Health Benefits of Iron
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Medically reviewed by Suzanne Fisher, MS
Iron is a mineral that’s an essential part of hemoglobin, a protein in red blood cells that carries oxygen from the lungs to the rest of your body.
This nutrient is found in a number of foods like meats, legumes, and dark, leafy greens. However, people with health conditions that impair iron absorption, pregnant women, and women with heavy periods may need to supplement with iron in order to maintain healthy levels.
Iron supplements are also used to treat iron deficiency anemia, a condition caused by low iron levels in the body. Supplementing with iron when you don't need it may cause health issues, so it's important to consult with a healthcare provider before taking iron supplements.
Benefits of Iron Supplements
Iron is an essential mineral that plays critical roles in health. In addition to oxygen transportation, iron is necessary for growth, energy production, hormone synthesis, and neurological development. People who cannot get enough iron through diet or who have certain medical conditions may require iron supplements.
Can Treat Low Iron Levels and Iron Deficiency
The main reason some people take iron supplements is to treat low or deficient iron levels, which can be caused by several factors, including:
Impaired iron absorption due to medical conditions such as Crohn’s disease or gastrointestinal surgery
Low dietary iron intake
Chronic blood loss from conditions such as colon cancer and ulcerative colitis
Anemia of chronic disease (ACD), which is a type of anemia that impacts people with inflammatory diseases such as autoimmune conditions
Medical conditions such as heart failure and kidney disease
Heavy periods that cause excessive blood loss
Higher iron requirements due to life stages such as infancy and pregnancy
Iron deficiency anemia happens when blood hemoglobin levels fall below 130 grams per liter (g/L) in men and 120g/L in women. Other markers, such as ferritin and total iron, can be used to assess iron status. When ferritin falls below 10 micrograms per liter (ug/L), it indicates iron deficiency anemia.
Iron deficiency can cause symptoms such as fatigue, shortness of breath, hair loss, dizziness, cold hands and feet, shortness of breath, pale skin, and weakness. The only way to know if you’re low in iron is to have your iron levels tested by a healthcare provider.
If your iron levels are low or deficient, your provider will prescribe a treatment, which typically involves oral iron supplementation. Oral iron supplements are the most common treatment for iron deficiency.
Iron deficiency anemia is usually treated with daily oral iron supplements for at least three months in order to replenish tissue iron stores. Some people may only need to take iron supplements for a few months until their levels are restored, while others may need to supplement with iron indefinitely in order to maintain healthy levels.
Can Reduce the Risk of Iron Deficiency
In addition to treating iron deficiency anemia and low iron stores, iron supplements are used to prevent iron levels from dropping too low in people with increased iron needs.
For example, during pregnancy, iron needs increase by 150% due to a significant increase in red blood cell production, so people who are pregnant typically need to take iron supplements.
People following restrictive diets low in iron-rich foods, people who have had weight loss surgery, and people with medical conditions that cause malabsorption—such as Crohn's disease and celiac disease—may also be at risk for developing iron deficiency and need to take iron supplements to maintain healthy levels.
Additionally, iron supplements are often used by endurance athletes because periods of intense training impair the body’s ability to maintain adequate iron stores, which can compromise athletic performance and overall health.
A recent study that included 93 athletes found compared to a placebo, supplementation with 3.6 milligrams (mg) of iron for four weeks prevented a decline in hemoglobin levels and reduced markers of stress, including the stress hormone cortisol, after a training regimen. The iron supplement also helped reduce fatigue and mood disturbance after training.
Good Sources of Iron
The body can’t produce iron on its own, but it can recycle iron from old red blood cells. Around 90% of iron needs for red blood cell production are met through iron recycling from aged red blood cells.
Even though iron recycling covers some of your iron requirements, you must also take in iron from dietary sources or supplements to reach and maintain healthy iron levels.
For people with no underlying medical conditions who follow balanced diets, iron needs can usually be met by regularly consuming foods rich in iron. There are two types found in food, heme iron and nonheme iron. Animal foods provide heme iron as well as non-heme iron, while plant foods only provide nonheme iron.
Heme iron has a higher bioavailability than nonheme iron. Your body absorbs around 25% of heme iron, compared to only 17% of nonheme iron.
In order to support healthy iron levels, it’s best to consume sources of both heme and nonheme iron regularly.
Some animal and plant-based foods that offer good sources of iron include:
Beef liver: 5 mg per 3 ounces, or 28% of the Daily Value (DV)
Oysters: 8 mg per 3 ounces, or 44% DV
White beans: 8 mg per cup, or 44% DV
Lentils: 6 mg per cup, or 34% DV
Spinach: 6 mg per cup, or 34% DV
Tofu: 6 mg per cup, or 34% DV
Dark chocolate (45%–69% cacao solids): 2 mg per ounce, or 11% DV
Sardines: 2 mg per 3 ounces, or 11% DV
Baked potato: 2 mg per medium potato, or 11% DV
Roasted cashews: 2 mg per ounce, or 11% DV
There are many other foods that are rich in iron, so most people can meet their daily needs through diet alone. Some foods like bread and breakfast cereals are also fortified with iron–meaning iron is added—to provide 100% of the DV.
However, people with increased iron requirements or those with conditions that impact their ability to absorb iron from food may require an iron supplement to prevent iron deficiency.
How to Take Iron
People who are diagnosed with low iron or iron deficiency anemia are usually instructed to take an oral iron supplement. Your healthcare provider may also recommend iron supplements if you’re at risk of developing iron deficiency in the future.
