Iron Absorption Question
August 5, 2016 2:36 PM   Subscribe

My blood tests came back low in iron. I was surprised as I eat a good diet including lots of iron rich foods. My iron supplement (Spatone) info leaflet recommends leaving a 30-45 minute gap between taking the supplement and meals. It says carbonated drinks (phosphates) can interfere with iron absorption. I usually drink about 2 litres of carbonated water a day. Do I need to stop this completely? Could it be preventing me from absorbing iron from my diet? How much carbonated drink is too much carbonated drink in this context?
posted by bimbam to Health & Fitness (13 answers total) 2 users marked this as a favorite
Best answer: Are you drinking literally carbonated water, with no flavoring or sweetening? That's a different thing and shouldn't have any phosphates. Check your packaging to be sure, but the only ingredient in my seltzer water right here is "carbonated water." Phosphates are added to, e.g., coca cola for flavor and preservative purposes, but (usually) not in plain old water.

It's unfortunate that so much health advice puts all "carbonated beverages" into the same category when it's usually "sugar-sweetened sodas" that are the problem. Confer with your doctor to be really sure, but have the packaging ready to make sure you are both talking about the actual thing you are drinking rather than an abstract category.
posted by Joey Buttafoucault at 2:55 PM on August 5, 2016

You should ask your doctor! You may have a genetic predisposition keeping you from absorbing Iron, there could be a conflict with some medication you are taking.

Ask you doctor. I'm totally serious.
posted by jbenben at 2:56 PM on August 5, 2016 [3 favorites]

Best answer: Yes, the warning is against flavored soft drinks that contain phosphates or phosphoric acid (aka "food acid," E338, or just 338) not plain carbonated water. Usually it's colas that have this ingredient. And I agree, ask your doctor. Or take the iron supplement, drink as usual, and have your iron levels tested at a follow-up.
posted by kindall at 3:01 PM on August 5, 2016

Not a medical doctor, but when I was low on iron I also needed Vitamin D. What about vitamin C for absorbtion?

This is a good question to call up your doctor and ask.
posted by freethefeet at 3:33 PM on August 5, 2016 [1 favorite]

When iron and calcium are taken together, it interferes with absorption. So if you are fond of cheeseburgers or broccoli with cheese sauce, you may not be getting as much iron as you think.

When I am anemic, I get real picky about separating calcium rich foods from iron rich foods by 30 minutes to an hour. So things like beef and broccoli are consumed separately from things like milk, yogurt, and cheese.
posted by Michele in California at 4:31 PM on August 5, 2016 [4 favorites]

If your doctor isn't available or can't give you an answer, pharmacists can also be a good resource for this kind of question.

That said--doing a quick look at studies, I'm not seeing much that says that even soda is a problem for iron absorption. This study said it "slightly increased absorption" and this one actually seems to be examining soda as a way to increase iron absorption because it lowers stomach pH. Perhaps the low pH of most soda makes up for the effects of the phosphates; eating acidic foods and/or foods high in vitamin C help with absorption of iron.

If you are someone who menstruates, it might not be that you're having trouble absorbing enough iron, just that you're losing a fair amount of blood regularly. Anemia is somewhat common in people who menstruate.
posted by needs more cowbell at 4:54 PM on August 5, 2016 [1 favorite]

There's a lot of different variables that could be causing you to not absorb the iron in your diet. Are you already taking the iron supplement, or not yet? Either way, possible solutions include:

- take more vitamin C to aid absorption
- take a different form of iron (although Spatone is liquid iron, which is already one of the most effective forms)
- take more iron (figure out how much elemental iron is in your supplement; if you've been taking less than 100mg/day you could probably increase your dose)
- don't take calcium with it, as it slows absorption
- get blood work done to see if you have a B12 deficiency, which would make it difficult for you to absorb iron (or if it's too cumbersome to get the bloodwork done first, just add a B-complex supplement with about 1000mg/day of B12 and see if your symptoms improve)
- make sure your gut has healthy bacteria, either by eating lots of fermented foods like kimchi and yogurt, or by adding a probiotic supplement and seeing if your symptoms improve

Consider that the problem may stem from something else entirely. Besides B12 deficiency and imbalanced gut bacteria, celiac disease and hypothyroidism are two conditions that make it hard to absorb iron. Investigation of this route will almost certainly start with getting new bloodwork done and examining the results more closely.

