What Are The Side Effects Of Iron Supplements?

October 18, 2023

Iron is a mineral that helps with the transportation of oxygen around the body, and it is a major component of red blood cells. The nutrient also helps keep the skin, hair, and nails healthy. Patients who do not get enough iron in their diet may develop iron-deficiency anemia. This condition causes patients to feel fatigued, and they might also experience cold hands and feet, pale skin, brittle nails, headaches, and dizziness. Women who are pregnant or menstruating are at an increased risk of iron deficiency, and vegetarians have a higher prevalence of this condition compared to individuals who eat meat. Doctors can check a patient's iron levels with a simple blood test. If the results are low, patients might be encouraged to include more iron-rich foods such as spinach, chickpeas, pumpkin seeds, meat, lentils, and tofu in their diets, and iron supplements may be prescribed. The supplements are generally taken for several months, and patients will be retested after this time to check whether their levels have returned to the normal range. To increase iron absorption, doctors recommend patients take their iron supplements with vitamin C. Patients might want to eat an orange or take a vitamin C supplement immediately after taking their iron supplement.

Of course, iron supplements can result in some side effects, which are discussed below.

Nausea And Vomiting

Nausea and vomiting may occur from the use of iron supplements. These side effects are most likely to develop when the patient first starts taking iron, and they often resolve during treatment. Nausea can be an early sign of an iron overdose, however, so individuals who experience this symptom should always let their doctor know. Patients should also inform their healthcare provider if they experience vomiting while taking iron supplements; this is another possible symptom that occurs in the early stages of an iron overdose. Vomiting associated with an iron overdose is generally severe and frequently contains blood. After patients have checked with a doctor to ensure they are not experiencing an iron overdose, they can take steps to treat their nausea and vomiting at home. Both symptoms can be managed by eating small, bland meals and sipping on water throughout the day. In addition, some patients find it helpful to consume foods or drinks that contain ginger. Patients who want to try ginger should ask their doctor before consuming ginger tea, as caffeinated teas can sometimes interfere with iron absorption.

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Stomach Pain Or Upset

Patients just starting iron supplementation may notice stomach pain or upset. To reduce the risk of these symptoms, doctors may start the patient on a half dose of iron at first, working up to a full dose within a few weeks. Iron is absorbed most effectively if it is taken on an empty stomach. However, doing this can increase the chance of experiencing stomach pain. For this reason, doctors typically recommend patients take iron supplements with food. When taking iron with meals, it is important to avoid drinking milk, taking antacids, or consuming calcium supplements or high-calcium foods at the same meal, as calcium decreases the body's ability to absorb iron. Patients should also avoid taking iron supplements with caffeinated drinks and with high-fiber foods such as oatmeal, whole grains, cereals, and raw vegetables. Individuals who notice sharp or stabbing stomach pain should let a doctor know right away as this type of pain could be a symptom of an iron overdose.

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Constipation Or Diarrhea

Patients might notice changes in their stools and bowel habits while taking iron. Dark stools are particularly common, and constipation or diarrhea could develop. Pregnant women who take iron are at an increased risk of constipation. To treat constipation, doctors recommend increasing dietary fiber intake by including more whole grains, oatmeal, fruits, and vegetables in daily meals. Some patients might want to take a fiber supplement or a stool softener, and individuals who have more troublesome constipation might need to use a laxative or an enema for relief. To treat diarrhea, patients could consider temporarily reducing dietary fiber. Foods such as white rice and applesauce may be beneficial in the treatment of diarrhea, and patients should aim to avoid fried foods, beans, cabbage, and spicy foods, all of which could worsen diarrhea. If diarrhea or constipation continue for more than a few days, patients should see their doctor for advice. In particular, patients should let their physician know if they experience bloody diarrhea, as this could be a sign of iron overload.

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Numbness And Tingling

Numbness and tingling are signs of nerve issues, and they develop most often in the hands and feet. Both symptoms can occur due to an iron deficiency and as a side effect of treatment with iron supplements. Some patients who have numbness and tingling might also experience pain in their hands and feet. To assess numbness and tingling, doctors can check a patient's sensation, and they might also perform an exam to test whether the patient can distinguish between warm and cool temperatures. Patients should let their doctor know about any numbness or tingling, especially if it spreads to the face, as this may be a sign of an allergic reaction to the iron supplements. In cases of persistent tingling, doctors may adjust the dose of the patient's iron medication, or they might recommend stopping the supplements for a few days to see if symptoms improve.

