How to Take Iron Supplements

Co-authored by Claudia Carberry, RD, MS

Last Updated: January 22, 2024 References

Anemia, or an iron deficiency, can cause fatigue, put you at a higher risk of infections, and lower your quality of life. If you need to take supplements to boost your iron levels, consult your doctor about the right dosage amount. To maximize absorption, take iron supplements as directed on an empty stomach with a small amount of food. If you've experienced symptoms of anemia, you may feel better as soon as a week after starting treatment.^{[1]
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Part 1

Part 1 of 3:

Choosing the Right Supplement

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Go for a multivitamin supplement if you don’t have anemia. If you don‘t have anemia and just want to make sure you’re getting enough iron, take a daily multivitamin. Multivitamin supplements usually contain 18 mg (100% daily value) of iron.^{[2]
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- It’s best to consult your doctor before taking a multivitamin, especially if you take medications or have a history of any medical conditions.
Spot signs of anemia: Symptoms of anemia include fatigue, shortness of breath, fast heartbeat, paleness, dizziness, and headache. A number of medical conditions can cause these symptoms, so see your doctor for an accurate diagnosis.^{[3]
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Treat anemia with an iron-only supplement. Schedule a doctor’s appointment if you think you have an iron deficiency. They'll perform an exam and order a blood test to make an accurate diagnosis. To correct an iron deficiency, they’ll recommend iron-only tablets or capsules, which often contain at least 65 mg (360% daily value) of iron.^{[4]
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- You may need to take higher-dose iron supplements if you have cancer, bleeding problems, kidney disease, Crohn’s disease, Celiac disease, or ulcerative colitis. These conditions often cause iron and other vitamin deficiencies.
- Consuming too much iron is dangerous if you don't have a serious deficiency, so do not try to take high doses of over-the-counter iron supplements. Never take high-dose iron unless directed by a doctor.
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Take a liquid iron supplement if you can’t swallow pills. Liquid, syrup, and powdered iron supplements are the best option for children and adults who can’t swallow pills. Specific steps vary, so use your product according to the package’s instructions or as directed by your doctor.^{[5]
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- Generally, carefully measure your prescribed amount of liquid, syrup, or powdered iron supplement with a dropper or measuring spoon, then mix it with juice or water.
- Your body may also absorb liquid iron supplements better, and some people report that they cause fewer side effects than tablets and capsules.
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Ask your doctor to recommend the right dosage amount. Whether you take an iron supplement in pill or liquid form, use it as your doctor prescribes. Depending on your specific condition, your doctor may prescribe a dose of iron that’s unsafe for people with normal iron levels.^{[6]
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- Remember to use high-dose iron supplements only under the guidance of a medical professional. Taking too much iron can cause severe vomiting and diarrhea, organ failure, coma, and death.
- Tell your doctor about any medicines you take. Excess iron can affect how some medications work, including some antibiotics and medications for Parkinson’s disease or hypothyroidism.

Part 2

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Using Iron Supplements Safely

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Take iron on an empty stomach with juice and a small amount of food. Taking your supplement on an empty stomach improves absorption, but it may cause stomach cramps, nausea, and diarrhea. To lower the risk of an upset stomach, take the supplement with 1 cup (240 mL) of orange juice and a snack or light meal.^{[7]
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- Vitamin C helps your body absorb iron, so it’s a good idea to take your supplement with orange juice. While taking iron supplements, you should also eat more foods that are rich in vitamin C, such as citrus fruits, cantaloupe, mango, strawberries, and tomato.
- Just be wary of eating raw high-fiber fruits and vegetables, such as broccoli and cabbage, within 2 hours of taking your supplement. Fiber can interfere with iron absorption.
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Wait 2 hours before consuming calcium, caffeine, and high-fiber foods. If you take iron with food, make sure you steer clear of dairy products, whole grains, and raw high-fiber veggies. Additionally, don’t drink caffeinated tea, coffee, or soda, and avoid sneaky sources of caffeine, such as chocolate.^{[8]
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- You should also avoid consuming calcium supplements and antacids within 2 hours of taking an iron supplement.
- Calcium, caffeine, and high-fiber foods make it more difficult for your body to absorb iron.
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Store iron supplements in a cool, dark, and dry place. Avoid storing iron tablets or capsules in your bathroom medicine cabinet, which may be too warm and humid. A pantry cupboard away from liquids and direct light is a better option.^{[9]
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- Iron supplements typically have a shelf life of 2 years or more. Check the expiration date, and avoid taking a supplement that has expired.
- If you take a liquid iron supplement, you may need to store it in the refrigerator. Check your product’s instruction label, and store it as directed.
Safety precaution: If you have children or pets, keep iron supplements out of their reach. Accidental iron overdose is a leading cause of fatal poisoning in children under 6.^{[10]
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See your healthcare provider regularly to monitor your iron levels. You’ll likely take supplements for 6 to 12 months if you’re treating an iron deficiency. During that time, you’ll need to get blood tests periodically to check your iron levels. They should return to normal in 2 to 6 months, but you’ll probably continue taking supplements to build up your body’s iron stores.^{[11]
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- If you’ve experienced symptoms of anemia, you should start to feel better within 1 to 4 weeks after you start taking iron supplements.