The most common types of iron found in supplements include ferrous sulfate, ferrous fumarate, ferrous bisglycinate, and ferrous gluconate.
For optimal absorption, it's recommended to take iron supplements on an empty stomach at least 30 minutes before eating. However, if your iron supplement is making you feel nauseated, you can try taking it with a small amount of food to soothe your stomach.
Previously, experts recommended taking vitamin C with iron to increase its absorption in the body. However, the evidence is mixed. Recent research has shown vitamin C does not significantly improve iron absorption.
It’s important to take iron supplements at least two hours before taking other medications, as certain medications may interfere with iron absorption and iron may interact with some medications.
Additionally, iron supplements should not be taken with dairy products, calcium supplements, antacid medications, high-fiber foods, or caffeine.
While iron supplements can help many people with low or deficient iron levels, some people are unable to properly absorb iron in their digestive tracts or have iron losses that are too high to be treated with oral iron supplements. In these cases, iron infusions, where iron solutions are infused through a vein, are required.
Dosage
Iron dosing varies depending on the form of iron you’re taking as well as your iron levels. People with iron deficiency typically need higher doses of iron compared to people with low or borderline iron levels.
To treat iron deficiency, it’s typically recommended to supplement with 100 to 200 mg of elemental iron—the total amount of iron that’s able to be absorbed by the body—usually in divided doses.
However, research suggests supplementing with smaller doses of iron and taking iron supplements a few times per week rather than every day may help improve absorption rates.
Because iron needs vary and higher doses may be required for some people, your healthcare provider will recommend an iron supplement and dosing schedule that works best for your specific needs.
Is Iron Safe?
Iron supplements are necessary for some people. However, supplementing with iron when it’s not needed can harm health. When iron levels are sufficient, taking in extra iron through dietary supplements can lead to oxidative stress and cause cellular damage.
Taking in excessive amounts of iron can also lead to iron toxicity, which can be life-threatening.
For these reasons, it's important to talk to a healthcare provider about your iron needs before taking an iron supplement.
Potential Drug Interactions
Certain medications can decrease the absorption of supplemental iron. Iron can also interfere with how some medications work in the body. Drugs that may interact with iron include:
Antacids and proton pump inhibitors. Taking iron supplements with antacid and proton pump inhibitors can interfere with iron absorption. You should wait at least two hours to take antacid medications after taking an iron supplement.
Levothyroxine. Iron supplements can reduce the absorption of thyroid medication Levothyroxine (Synthroid). You should wait at least four hours to take levothyroxine after taking an iron supplement.
Levodopa. Taking iron supplements with the Parkinson’s medication Levodopa (Duopa) could reduce the drug's absorption. You should leave around two hours between taking iron supplements and Levodopa.
If you’re concerned that your iron supplement may interfere with your medications, consult your healthcare provider for advice.
What to Look For
When shopping for an iron supplement, it’s important to choose high-quality products from trusted supplement brands.
When possible, look for products from supplement manufacturers that are certified by organizations like U.S. Pharmacopeia and NSF International, which set strict standards for supplement quality and safety.
You should also choose supplements that are easy to tolerate. For example, people who can’t tolerate swallowing pills may want to purchase a powdered supplement or a liquid iron product.
Unless specifically recommended by a healthcare provider, high-dose iron supplements should generally be avoided, as they're not appropriate for most people.
Can You Take Too Much Iron?
It's possible to get iron toxicity, or iron poisoning, from taking in too much iron from dietary supplements. Iron toxicity can cause gastrointestinal symptoms like stomach pain, vomiting, and diarrhea, and may progress into serious or life-threatening conditions.
Ingesting doses between 9 and 27 mg of elemental iron per pound (lb) of bodyweight can be mildly to moderately toxic. Exceeding 27 mg/lb can lead to severe symptoms, such as kidney and liver failure, and can even be fatal.
Ingesting up to 9 mg/lb of elemental iron is usually safe and well-tolerated. However, you should only take high doses of iron if prescribed and monitored by a healthcare provider.
Children are especially vulnerable to iron toxicity. Iron supplements should always be kept out of reach of children to avoid accidental overdose.
Side Effects of Iron
Iron supplements can cause side effects, some of which can be significant. The most common side effects include:
Constipation
Nausea
Diarrhea
Vomiting
Dark stools
Some forms of iron are more likely to cause gastrointestinal side effects than others. For example, ferrous sulfate, which is one of the most common forms of iron used in supplements, is more likely to cause side effects like constipation and nausea compared to iron bisglycinate.
High-dose iron supplements and taking iron supplements every day can increase the risk of side effects. If you’re experiencing uncomfortable symptoms related to iron supplementation, your healthcare provider may recommend lowering your dose, taking another form of iron, or taking iron a few times a week rather than every day.
Taking in excessive amounts of iron can lead to more serious health issues, such as cardiomyopathy, which is a condition that impacts the heart’s ability to pump blood, and kidney failure.
A Quick Review
Iron is an essential mineral that's involved in many critical processes in the body. Most people can get enough iron through diet alone, but certain groups, such as people who are pregnant and people with certain medical conditions, require supplemental iron to meet their body's needs.
Iron supplements can help people with low or deficient iron stores reach and maintain healthy iron levels and can also prevent iron deficiency in at-risk populations.
If you think you might be low in iron or are concerned that you’re not taking in enough iron through your diet, talk to your healthcare provider about getting your iron levels tested.
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