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Upset stomach is the most common side effect of iron supplements. Constipation is another very common side effect with some forms of iron. The risk of iron overload in a diet is low in most healthy adults. People with certain genetic disorders are at risk for an iron overload if their conditions cause them to absorb more iron from food.
Iron overload may cause a buildup of iron in the liver and other organs as well as the creation of free radicals that damage cells and tissues. This increases the risk for certain cancers.
Taking high doses of iron supplements can cause nausea, vomiting, and stomach pains. There are very rare cases of iron overdoses leading to internal bleeding, seizure, coma, and even death.
Iron supplements can decrease the effects of certain medications, including those for treating restless leg syndrome and thyroid problems. Reflux disease medications can reduce the amount of iron that the body absorbs from food and supplements. It is always important to discuss with a physician whether you should take an iron supplement, especially if you take any prescription medication. *
When taken by mouth: Iron is LIKELY SAFE for most people when it is taken by mouth in appropriate amounts. It can cause side effects such as stomach upset and pain, constipation or diarrhea, nausea, and vomiting. Taking iron supplements with food seems to reduce some of these side effects. However, food can also reduce how well the body can absorb iron. Iron should be taken on an empty stomach if possible. If it causes too many side effects, it can be taken with food. Try to avoid taking iron with foods containing dairy products, coffee, tea, or cereals.
There are many forms of iron products such as ferrous sulfate, ferrous gluconate, ferrous fumarate, and others. Some products, such as those containing polysaccharide-iron complex (Niferex-150, etc), claim to cause fewer side effects than others. But there is no reliable evidence to support this claim.
Some enteric coated or controlled release iron products might reduce nausea for some people; however, the body may not be able to absorb these products as well.
Liquid iron supplements may blacken teeth.
When given by IV: Iron is LIKELY SAFE for most people when it is given by IV in appropriate amounts.
Special Precautions & Warnings:
Pregnancy and breast-feeding: Iron is
LIKELY SAFE for pregnant and breast-feeding women who have enough iron stored in their bodies when used in doses below the tolerable upper intake level (UL) of 45 mg per day of elemental iron. The UL is the highest level of intake at which no harmful side effects are expected. However, iron is
LIKELY UNSAFE when taken by mouth in high doses. If you do not have iron deficiency, do not take more than 45 mg per day of elemental iron. Higher doses cause stomach and intestinal side effects such as nausea and vomiting and may even cause preterm birth in some women. Higher doses of iron can cause high levels of hemoglobin in the blood. High hemoglobin levels at the time of delivery are associated with bad pregnancy outcomes.
Children: High doses of iron are
LIKELY UNSAFE, for children. Iron is the most common cause of poisoning deaths in children. Doses as low as 60 mg/kg can be fatal. Iron poisoning can cause many serious problems including stomach and intestinal distress, liver failure, dangerously low blood pressure, and death. If you suspect a child has taken more than the recommended amount of iron, call your healthcare professional or the nearest poison control center immediately.
Diabetes: There is concern that a diet that is high in iron might increase the risk of heart disease in women with type 2 diabetes, although this has not been proven. If you have diabetes, discuss your iron intake with your healthcare provider.
Hemoglobin diseases: Taking iron might cause iron overload in people with these conditions. If you have a hemoglobin disease, do not take iron unless directed by your healthcare provider.
An inherited disorder that affects the formation of blood vessels (hereditary hemorrhagic telangiectasia or HHT): Taking iron might increase the risk of nosebleed in patients with HHT. Use with caution.
Inflammatory bowel disease (ulcerative colitis or Crohn disease): Iron might cause irritation and make these conditions worse. Use iron with care.
Premature infants: Giving iron to premature infants with low blood levels of vitamin E can cause serious problems. Low levels of vitamin E should be treated before giving iron. Talk with your healthcare provider before giving iron to a premature infant.
Stomach or intestinal ulcers: Iron might cause irritation and make these conditions worse. Use iron with care.
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