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Issues Breathing

Breathing issues are a rare side effect of iron supplements, and they generally occur only in instances of late-stage iron overdose. In these cases, the patient's breathing is typically rapid and shallow, and they might also have a weak, rapid pulse, and bluish-tinged fingernails. Patients who experience any issues breathing should seek emergency medical care, and they should let hospital staff know they have been taking iron supplements. To assess breathing difficulties, doctors will listen to the patient's lungs with a stethoscope, and they will measure their respiration rate. Supplemental oxygen will be provided to ease breathing, and patients might need to stay in the hospital for a few hours or days so doctors can successfully treat the issue.

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Skin Rash

If a skin rash develops while taking an iron supplement, this could be caused by an allergic reaction to the supplement ingredients. Iron supplements are available over-the-counter, and some formulations may contain milk, soy, wheat, or other inactive ingredients to which the patient might have an unknown allergy. Individuals who have a rash due to an allergy often develop hives. Red welts form in clusters on the body, and these are often intensely itchy. The welts might be elevated, and they could quickly spread from one area of the body to another. Some patients notice hives within minutes of consuming a supplement to which they are allergic. Patients should have all skin rashes examined by a doctor as soon as possible. If a skin rash occurs in conjunction with an increased heart rate, swelling of the face or tongue, stomach pain, or breathing difficulties, the patient should be taken to the emergency room to be evaluated for possible anaphylaxis. Patients who are allergic to iron supplements may need to increase their intake of iron-rich foods.

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Increased Heartbeat

The overuse of and allergic reactions to iron supplements could both lead to an increased heartbeat. Excessive iron in the blood is associated with an increased risk of heart rhythm abnormalities too. While oral iron supplements are not typically associated with an increased heartbeat, this side effect is relatively common when iron is given via an injection. For adults, a normal heart rate is between sixty to one hundred beats per minute. Heart rate can be affected by anxiety, medication use, physical activity, caffeine intake, and dehydration. Individuals who receive iron injections should let their nurse or other healthcare provider know immediately if they notice an increased heart rate.

Patients taking oral iron supplements can check their heart rate at home, and this can be done manually or with at-home blood pressure monitors or fitness trackers. Heart rate changes throughout the day, so it may be beneficial for the patient to check their pulse in the morning, afternoon, and evening. Measurements can be recorded in a log and compared over several days or weeks. Individuals who notice their heart rate is consistently above eighty-five beats per minute may want to discuss this with their physician. Prescription medications such as beta-blockers can be used to reduce heart rate if necessary, and doctors might recommend lifestyle modifications, breathing exercises, and stress-reduction techniques as well. Patients who feel a pounding or racing heartbeat, chest pain, or a sensation of skipped or irregular heartbeats should seek urgent medical attention.

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Pale and Clammy Skin

Patients in the late stages of an iron overdose may notice pale and clammy skin. Clammy skin generally feels wet, moist, or sweaty. The skin often becomes significantly paler than usual, and this symptom could occur suddenly. Patients with pale and clammy skin might have lips and fingernails that appear blue, and the palms of the hands take on a blue discoloration as well. Patients who have pale and clammy skin along with weakness, unusual tiredness, and shallow and rapid breathing should be taken to an emergency room for immediate evaluation. These patients may develop a weak and fast heartbeat, and seizures could occur. Doctors will make a note of the patient's skin symptoms, and blood tests will be performed to determine the underlying cause. Most patient's skin returns to its normal color once the iron overdose is corrected.

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Overall Weakness

Although it is uncommon, some patients could experience overall weakness and a general feeling of being unwell after having an iron injection. In these cases, overall weakness occurs in the absence of dizziness or feeling faint. Overall weakness also develops in the later stages of an iron overdose. If weakness is present after receiving an iron injection, the patient should alert the healthcare provider who administered it immediately. For weakness that occurs at home in conjunction with breathing difficulties, heart rate increases, or skin that is clammy or blue, emergency medical attention is required. While waiting for medical attention, the patient should try to sit or lie down to prevent a fall. It can be helpful for doctors at the hospital to know when the patient first started feeling weak and how long this symptom has persisted. The doctor will also need to know about all of the medications the patient is taking and whether any other symptoms are present. Weakness generally resolves quickly with successful treatment.

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Dark Stools

Dark stools are a very common side effect of oral iron supplements. The stool may appear dark green or black, and these discolorations are caused by unabsorbed iron. Generally, dark stools associated with the use of oral iron supplements are considered harmless. They may resolve as the patient's body adjusts to the medication, and medical treatment is not normally necessary. If dark stools persist for a prolonged period or if they become bothersome, the patient should mention them to their primary care physician. Black stools accompanied by stomach pain, sharp cramps in the abdominal area, or red streaks in the stool may indicate a potentially serious medical issue. Patients with these symptoms should contact their healthcare provider immediately.

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