Iron supplements - skip day?

September 18, 2024 11:03 PM

I have an iron deficiency due to excessive periods (working on the problem with my OBGYN). In the meantime, my GP has prescribed some rather potent iron tablets. My friend says that she knows a medical university professor who says his research suggests it's better to take them every two days instead of every day, as it allows the body to absorb it better, and that GPs are usually unaware of this. Is this bogus or is this supported by research?
posted by Omnomnom to Health & Fitness (13 answers total)

I don’t know anything about the research behind this but my doctor prescribed me an iron supplement to be taken every other day, and did also say that the body seems to absorb it better this way.
posted by scorpion proof at 11:19 PM on September 18

Seems real enough, just make sure it applies to you:

In iron-depleted women without anemia, oral iron supplements induce an increase in serum hepcidin (SHep) that persists for 24 hours, decreasing iron absorption from supplements given later on the same or next day. Consequently, iron absorption from supplements is highest if iron is given on alternate days. Whether this dosing schedule is also beneficial in women with iron-deficiency anemia (IDA) given high-dose iron supplements is uncertain. ...

posted by kschang at 11:21 PM on September 18

Yeah I also was prescribed iron supplements every other day for a while. I went on an online research dive because previously when I’d taken iron supplements in my early 20s they totally destroyed my GI system and were just super rough so I wanted to figure out exactly the best type and dosage was and all that. I asked my doctor about the every other day thing and she explained that the every other day thing was a combination of giving the patient’s body a chance to fully process the supplement if it was difficult on the system, and optimal absorption. She also told me to have vitamin C with it in some form, so I had either a little chewable vitamin C tablet, a small glass of OJ, or some kind of vitamin C-having vegetable with it like broccoli or peppers.

My online research confirmed her instructions about the vitamin C helping iron absorption, but I only found anecdotes (like the one I’m writing now!) about the alternate days thing. I’m willing to believe it though because she was a lot more detailed and knowledgeable about iron supplementation overall. It really did help me tolerate the supplements and over time I adjusted my diet to include more iron rich foods and did lots of combining with vitamin c things and my periods chilled out somewhat and I have had normal iron levels since. Compared to that rough first time when I took them every day and it was a crappy formulation and I didn’t know about nutrient absorption and it sucked so bad I stopped after maybe a month, it worked out much better.

Best of all is IV iron. If you can get insurance to pay for that, oh my gosh it’s a game changer.
posted by Mizu at 2:01 AM on September 19 [1 favorite]

My hematologist suggested this and I was able to raise my iron levels much more successfully than I had on an every day dosage schedule. I also took liquid iron and I think that played a huge role in absorption as well. I took the brand Palafar, there are others, but I can’t vouch for them.
posted by kate blank at 4:16 AM on September 19

To be clear, the data support that efficacy is roughly equivalent for dosing every day or every other day — your friend's assertion that every other day dosing is better is incorrect. Many people still prefer to take their supplement daily because it's harder to remember to take a pill every other day.
posted by telegraph at 5:06 AM on September 19 [2 favorites]

it's harder to remember to take a pill every other day

Fourteen-compartment pill organizer will deal with that. They're usually laid out as two rows of seven compartments each with the rows labelled AM and PM, but you can easily relabel them Week 1, Week 2 instead and then put an iron pill in every second day's compartment. You can put tic-tacs in the unused compartments if you need to establish a daily routine to make it stick.
posted by flabdablet at 6:47 AM on September 19 [1 favorite]

I have had a doctor tell me this. But I wasn't remembering to take them, making it moot. I now do every day, both because of the remembering issue, and the consistent seems to minimize negative effects on my digestive system. YMMV
posted by lookoutbelow at 6:57 AM on September 19 [1 favorite]

My doctor recommended the every-other-day schedule to me, too, and I found that it was effective and easier on my stomach. Also cheaper, because the pills I was taking ran about $2 each, and I'd much rather spread that $60/30 pills out over two months than one. You could always try it, and if you feel it's not working, go up to daily.

Good luck. Being anemic is awful.
posted by notquitejane at 7:30 AM on September 19

I dealt with iron deficiency from heavy periods just recently and taking iron every other day was exactly what my primary care doc recommended. I also did a round of iron infusions.
posted by brookeb at 7:54 AM on September 19

I believe vitamin c helps the body absorb iron, so take with orange juice or eat an orange.
posted by Enid Lareg at 9:07 AM on September 19

I don’t know if it absorbs better, but every other day dosing (and a lot of chia seeds) keeps the constipation to a level that I’m willing to keep taking the pills.
posted by congen at 10:12 AM on September 19

In addition to the advice above, I was instructed that calcium and polyphenols both interfere with absorption, so best to take iron supplements well after your morning latte (if you have one).
posted by moosetracks at 10:15 AM on September 19

"At equal total iron doses, compared to consecutive day dosing of iron, alternate day dosing did not result in higher serum ferritin but reduced iron deficiency at 6 months and triggered fewer gastrointestinal side effects," was a Nov. 2023 finding, which references previous alt-day dosing research. (If your deficiency proves stubborn, maybe talk with your doc about infusion therapy. It's the only thing that worked for me, several years after the deficit was identified.)
posted by Iris Gambol at 2:55 PM on September 19 [1 favorite]