How To Take Iron Tablets During Pregnancy?

Try to take the pills on an empty stomach about 1 hour before or 2 hours after meals. But you may need to take iron with food to avoid an upset stomach. Do not take antacids or drink milk or caffeine drinks (such as coffee, tea, or cola) at the same time or within 2 hours of the time that you take your iron.
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How many iron tablets should I take when pregnant?

What does this indicator tell us? This indicator reflects the percentage of women who consumed any iron-containing supplements during their current or previous pregnancy within the past 2 years. It provides information about the quality and coverage of perinatal medical services.

• Daily iron and folic acid supplementation is currently recommended by WHO as part of antenatal care, to reduce the risk of low birth weight, maternal anaemia and iron deficiency.
• It is suggested that the supplement contains 30-60 mg of iron, with the higher dose preferred in settings where anaemia in pregnant women is a severe public health problem (≥40%), along with 400 µg of folic acid.

Daily supplementation throughout pregnancy, beginning as early as possible after conception, is recommended in all settings. Despite its proven efficacy and wide inclusion in antenatal care programmes, the use of iron and folic acid supplementation has been limited in programme settings.

Possible reasons for this include a lack of compliance, concerns about the safety of the intervention among women with an adequate iron intake, and variable availability of the supplements at community level. Intermittent use of iron and folic acid supplements by non-anaemic women is a recommended alternative to prevent anaemia and improve gestational outcomes in areas where the prevalence of anaemia among pregnant women is lower than 20%.

The suggested dose is 120 mg elemental iron and 2800 µg (2.8 mg) folic acid provided weekly throughout the pregnancy, beginning as early as possible after conception. This indicator is included as a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework.

1. How is it defined? This indicator is defined as the proportion of women who consumed any iron-containing supplements during their current or previous pregnancy within the past 2 years.
2. Data can be reported on any iron-containing supplement, including iron and folic acid tablets, multiple micronutrient tablets or powders, or iron-only tablets (which will vary, depending on the country policy).

What are the consequences and implications? Improving the intake of iron and folic acid by women of reproductive age could improve pregnancy outcomes, and improve maternal and infant health. Iron and folic acid supplementation is used to improve the iron and folate status of women before and during pregnancy, in communities where food-based strategies are not yet fully implemented or effective.

1. Folic acid supplementation (with or without iron) provided before conception and during the first trimester of pregnancy is also recommended for decreasing the risk of neural tube defects.
2. Anaemia during pregnancy places women at risk for poor pregnancy outcomes, including maternal mortality; it also increases the risks for perinatal mortality, premature birth and low birth weight.

Infants born to anaemic mothers have less than one half the normal iron reserves. Morbidity from infectious diseases is increased in iron-deficient populations, owing to the adverse effect of iron deficiency on the immune system. Iron deficiency is also associated with reduced work capacity and reduced neurocognitive development.

1. Source of data Demographic and health surveys (DHS) program STATcompiler ( http://www.statcompiler.com/ ).
2. Further reading WHO.
3. Developing and validating an iron and folic acid supplementation indicator for tracking progress towards global nutrition monitoring framework targets.
4. Final report – June 2018.

Geneva: World Health Organization; 2018 (https://www.who.int/nutrition/publications/iron-folic-indicator-GNMF/en/). WHO. Weekly iron and folic acid supplementation as an anaemia-prevention strategy in women and adolescent girls. Lessons learnt from implementation of programmes among non-pregnant women of reproductive age.

Geneva: World Health Organization; 2018 (https://www.who.int/nutrition/publications/micronutrients/WIFS-anaemia-prevention-women-adolescent-girls/en/). WHO. Weekly iron-folic acid supplementation (WIFs) in women of reproductive age: its role in promoting optimal maternal and child health. Geneva: World Health Organization; 2009 (http://www.who.int/nutrition/publications/micronutrients/weekly_iron_folicacid.pdf).

WHO, UNICEF. Global Nutrition Monitoring Framework: operational guidance for tracking progress in meeting targets for 2025. Geneva: World Health Organization; 2017 ( http://www.who.int/nutrition/publications/operational-guidance-GNMF-indicators/en/ ). Internet resources WHO.

