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Do you need iron supplements?

Iron is a mineral that’s vital to your health. All of your cells contain some iron, but most of the iron in your body is in your red blood cells. Red blood cells transport oxygen from your lungs to the organs and tissues throughout your body. Iron has a role in creating energy from nutrients. It also contributes to the transmission of nerve impulses — the signals that coordinate the actions of different parts of your body. If you have more iron than is needed, it’s stored in your body for future use. The average American gets all the iron they need from the foods they eat. But there are certain situations and conditions that may make it necessary to add supplemental iron to your diet.

You have iron deficiency anemia

Iron deficiency anemia is caused when there’s not enough iron in your red blood cells. Without healthy levels of iron, your red blood cells cannot effectively provide oxygen to your cells and tissues. Symptoms of anemia include:
  • fatigue
  • weakness
  • dizziness
  • difficulty concentrating
Iron deficiency anemia is the most common form of anemia in the United States. Almost five million Americans have it. Common causes of anemia include:

You’re pregnant

Women who aren’t pregnant or nursing need to take in 15 to 18 milligrams of iron daily. Women who are pregnant need significantly more iron. According to the National Institutes of Health (NIH), the recommended dietary allowance of iron for pregnant women is 27 milligrams per day. Don’t double up on your prenatal vitamins if you’re concerned that you’re not getting enough iron. This could cause you to get too much of other vitamins, and may hurt your baby. Instead, talk to your doctor about taking an iron supplement along with your prenatal vitamin.

 You have an infant

Babies build stores of excess iron from their mothers while they’re in the womb. These stores are used during their first six months of life when they’re nursing. You should add iron-fortified foods to their diet when your baby is 6 months of age. Most pediatricians recommend using a formula that’s fortified with iron if you bottle-feed your baby. Premature babies who haven’t had time to build their iron stores are likely to need supplemental iron. Always check with your pediatrician before giving your infant iron supplements.

You menstruate

Menstruation depletes iron stores. This is why women have higher anemia rates than men. Some research suggests that ethnicity is a risk factor for anemia. It is estimated that 19 percent of African-American and Mexican-American women are anemic. Compared to 9 to 12 percent of non-Hispanic white women.

You exercise

According to the Office on Women’s Health, female athletes are at an increased risk for iron deficiency. The exact reason isn’t known. Researchers theorize that athletes may need more red blood cells to carry oxygen so they can keep exercising. Talk to your doctor if you’re very active and you are experiencing symptoms associated with anemia.

You experience regular blood loss

People who experience excessive blood loss often need extra iron. Regular blood donors and people who have gastrointestinal bleeding are at risk. Gastrointestinal bleeding can be caused by medications or conditions such as ulcers and cancer. Donating blood on a regular basis isn’t recommended if you’re consistently low in iron.

You’re on dialysis

Many people who are on kidney dialysis need extra iron. The kidneys are responsible for making erythropoietin, a hormone that tells the body to make red blood cells. If the kidneys don’t work as well, anemia is often a side effect. You may lose a small amount of blood during dialysis. And dialysis diets also often limit iron intake. Some medications that people on dialysis take can use up iron or interfere with the body’s ability to absorb it. Talk to your doctor about how to maintain healthy blood iron levels if you’re on dialysis.

You take iron depleting medications

Some medications can interfere with your body’s ability to absorb iron. Medications that can deplete iron include:
  • quinolones, a family of antibiotics that includes ciprofloxacin (Cipro) and levofloxacin (Levaquin)
  • tetracycline (Panmycin)
  • ranitidine (Zantac) and omeprazole (Prilosec) for ulcers, heartburn, and other stomach problems
  • angiotensin converting enzyme (ACE) inhibitors for high blood pressure
  • colestipol (Colestid) and cholestyramine (Prevalite) for cholesterol lowering bile acid sequestrants
If you’re concerned about one of your medicines causing anemia, see your doctor. But don’t stop taking a medication unless you are specifically instructed to do so.

You have ADHD

A 2014 study published in the Annals of Medical & Health Sciences Research found that iron deficiency was increasingly associated with attention deficit hyperactivity disorder (ADHD). After studying blood levels of iron, ferritin, vitamin D, magnesium, calcium, and phosphorus, the researchers found children with ADHD had lower levels of iron and ferritin. Ferritin stores iron inside the cells for later use.

You have ACE inhibitor associated cough

Doctors prescribe ACE inhibitors to treat a number of conditions, including: ACE inhibitors may even help prevent kidney disease in those with type 2 diabetes. A dry cough is a common side effect of the medication. According to a study published in the Journal of the Renin-Angiotensin-Aldosterone System, people who took 200 milligrams of ferrous sulfate supplement daily, at least two hours after taking their ACE inhibitor, were less likely to have a cough. The researchers found taking iron increased the amount of nitric oxide in the blood. Nitric oxide helps to reduce ACE inhibitor-associated coughs.

The takeaway

Most people respond well to taking iron supplements, which are available in capsules. Some people with very low iron levels may need intravenous iron. Ideally, you should take iron supplements on an empty stomach because food can decrease the amount of iron your body absorbs. Taking iron supplements with foods or drinks that have vitamin C will help your body absorb the iron. Be sure to take only the recommended dose of iron. Too much can be toxic, especially for children. And talk to your doctor to find out how long you need to take an iron supplement. Shop for iron supplements.