Per the other comments, I wouldn't worry about the carbonated drinks. On the other hand, if they're not essential to your daily regimen, you could try going without for 2 weeks to see what happens.
posted by danceswithlight at 5:01 PM on August 5, 2016 [3 favorites]

I had low ferritin for years that never swayed, no matter how I tinkered with supplements or diet. Finally I gave in and had iron transfusions. Not only did I feel amazing, my levels normalized and I was able to maintain them with no special trouble. (Despite being a coffee junkie!) Seemed like the feedback loop needed a hefty intervention. Perhaps you're so low you can't absorb or retain it?
posted by fritillary at 6:12 PM on August 5, 2016 [1 favorite]

They discovered I had celiac because my ferritin was so low. Even super diligent about my diet, I lose iron. So I get transfusions a couple times a year. (Really not a big deal, just seems like it at first.)

But it's worth a test to see if you have celiac.
posted by crankyrogalsky at 6:47 PM on August 5, 2016

Some people just don't absorb iron well. My doc and I tinkered with a bunch of stuff for years as even when I wasn't officially anemic I was barely a point away from it. For what it's worth they never fussed about carbonated beverages if my diet was ok - i was anemic during times I drank them all the time and times I didn't.

In the end I had an iron infusion. God I wish I'd known that as an option before I spent nearly twenty years trying every damn supplement and trying to remember all the rules about what to have with and what to avoid. Those things may work when my iron is normal but as ways of fixing it, nope.
posted by kitten magic at 6:05 AM on August 6, 2016

You don't mention if you are a man or a woman. If you are a woman with regular monthly cycles and your iron is low, then just take the pill and don't worry, you are normal. If that is not the issue, then you will want to find out why it is low. Is it a tummy issue, a bowl issue, or a genetic issue. Ask your parents to rule out genetic. If you have certain foods that you cannot eat or if you take antacids, then it could be a tummy issue. Probiotics can sometimes help with digestion. If it's in your poop shoot, it is much more serious but, you would have noticed something before now and your iron level would have been much lower. It's probably nothing to worry about. I think drinking that much carbonated anything isn't good for you so best to cut back anyway.
posted by myselfasme at 8:53 AM on August 6, 2016

This is really a question for a doctor or a dietician. You want somebody who knows enough about your whole health situation to be able to steer you in the right direction, or who is in a position to ask you relevant questions until they have enough information to five you an informed answer. People are giving you lots of advice here, but we don't really know how much if any of it applies to you. For that matter, iron poisoning is a thing and doing something like just doubling your dosage without consulting a professional who has the full picture on your situation is probably not a great idea. That's the kind of thing that is probably OK, but might not be depending on a number of other factors that we here have no way of knowing about.

That said, if the real issue is phosphates and your carbonated water doesn't contain any phosphates, then you should be in the clear to keep drinking that water. Still, it's a question for your doctor the next time you see them. In your shoes (and assuming that you've just recently been put on these supplements and are due for a followup at some point) I would probably just keep on drinking my bubbly water, mention it to my doctor at my next appointment, and see how my next batch of test results comes back. It sounds like it's unlikely to be an emergency.
posted by Anticipation Of A New Lover's Arrival, The at 10:56 AM on August 6, 2016

Response by poster: Thanks all! Since there are no phosphates in my ordinary carbonated water I'll continue to enjoy heavy bubbles, yay!

(Just for further background, the low iron result was part of a full blood count which included celiac, Vit D, B12, thyroid, etc etc. Everything else came back fine. These are good suggestions tho.)
posted by bimbam at 12:20 PM on August 7, 2016

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