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Managing Side Effects

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Seek medical attention if you experience serious side effects. Signs of an iron overdose include severe or bloody diarrhea and vomiting, fever, sharp stomach cramps, bluish lips and fingernails, rapid breathing, fast heartbeat, and seizures. Other causes for concern include rash, swelling, numbness or tingling, and trouble breathing. Call emergency services or get to an emergency room if you experience any of these symptoms while taking iron supplements.^{[12]
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- While black stools are normal and are a sign the supplements are working, they shouldn’t have a tarry appearance. See your doctor if you experience tar-like stools, which are serious and could indicate intestinal bleeding.
Constipation is a common side effect, but medications can help. Use an over-the-counter stool softener, or ask your doctor if they recommend a prescription-strength medication. Take your medication according the package’s instructions or as directed by your doctor.^{[13]
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Tip: Staying hydrated can also help relieve constipation, so drink at least 8 cups (1.9 L) of fluids per day. Physical activity can also help, so try to walk briskly or jog for at least 30 minutes a day.
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Ask your doctor about lowering your dose if side effects persist. Tell your doctor if you experience persistent nausea, cramps, constipation, or diarrhea. Ask them if you can take a lower dose or switch to an iron supplement in another form. If altering your dose isn't possible, ask them to recommend medication to relieve your specific symptoms, such as an anti-nausea or anti-diarrheal drug.^{[14]
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- If you haven’t been taking your iron supplement with a meal, doing so could also help relieve side effects.
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Drink a liquid iron supplement through a straw if it stains your teeth. Liquid iron supplements can give teeth a blackish tinge. To prevent stains, mix the dose with water or juice, and drink the beverage through a straw to minimize contact with your teeth.^{[15]
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- To remove stains, simply brush your teeth with baking soda or rinse your mouth with 3% hydrogen peroxide.

Expert Q&A

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Question

What can I do if my iron level is 6.0?

Claudia Carberry, RD, MS
Registered Dietitian
Claudia Carberry is a Registered Dietitian based in Little Rock, Arkansas. Claudia specializes in kidney transplants and counseling patients for weight loss. She works at the University of Arkansas for Medical Sciences center, and has been working there since 2015. Before her current role, she worked as a Clinical Nutrition Manager at Jefferson Regional Medical Center. She is a member of the Arkansas Academy of Nutrition and Dietetics. Claudia received her MS in Nutrition from the University of Tennessee, Knoxville, where she completed her 1200 hour dietetic internship. She received a BS in Nutrition Sciences from Southeast Missouri State University.

Claudia Carberry, RD, MS

Registered Dietitian

Expert Answer

If you're worried about your iron levels, talk to your doctor to find out if an iron supplement might be right for you.

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Is good to take an iron supplement with lemon and water?

Claudia Carberry, RD, MS
Registered Dietitian
Claudia Carberry is a Registered Dietitian based in Little Rock, Arkansas. Claudia specializes in kidney transplants and counseling patients for weight loss. She works at the University of Arkansas for Medical Sciences center, and has been working there since 2015. Before her current role, she worked as a Clinical Nutrition Manager at Jefferson Regional Medical Center. She is a member of the Arkansas Academy of Nutrition and Dietetics. Claudia received her MS in Nutrition from the University of Tennessee, Knoxville, where she completed her 1200 hour dietetic internship. She received a BS in Nutrition Sciences from Southeast Missouri State University.

Claudia Carberry, RD, MS

Registered Dietitian

Expert Answer

A better option is to take your iron supplement with a good source of vitamin C. For example, you might take it with 4-8 oz of orange juice.

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If you’re concerned about your iron intake, try to eat more iron-rich foods, such as red meat, poultry, seafood, beans, and fortified cereals.^{[16]
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Ask your doctor if they recommend keeping a 1 fl oz (30 mL) bottle of ipecac syrup in your first aid kit. This is a drug used to induce vomiting in cases of iron overdoses.

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Warnings

If you suspect an iron overdose, call emergency services immediately.

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If you’re treating a medical condition, don’t stop taking iron supplements without consulting your doctor. Take your supplements exactly as directed.^{[17]
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