Daily iron and folic acid daily supplementation during pregnancy ( http://www.who.int/entity/elena/titles/daily_iron_pregnancy/en ).Intermittent iron and folic supplementation in non-anaemic pregnant women ( http://www.who.int/elena/titles/guidance_summaries/intermittent_iron_pregnancy/en/ )

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How long should you take iron tablets for when pregnant?

Very low iron levels can affect your baby’s growth and can increase the risk of your baby coming early. Your iron intake is most important in the final 10 weeks of pregnancy as this is when your baby begins to build their own iron stores ready for the first 6 months of life.
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Can I take iron tablets twice a day during pregnancy?

Abstract – Background: The International Nutritional Anaemia Consultative Group has recommended a twice daily dose of 65 mg elemental iron supplementation in pregnant women living in areas where anaemia is prevalent contrary to the World Health Organization (WHO) universal recommendation of a daily dose of 60 mg.

1. Whether twice or daily dose schedules proffer a better outcome is a subject of on-going research.
2. Objective: To compare the effectiveness of the once versus twice daily doses of ferrous sulphate in the prevention of iron deficiency anaemia in pregnancy.
3. Methods: There are about one hundred and eighty two (182) pregnant women at gestational ages of 14-24 weeks with haemoglobin (Hb) levels ≥10 g/dl but ≤14.5 g/dl were recruited during the antenatal booking clinic.

They were randomized into receiving either once daily dose (65 mg of elemental iron) or twice daily dose (130 mg of elemental iron) of ferrous sulphate. Pre and post- supplementation haemoglobin, serum iron and ferritin levels were assessed at recruitment and at 37 weeks gestation respectively.

• Results: Eighty-four (84) and 80 women respectively in the once and twice daily dose groups were analysed.
• The serum haemoglobin was significantly lower (P = 0.002) among those on once daily than those on twice daily supplementation.
• The side effects were however, significantly higher in the twice daily group (P = 0.005, P = 0.043 and P = 0.004 respectively).

There were no differences between the serum ferritin levels pre and post supplementation in both groups just as they were no reported significant differences in both birth weight of neonates (P = 0.936) and average gestational age at delivery (P = 0.469) between the two groups.
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Can I take 2 iron tablets at a time?

How much will I take? – The dose of ferrous sulfate depends on why you’re taking it and whether you have tablets, capsules or drops. For children under the age of 18 years, the doctor will use your child’s age, weight and blood results to work out the right dose. To treat anaemia The usual dose for adults is:

tablets : one 200mg tablet, taken 2 to 3 times a day drops : 4ml, taken once or twice a day

To prevent anaemia The usual dose for adults is:

tablets : one 200mg tablet, taken once a day drops : 2.4ml to 4.8ml daily

How to take it Ferrous sulfate works best when you take it on an empty stomach. However, if it upsets your stomach, you can take it with or after food. A doctor (or a pharmacist) may recommend taking ferrous sulfate with orange juice or a vitamin C supplement.

Vitamin C is believed to increase the amount of iron absorbed by the body. Swallow the tablet or capsule whole with a glass of water. Do not suck, chew or keep the tablet in your mouth as this can cause mouth ulcers or stain your teeth. Do not take it with tea, coffee, eggs, dairy products and soybean products, as they can reduce the amount of iron that gets into your system.

When you take ferrous sulfate (or when you eat foods that are high in iron), leave a 2-hour gap before having these foods or drinks. If you have difficulty swallowing the tablets tell your doctor or pharmacist. If you’re taking ferrous sulfate as drops, it will come with a plastic syringe or dropper to help you measure out the right dose.
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Is it OK to take iron before bed?

Iron – Majumdar says that iron is best absorbed on an empty stomach, but can be difficult to tolerate, causing upset stomach, nausea and constipation. “Consider first trying it on an empty stomach, and if not tolerated, take at night before bed,” she suggests.

• Taking iron in smaller, divided doses throughout the day can also help with tolerance.
• Generally, the side effects are mild enough to sleep through, and if you avoid eating a few hours before bed, you can maximize absorption.
• Iron competes for absorption in the small intestine with calcium and zinc, so taking iron at least two hours apart from these nutrients is ideal,” she says.

Since multivitamins often include iron, consider taking iron separately if it’s needed for a true iron deficiency, But beware of overdosing. “Excess iron is stored in the liver and if taken in excess amounts, can be damaging, so consult a medical professional like a registered dietitian nutritionist before taking iron,” Majumdar says.

