, you could try changing forms of iron; some people have more or less GI upset with different preparations.
posted by cobaltnine at 2:02 PM on October 4, 2010

I had diarrhea on prescription iron as well, although mine was ferrous gluconate. There are different types of iron supplements and some people tolerate one better than the other. You could ask for a different type. My diarrhea did get somewhat better with time, but what really helped me was to stop taking the pills (both prescription and OTC) and switch to Floradix liquid. I believe I first heard about Floradix on Metafilter, but if you Google around you'll see that many, many people have found success with Floradix when other supplements failed or had unacceptable side effects. I wish I had tried it sooner. I began feeling stronger and more energetic within days of starting it. I was reluctant to try it because it seemed too expensive and the web site scared me with its talk of "God's pharmacy," but it really does work as well as people say. (Also, it is vegetarian.)
posted by HotToddy at 2:08 PM on October 4, 2010

I understand why you don't want to make another appointment, but I would be surprised if they charged you if you just called the office and told them you were having a problem with the prescription.
posted by desjardins at 2:13 PM on October 4, 2010

Ferrous sulfate is the harshest iron supplement, I can't take it. I take Proferrin. It causes no intestinal upset and it has no dietary restrictions nor does it require vitamin C for absorption. The only downside is that it's ungodly expensive. Bifera is a good one too, and more easily accessible.
posted by elsietheeel at 2:22 PM on October 4, 2010

Other people's suggestions above sound good. How high is your dosage? Perhaps you could cut the pills in half and then slowly ramp up?

I also second the suggestion to call the doctor or ask to speak to a nurse on duty--they might have suggestions and a phone call should be free.
posted by purple_bird at 2:25 PM on October 4, 2010

Bananas are supposed to be somewhat binding. There's also eating more white flour, but that seems kind of silly as it's not especially healthy.

I'd try a different form of iron. If you switch to other pills, make sure you're getting the same amount of elemental iron as prescribed. With Floradix, the dose listed on the bottle contains a lot less elemental iron than most supplements for anemic people do. I'm not sure exactly why (perhaps better absorption), but I wouldn't be inclined to guzzle Floradix to take in as much elemental iron as the pills.
posted by needs more cowbell at 2:27 PM on October 4, 2010

Call your dr's office and leave a message stating what you told us. You don't need to go back for an appt. for this side-effect. Another option--your pharmacist is a great tool that is frequently under utilized. Go to your pharmacy and ask to speak with the pharmacist.
posted by 6:1 at 3:20 PM on October 4, 2010

Probably the simplest thing you could try immediately is to cut out the orange juice and take the iron with a vitamin C supplement instead. OJ totally gives me the runs.
posted by peep at 3:20 PM on October 4, 2010

I can tolerate the floradix HotToddy suggested, but my doc said I needed to take more iron than you can get with it. It delivers a dose of about 10 mg. However, it might be worth it to try. I am having the same problem you are, so I lowered the amount i was taking for a day or so, and took some Pepto. It seemed to help. However, my issue is not as severe as yours. (8 times day? You have my sympathy!) If you can't get it to slow down, this could cause some mal-absorption problems. Definitely call your Dpctor's office.
posted by annsunny at 3:46 PM on October 4, 2010

Um Doctor's

Gah!
posted by annsunny at 3:46 PM on October 4, 2010

Following peep's comment, any Vitamin C source gives me the runs. I have a tolerance for about 1000mg of vitamin C per day, any excess is disposed of post haste!
posted by Trivia Newton John at 4:45 PM on October 4, 2010

Solgar makes a product called "Gentle Iron."
posted by cheerwine at 8:45 PM on October 4, 2010

Some forms of iron supplements have a built in stool softener, despite this not being labeled very well on the package. The brand I took was called Ferro-Sequels, and the ingredients were listed as "Ferrous Fumarate/Docusate", with Docusate being the surprise ingredient.

If this image link works, check out how the front of the box is so unhelpful in explaining the full situation:

http://ecx.images-amazon.com/images/I/51AQCJMKQTL.jpg
posted by TheClonusHorror at 7:34 PM on October 10, 2010