By Paula Kue, MD Provided by: Johns Hopkins University

Women's Health

Pumping Up Your Iron Posted Mon, Apr 07, 2008, 9:39 am PDT

90% of users found this article helpful.

If you've suffered heavy periods and tests show you have anemia with low iron levels, then you may have been told to start an iron supplement. Sounds simple enough - until you get to the pharmacy and are confronted by the dozens of supplements from which to choose. Which one is best? Whichever one suits your budget. But some words of experience may help you decide.

The most commonly recommended iron supplement is ferrous sulfate at a dose of 325 mg twice daily. This compound has a good amount of elemental iron. To maximize iron absorption, take the supplement with orange juice or vitamin C. Avoid mixing your iron supplement with milk, antacids or your calcium supplement, though, because these substances will reduce iron absorption.

Unfortunately, iron supplements can cause nausea, constipation, and change the color of your stools. Some women manage better with slow-release preparations which have fewer of these bothersome side effects. You may be able to tolerate ferrous gluconate, but this form of iron provides less elemental iron. If constipation is a problem, try reducing the dose or adding a fiber supplement like Metamucil, Citrucel, or Benefiber.

If you don't like having to take supplements and have only borderline anemia, then I often recommend simply taking iron pills during the menstrual cycle when there's greater loss of iron through bleeding. There's even an oral contraceptive pill that provides iron tablets in the package for each day of the menstrual cycle.

Speaking of oral contraceptives, they often lighten menstrual periods which means less bleeding and iron loss and can eliminate the need for iron pills. Intrauterine devices (IUDs) also typically lead to lighter periods, especially the newer progesterone-releasing one (Mirena).

Of course, one of the most important ways to make sure you get enough iron is through a varied diet with lots of iron-rich foods. Meats, especially liver, and veggies like spinach and other dark leafy green ones, are great sources of iron. Also look for iron-enriched breads and cereals. If you spend a little time reading food labels, you may be able to adjust your diet to compensate for your low iron levels without having to take a pill!

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