• The Recommended Dietary Allowance – or the National Food and Nutrition Board’s suggested dietary intake – for all age groups of men and postmenopausal women is 8 milligrams a day; the RDA for premenopausal women is 18 mg/day.
• The Tolerable Upper Intake Level – the maximum dose that can be taken without risking overdose or serious side effects – is 45 mg/day for adults, according to the National Institutes of Health.

(People who are being treated for iron deficiencies or anemias will typically be prescribed doses higher than this until their levels normalize.) A specific type of iron known as heme iron, which is found in meat and other animal products, is better absorbed than nonheme iron, found in vegetarian foods like nuts, seeds and beans.
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What happens if I skip iron tablets during pregnancy?

What are the consequences of iron deficiency in pregnancy? – Iron deficiency anemia can make you feel tired and exhausted. Severe anemia can also lead to complications in pregnancy. For instance, it can weaken the mother’s immune system and make infections more likely.
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How many hours in between can you take iron pills?

Precautions – Drug information provided by: IBM Micromedex When iron is combined with certain foods it may lose much of its value. If you are taking iron, the following foods should be avoided, or only taken in very small amounts, for at least 1 hour before or 2 hours after you take iron:

Cheese and yogurt Eggs Milk Spinach Tea or coffee Whole-grain breads and cereals and bran

Do not take iron supplements and antacids or calcium supplements at the same time. It is best to space doses of these 2 products 1 to 2 hours apart, to get the full benefit from each medicine or dietary supplement. If you are taking iron supplements without a prescription:

Do not take iron supplements by mouth if you are receiving iron injections. To do so may result in iron poisoning. Do not regularly take large amounts of iron for longer than 6 months without checking with your health care professional. People differ in their need for iron, and those with certain medical conditions can gradually become poisoned by taking too much iron over a period of time.

Iron pills can change the color of your stool to a greenish or grayish black. This is normal, but because internal bleeding can also cause dark stool, be sure to mention any color changes to your doctor. If you think you or anyone else has taken an overdose of iron medicine:

Call your doctor, a poison control center, or the nearest hospital emergency room at once. Always keep these phone numbers readily available. Go to the emergency room without delay Take the container of iron with you.

Early signs of iron overdose may not appear for up to 60 minutes or more. Do not delay going to the emergency room while waiting for signs to appear.
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Do iron pills make you sleepy?

You may tire easily. You also may feel grumpy, have headaches, and have trouble concentrating. Most people begin to feel normal after a few weeks of taking iron pills. But you need to take the pills for several months to build up the iron supply in your body.
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Why is iron low in pregnancy?

When you’re pregnant, you may develop anemia, When you have anemia, your blood doesn’t have enough healthy red blood cells to carry oxygen to your tissues and to your baby. During pregnancy, your body produces more blood to support the growth of your baby.

If you’re not getting enough iron or certain other nutrients, your body might not be able to produce the amount of red blood cells it needs to make this additional blood. It’s normal to have mild anemia when you are pregnant. But you may have more severe anemia from low iron or vitamin levels or from other reasons.

Anemia can leave you feeling tired and weak. If it is severe but goes untreated, it can increase your risk of serious complications like preterm delivery. Here’s what you need to know about the causes, symptoms, and treatment of anemia during pregnancy.
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What iron level is too low in pregnancy?

Who is considered anemic? – The World Health Organization (WHO) defines anemia in pregnant women as:

First trimester: hemoglobin less than 11.0 g/dL Second trimester: hemoglobin less than 10.5 g/dL Third trimester: hemoglobin less than 11.0 g/dL

Pregnant women are routinely screened for anemia at their first prenatal visit and again between 24 and 28 weeks. For nonpregnant women, hemoglobin lower than 12.0 g/dL is considered anemic,
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What happens if you take 2 iron pills a day?

Iron Toxicity – Iron toxicity can be caused by taking high doses of iron supplements for prolonged periods of time, or by taking a single overdose. Single doses as low as 10 to 20 mg/kg can cause some symptoms of iron toxicity. Medical attention is required at doses greater than 40 mg/kg, and more than 60 mg/kg can be lethal.

