crowdsourced medical advice: iron supplement edition.

May 23, 2023 6:59 PM

my kid and I both have low iron ("ferritin", specifically) levels and need to raise them, but have had trouble with supplements causing constipation. Do you know of an iron supplement that doesn't cause constipation?

What it says on the tin, but with the extra note that the kid's digestion is delicate, and constipation is a serious problem anyway and not to be trifled with. So I can't do what the careless practitioner did and give her regular supplements and hope for the best: that was disastrous. Are there any iron supplements that really don't cause constipation?

(We've already switched to cast iron pan cooking, which is a pain in the ass; and daily spinach.)

posted by fingersandtoes to Health & Fitness (16 answers total)

Best answer: Run it by your doctor to make sure it's the right kind of iron, but I couldn't tolerate iron supplements or prenatals, so I went looking for diet sources. Spinach is always suggested but Cheerios blows it out of the water. 1 serving has 70% of your daily iron needs (it's fortified), and you can eat it dry as a snack or in a bowl with your milk of choice.

I did not notice any of the side effects I had taking iron pills.
posted by Narrow Harbor at 7:07 PM on May 23, 2023 [8 favorites]

I had no idea about Cheerios, but diet-wise, baby clams are pretty fantastic and are shelf-stable in a can. They work in a red tomato sauce over pasta, and Rachel Ray has a pretty decent white clam sauce recipe with baby clams that brings out good iron, and it pairs well with a side of steamed garlic spinach or similar iron-friendly greens.
posted by childofTethys at 7:13 PM on May 23, 2023 [2 favorites]

Yes, most (all?) shellfish is very high in iron - canned clams, shrimp, muscles, crab, etc. Liver is especially packed with iron.

I have never had a problem with iron pills, but make sure you are taking heme iron - this makes a big difference.

Edit to add: black strap molasses is also iron rich. I sometimes drink it as a tea. Or make molasses cookies.
posted by coffeecat at 7:25 PM on May 23, 2023 [3 favorites]

Any chance you like (or can learn to like) liverwurst or braunschweiger? Both are super high in iron (like 30% of rda in 1 serving). That's what I used when I tried dietary sources.

There's also the Lucky Iron Fish, which is another way of adding dietary iron that might be easier than using cast iron pans.
posted by Gorgik at 7:37 PM on May 23, 2023 [5 favorites]

For my relative in a similar situation, we ended up traying Spatone, which is a kind of iron-rich spring water. The story is that the exact type of iron it has is much more absorbable, like many more times than a typical iron supplement, so you only need to take a far smaller dosage of iron each day, and thus the digestive issues are avoided.

There is some research (1, 2, 3) which you can read and judge for yourself. My summary: The studies are quite small but reasonably promising. That seemed enough for us to at least try it, and relative did tolerate it well and iron levels did rise.

Downside: It is fairly expensive.
posted by flug at 7:41 PM on May 23, 2023

My issues with iron supplements causing constipation resolved when I noticed that 'gentle iron' is just half the dose of the regular supplement. Now I buy the cheap iron tablets and cut them in half. Not sure if this would help your kid.
posted by arrmatie at 8:31 PM on May 23, 2023

Best answer: Seconding Spatone water. It's weird, but it works. My spouse had ferritin levels so low the doctor said it was shocking they could walk through the office door without help. Alas, digestive issues were one of the reasons it got so low, so it was critical to avoid making those worse. Supplementing solely through food wasn't doing anywhere near enough. Ruinously expensive grass fed beef liver supplements that had to be stored in the freezer and slightly less expensive Spatone were what did the trick. It doesn't taste good, but you just shoot it down, maybe chase it with some juice, and it's over in 20 seconds.
posted by mostlymartha at 10:48 PM on May 23, 2023 [2 favorites]

Best answer: Heme iron supplements don't give me any GI issues (and, based on how I feel, actually seem to be replenishing my ferritin stores as well as just upping my haemoglobin). I find them better than elemental iron supplements in every way except for the fact that they're made from animal products.
posted by terretu at 12:42 AM on May 24, 2023

When I was taking supplements my friend suggested ferrous glutonate instead of ferrous sulfate, and I had no problem with it. She also suggested taking it at bedtime instead of the morning, but I'm not sure if that made much of a difference.
posted by gideonfrog at 4:45 AM on May 24, 2023

Best answer: Just a note on Cheerios. They are definitely a wonderful food to add to your diet to get more vitamins and minerals, but they provide 12.6mg of iron per serving, compared to the 65-130mg/day that is usually recommended for an adult to bring their iron levels up, so it's not necessarily going to make a huge dent in your deficiency. But still, a good tool to keep in your pocket to continue using once your levels are normalized. Additionally, I would advise against eating them with milk, as the calcium in milk can reduce absorption of iron. You're better off eating them with a vitamin C rich food such as citrus, because vitamin C enhances absorption of non-heme iron.

You can also look into Novaferrum. The doses are not necessarily optimal, but my understanding is it's often better tolerated than other supplements, and I've heard hematologists at my hospital recommend it.

Alternate day supplementation may be a good fit for you, too. There is evidence that taking iron every other day is better for absorption, and I'd think that may reduce GI effects as well.
posted by obfuscation at 5:40 AM on May 24, 2023 [3 favorites]

Lucky Iron Fish and use a cast iron pan.
It's so geezer-y, but my health is improved a lot by fiber like psyllium husk capsules, wheat and oat bran, whole grains, lots of vegetable, fruit, and water.
posted by theora55 at 9:37 AM on May 24, 2023

There are a lot of different types, so worth trying them all. Also, I think you need to give it a bit of time before writing them off. There's an adjustment period after which I didn't have this problem.
posted by lookoutbelow at 2:57 PM on May 24, 2023

Quaker Instant Grits have 12.9mg of iron (70% of the RDA) per serving. I started having grits for breakfast in addition to taking an iron supplement.
posted by belladonna at 3:01 PM on May 24, 2023 [1 favorite]

Best answer: For me, I had to start taking iron and Vitamin C tablets at the same time. I don't even need extra vitamin C, but when I (very skeptically) took this advice, all issues went away. I do also use Iron Bisglycinate, a "gentle" iron. The Vitamin C tablets I use are from Mason Natural and come in 250 MG doses.
posted by desert outpost at 3:44 PM on May 24, 2023

Response by poster: FYI for folks following, Spatone seems to be out of stock for the USA vendors listed on the Spatone site. If you happen to know of a USA vendor that has them in stock to ship, or anyone in the bay area that has it, that would be awesome.
posted by fingersandtoes at 8:02 AM on May 25, 2023

Best answer: Heme iron supplements were the only ones that didn’t give me constipation. They also actually raised my levels, unlike the endless other iron formulations I tried.
posted by congen at 7:56 PM on May 25, 2023