The best time to take iron supplements to maximize absorption

If you’ve been advised to add more iron to your diet, you may be wondering when is the best time to take iron supplements. At least you take one Iron supplement can be an effective way to address some common symptoms of iron deficiency – especially if changes to your diet are not enough to relieve symptoms such as lack of energy, shortness of breath, pale skin, brittle nails and hair, headaches, and cold hands and feet.

Although these signs may lead you to the vitamin aisle at your local grocery store, you shouldn’t take too many supplements without speaking to your doctor first. “Don’t take iron just because you experience these symptoms or you risk iron overload, which can bring various problems to the surface,” says Dr. Indhira Ghyssaert, family doctor and nutritionist.

Dr. Ghyssaert says the best way to determine whether you need to add a daily dose of iron to your diet is to talk to your doctor about any symptoms you’re experiencing. They may suggest a blood test to check your levels.

Meet the experts: Indhira Ghyssaert, MDa family doctor and nutritionist; Gregory Castelli, PharmD., Director, Pharmacy Residency Program, UPMC Family Medicine

After confirming with your doctor that an iron supplement is right for you, here’s what you should know about iron supplements, including the best time of day to take them and medications to avoid while taking iron.

The best time to take iron supplements

Ideally, you should take your iron supplement first thing in the morning and before food or other medications for best results, says Gregory Castelli, PharmD., director of the pharmacy residency program, UPMC Family Medicine.

In addition to the best Time According to Castelli, the frequency with which you take your iron supplements can also play a role in absorption. “Some experts may recommend taking an iron supplement every other day instead of taking it every day,” he says, which some studies support. “It may lead to greater iron absorption in the long term.” This may be because of how it affects the way your body stores iron, but more research needs to be done on the topic.

Factors affecting the absorption of iron supplements

The type of supplement

According to Castelli, there isn’t much difference between the way your body absorbs iron when it’s taken in tablet form or in liquid form. However, says Dr. Ghyssaert said some people may find it more difficult to take the liquid dose because of the taste.

Once you’ve decided which version of the supplement you want to take, Dr. Ghyssaert and Castelli agree that it’s important to know what other factors play a role in how well your body handles the supplement.

The pH of your stomach

“A slightly more acidic stomach pH increases absorption [of iron]says Castelli. “So foods or products that increase pH decrease absorption.” Some examples of things that have a lower pH (more acidic) and can aid absorption are citrus-based juices and foods like tomatoes or peppers.

Vitamin C

While the general recommendation is to take iron without other medications, Dr. Ghyssaert said adding a specific vitamin could actually help you get the most out of your daily dose of iron. “It is highly recommended that you take your iron supplement along with your vitamin C supplement,” she says. “This has been shown to aid absorption.”

Some foods

Castelli says there are also foods that can prevent your body from properly absorbing the iron in your supplement. You should therefore avoid consuming these shortly before or after taking your supplement. “Products containing calcium can bind iron and limit absorption,” he warns. “Products that contain calcium, such as dairy products, yogurt, cheese and fortified products, reduce iron absorption.”

Additionally, Castelli says high intakes of eggs, coffee, and tea can also reduce absorption. Therefore, it is usually best to take iron without food if possible.

Certain health conditions

Pre-existing conditions can also affect iron absorption. Dr. Ghyssaert says that people with chronic infections such as hepatitis C, HIV, malaria, ulcerative colitis or Crohn’s disease should not take iron supplements unless their doctor tells them to because it could “increase the risk of infection” and excess iron can build up accumulate in the liver and cause damage.”

Interactions between iron supplements and medications

According to Castelli, over-the-counter medications such as antacids (containing calcium) and acid suppressants such as PPIs and histamine blockers can also reduce absorption. “Patients should separate iron supplementation from products for a few hours or discontinue them if possible.”

Additionally, Castelli says to be aware of possible interactions when taking the following prescribed medications:

Antibiotics such as tetracycline, doxycycline, penicillin and ciprofloxacin
Levothyroxine
Bisphosphonates such as alendronate

Should you take iron in the morning or evening?

Because of the possible interactions between different foods and medications, Castelli says it’s always best to take your iron supplement in the morning. But that’s not the only consideration that makes the start of the day ideal.

“It can also help with better digestion if you don’t lie down immediately afterwards,” explains Dr. Ghyssaert. “So if you take it at night, stay upright and active for about an hour before bed. This way you can also keep an eye on symptoms and any negative findings and report them to your doctor.”

Side effects of taking iron

As with many medications and supplements, there is a possibility of side effects. Castelli says the most common side effect in people is constipation, which he says has a lot to do with the amount of “elemental iron” in the supplement.

“There are many different formulations of iron supplementation, including ferrous sulfate, ferrous gluconate and ferrous citrate,” explains Castelli, pointing out that there is not much difference between these formulations other than the amount of elemental iron in them. A formulation with less elemental iron can result in lower iron levels and less constipation, he says.

Another possible side effect is stomach upset, which may be made worse by taking the supplement on an empty stomach. “If you have digestive problems, try to find a healthy remedy,” says Dr. Ghyssaert. “Take it two hours after your first meal and two hours before your next meal to allow it to absorb as much as possible.”

Of course, if you are having trouble knowing the right time to dose iron, it is always best to contact your doctor or pharmacist and ask them for help determining the right time of day You Take your iron supplements to meet your individual needs and situation.

Disclaimer: Dietary supplements are products used to supplement your diet. They are not medicines and are not intended to treat, diagnose, alleviate, prevent or cure any disease. Be careful when taking supplements if you are pregnant or breastfeeding, and be sure to consult your doctor before taking any new supplements (or giving them to a family member), as they may interfere with the effects of medications.