Having Trouble with Your Iron Supplement? Here’s What You Can Do

So, you’ve started taking an iron supplement and now it’s not going so well. Maybe it’s the side effects, or you keep forgetting to take all of your doses each day, or perhaps you just don’t feel like it’s working. What should you do? Well, here are a few tips for you:


#1: Keep Taking It

If you’ve been diagnosed with iron deficiency and have been recommended to take a supplement, then you’ll likely need to be on it for at least 3 months. Iron supplements may help you feel better rather quickly, but your iron level and iron stores will take much longer to be regained. Learn more about how long you should take your iron supplement →

Even if side effects are getting you down, it’s still important to keep taking your supplement as directed by a healthcare professional. Don’t worry though, because I’ll give you some tips on how to help with those side effects in the next step.


 #2: Mitigate Side Effects

Side effects like stomach upset, nausea, constipation or diarrhea are common when taking iron supplements, although some classes of iron are better tolerated than others.

Now, don’t go playing doctor and taking matters into your own hands because reducing your dose could make treatment less effective. Instead, here are a few tips:

  • Drink more water and spread out your doses if possible (start with half the recommended dose and gradually increase to the full dose)
  • Take your supplement with food to help reduce stomach upset (ensure that you check the label closely as some products don’t recommend this because food can significantly reduce absorption)
  • Use a stool softener to alleviate constipation
  • Switch to a different class of iron supplements


#3: Switch to a Difference Class of Iron Supplements

There are different classes of iron with different brands within each class (ie. Polysaccharide-Iron Complex (PIC), Heme Iron Polypeptide or ferrous salts). The different irons offer varying available elemental iron, dosing regimens, and different side effects profile. Learn more about the different classes of iron and available brands here

If you feel like your iron supplement isn’t doing enough for you or you can’t tolerate the side effects, talk to your doctor or pharmacist about switching to a different class. Just switching brands (unless switching class too) will likely leave you with the same side effects so make sure that you’re clear when talking to your doctor/pharmacist about the available options. Also, compliance is extremely important because as I mentioned above, if you’ve been diagnosed with iron deficiency, you will likely need to take your supplement for at least 3 months – if your issue is forgetting to take your supplement due to frequent dosing, ask about the different dosing options that other supplements may offer. Learn more about the dosing regimens of different iron supplements here


So, if you’re not happy with your current supplement, there are things you can do to stay on track and complete the needed therapy. Talk to your doctor or pharmacist for more information.

Content and advice provided on The Iron Maiden is for information purposes only and should not serve as a substitute for a licensed health care provider, who is knowledgeable about an individual’s unique health care needs

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8 thoughts on “Having Trouble with Your Iron Supplement? Here’s What You Can Do

    • Leona, RN & Blood Specialist says:

      Hi Carolyn,

      Iron gluconate (aka ferrous gluconate) is an iron salt which should be taken on an empty stomach, in the presence of vitamin C and the absence of iron inhibitors (coffee, tea, cola, chocolate, calcium, dairy and dairy substitutes). It is converted from the type of iron it is to the type of iron our body absorbs in the presence of acid. If you take a Proton Pump Inhibitor (PPI) or H2 Inhibitor (medications that suppress the production of stomach acid), there will not be enough acid to convert this iron; therefore, not the best choice. Common side effects include nausea, heart burn and constipation.

      While all iron supplements work in a healthy unaltered gut, if you have any issues with your digestive tract this is likely not the best choice. You may wish to discuss your treatment options with your personal health care provider or pharmacist.


  1. Holly says:

    I’m familiar with you from a wls Facebook group and was wondering if you could help me out. I’m an admin in a pregnancy post wls group and these girls and their doctors are clueless. They get into full on arguments about Flintstone vitamins being suitable for iron deficiencies and being that I don’t have a medical title behind my name they just don’t believe me. Would you be able to email me one of your articles or a post I can pin for reference?


      Hi Holly,

      First, the iron in Flintstones Vitamins is an iron salt and, as such, is not suitable for post-bariatric patients. This is because the section of the small intestine is the part that is bypassed. I encourage you to pose the following two questions of this group that is arguing with you:

      1. Where are iron salts absorbed?
      2. What section of the small intestine has been bypassed?

      The answer to this question is the first section of the small intestine. Follow this with the knowledge that, in a normal healthy surgically-unaltered gut, only 8% of iron salts is converted and available for absorption. Polysaccharide and heme polypeptide iron supplements are the only oral iron source that is recommended post bariatric surgery, and their side effect profile alone should be enough to win converts.

      There is also a series of articles published on my blog by Dr. Anne McLeod regarding iron deficiency and pregnancy – check them out!

      I hope this helps!

  2. Nicole says:

    I have gut issues and can’t tolerate iron pills but I need to get my iron up. I’m so dizzy daily and feel itchy and tired so much that Its affecting my daily life. What can I do?

    • The Iron Maiden says:

      Hi Nicole,

      When you say you cannot tolerate any oral iron supplements I have to ask if you have tried polysaccharide iron complexes like FeraMAX or heme polypeptide iron supplements both known to significantly reduce, if not eliminate, “gut” side effects.

      As for advising you as to what to do. I urge you to speak with your primary healthcare provider as s/he knows you and your health history a great deal better than I. I would recommend printing and completing the symptoms checker and the article on the progression of iron deficiency. Take these to your appointment and let your healthcare provider know you want to play an active role in your health and wellbeing. Your healthcare provider is the expert in medicine and you are the expert in you.

      I hope this is helpful and good luck with the self-advocacy.


  3. Sara says:

    I have been dignosed with low ferittin of 13 HC 32 and Hg 10.5 . I also have B12 and D deficiency. My doctor put me on Feramx 100 once a day and B12 injections. How long it takes for Feramax to rise my iron storage? My doctor also said taking iron after dinner reduces the side effects. Is that a fact? Because I am having GERD and taking anti acids too . Although Feramx goes way better than other supplements with me still makes me nauseous throughout the day. I already suffer vertigo because of my low ferittin. So life is not going well with me these days at all. Feeling sick all the time.

    • The Iron Maiden says:

      Hi Sara,

      You are currently in stage three of iron deficiency complicated by B12 deficiency. Unfortunately, when your ferritin is less than 20 it is difficult if not impossible for you to replete your iron stores. At 13, the FeraMAX you are taking will help build your hemoglobin but will not replete your stores and you will likely continue to be symptomatic of stage one and two iron deficiency specifically: chronic fatigue, irritability, and difficulty concentrating. You need a referral to a benign clinical hematologist who will hopefully order IV iron for you.

      I wish you the best in your work towards a definitive treatment of your iron deficiency. Looking at your numbers, I can only imagine how poorly you feel. Please continue to update us regularly on your progress.


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