Excessive iron can be damaging to the gastrointestinal system. Symptoms of iron toxicity include nausea, vomiting, diarrhea and stomach pain. Over time, iron can accumulate in the organs, and cause fatal damage to the liver or brain. Toxic cellular effects occur as well. Oxidative phosphorylation and mitochondrial function can be hindered by large amounts of iron, leading to death of cells.

Iron toxicity primarily affects the liver, but other organs and the blood may also be affected. Metabolic acidosis occurs due to fluid loss, dilation of the blood vessels and an anaerobic metabolism due to inhibition of oxidative phosphorylation.
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What happens if you take 2 iron tablets instead of 1?

Frequently taking iron supplements that contain more than 20 mg of elemental iron at a time can cause nausea, vomiting, and stomach pain, especially if the supplement is not taken with food. In severe cases, iron overdoses can lead to organ failure, internal bleeding, coma, seizure, and even death.
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What to avoid when taking iron supplements?

Eating iron rich foods is a key part of treating anemia caused by low iron levels. You may also need to take iron supplements as well to rebuild iron stores in your body. ABOUT IRON SUPPLEMENTS Iron supplements may be taken as capsules, tablets, chewable tablets, and liquids.

• The most common tablet size is 325 mg (ferrous sulfate).
• Other common chemical forms are ferrous gluconate and ferrous fumarate.
• Have your health care provider tell you how many pills you should take each day and when you should take them.
• Taking more iron than your body needs can cause serious medical problems.

Blood counts return to normal after 2 months of iron therapy for most people. You should continue taking supplements for another 6 to 12 months to build up the body’s iron stores in the bone marrow. TIPS FOR TAKING IRON Iron is absorbed the best on an empty stomach.

• Yet, iron supplements can cause stomach cramps, nausea, and diarrhea in some people.
• You may need to take iron with a small amount of food to avoid this problem.
• Milk, calcium and antacids should not be taken at the same time as iron supplements.
• You should wait at least 2 hours after having these foods before taking your iron supplements.

Foods that you should not eat at the same time as you take your iron include:

High fiber foods, such as whole grains, raw vegetables, and branFoods or drinks with caffeine

Some doctors suggest taking a vitamin C supplement or drinking orange juice with your iron pill. This can help the iron absorb into your body. Drinking 8 ounces of fluid with an iron pill is also OK. Tell your provider about all the medicines you are taking.

Iron tablets may cause other drugs you are taking to not work as well. Some of these include tetracycline, penicillin, ciprofloxacin, and drugs used for Parkinson’s disease and seizures. Medicines that reduce stomach acid will impair iron absorption and may cause iron deficiency. Your provider may suggest changing these.Wait at least 2 hours between doses of these drugs and iron supplements.

SIDE EFFECTS Constipation and diarrhea are very common. If constipation becomes a problem, take a stool softener such as docusate sodium (Colace). Nausea and vomiting may occur with higher doses, but they can usually be controlled by taking the iron in smaller amounts.

The stools are tarry looking as well as blackIf they have red streaksCramps, sharp pains, or soreness in the stomach occur

Liquid forms of iron may stain your teeth.

Try mixing the iron with water or other liquids (such as fruit juice or tomato juice) and drinking the medicine with a straw.Iron stains can be removed by brushing your teeth with baking soda or peroxide.

Keep tablets should in a cool place. (Bathroom medicine cabinets may be too warm and humid, which may cause the pills to fall apart.) Keep iron supplements out of the reach of children. If your child swallows an iron pill, contact a poison control center right away.

1. Brittenham GM.
2. Disorders of iron homeostasis: iron deficiency and overload.
3. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al, eds.
4. Hematology: Basic Principles and Practice,7th ed.
5. Philadelphia, PA: Elsevier; 2018:chap 36.
6. Camaschella C.
7. Microcytic and hypochromic anemias.
8. In: Goldman L, Schafer AI, eds.
9. Goldman-Cecil Medicine,26th ed.

Philadelphia, PA: Elsevier ; 2020:chap 150. Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M.
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Can I take 65 mg of iron while pregnant?

Iron Supplementation For Prenatal Anemia An iron deficiency called anemia is a common occurrence among pregnant women. Especially in severe cases, such a deficiency will lead to negative effects, which include infant mortality, maternal mortality, and premature birth.

Pregnant women will also feel lousy, dizzy, light-headed, and tired when the iron is at a low level. Iron also helps in maintaining your immune system, which is important to have defense from a number of illnesses that can commonly happen during pregnancy. It is also important in the production of enzymes and collagen, a protein that is present in the connective tissues.

How Much Iron Do You Need? For women who are not pregnant, 18 milligrams of iron is the recommended daily dosage. When you are pregnant, however, you need to have at least 27 milligrams of iron. This is because iron is not only needed by the pregnant woman, but by the baby in the placenta as well.

As the iron requirement increases in the second half of pregnancy, you may want to aim for 30-50 mg of iron. Iron supplements should be taken 1-2 hours before or after meals and with a small glass of orange juice to increase absorption. Do not take it with your prenatal vitamin or with dairy products as the calcium will decrease absorption of the iron.

Can You Have Too Much Iron? Iron toxicity is only an issue among adults who consume more than 1,000 mg of iron daily. It can lead to diarrhea and constipation.If you go beyond the 27mg of iron that is recommended daily, as long as it is not too much above, the only thing that can happen is that the iron will no longer be absorbed by the body.

Look at the dosage of the iron supplement. Remember, you will need to have 27 mg of iron in a day. However, take note that you will not only get it from the supplement, but also from food intake. This is why even lower doses for a supplement will be fine, as long as you take food rich in iron as well.Be familiar with the different forms of iron supplements that are available, such as capsules, tablet, and liquid. Look at the label and look for one that can be easily absorbed by the body. A slow-release form will also be a great choice.As much as possible, look for a supplement that contains multiple vitamins that will support a healthy pregnancy, not just iron. Vitamin C is one of the most important, since it will help in the improvement of iron absorption.Before you decide which to buy, you also need to be familiar with the different forms of iron that are present in the supplement, such as elemental iron, ferrous sulfate, and ferrous fumarate, among others. Your provider can help you decide which will be best to try for your body’s needs.

The equivalent of 60 mg of elemental iron is 300 mg ferrous sulfate heptahydrate, 180 mg ferrous fumarate or 500 mg of ferrous gluconate

Here are some brand names to compare and try:

SlowFe. With this supplement, you will get 45 mg of elemental iron, which is equal to 142 mg of ferrous sulfate. This supplement has great potency and is also easy to swallow. It has a controlled-release system, which means it will be able to deliver iron slowly, minimizing possible side effects.FerroSequels High Potency. This supplement provides 65 mg of iron and includes Vitamin C, which will provide a boost for your immune system. It also is timed-release to deliver iron slowly to maximize absorption and minimize upset stomach. It is low in sodium and gluten-free.Floradix. This supplement comes in both liquid and tablet form, so you can decide which your body will tolerate better.Nature’s Plus chewable. If you prefer a supplement you can chew, this one provides potent iron as well as Vitamin C.

: Iron Supplementation For Prenatal Anemia
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What happens if you take more iron during pregnancy?

Abstract – Iron-deficiency anemia is still prevalent among pregnant women living in industrialized countries such as Canada. To prevent this deficiency, iron supplements (30 mg/d) are routinely prescribed to Canadian pregnant women. Recently, dietary reference intakes for iron have increased from 18 and 23 mg/d during the second and third trimesters, respectively, to 27 mg/d throughout the pregnancy for all age groups.

• Whether this new recommendation implies an increase of iron dosage in supplements has not been answered.
• Are there any benefits or risks for the mother and her infant associated with iron supplementation during pregnancy? If iron supplementation is recommended, what should be the ideal dosage? This article reviews current knowledge on the potential negative or positive impact of iron supplementation during pregnancy on the outcomes of both infants and mothers.

Based on the literature reviewed, a low daily dose of iron (30 mg elemental iron) during pregnancy improves women’s iron status and seems to protect their infants from iron-deficiency anemia. Several studies have also shown that a low daily dose of iron may improve birth weight even in non-anemic pregnant women.

1. However, higher dosages are not recommended because of the potential negative effects on mineral absorption, oxidative pathways, and adverse gastrointestinal symptoms.
2. To date, it is still not clear if health professionals should recommend routine or selective supplementation.
3. However, neither routine nor selective iron supplementation during pregnancy is able to eliminate iron-deficiency anemia.

Even though the dietary reference intake for iron during pregnancy has been recently increased, we do not recommend higher doses of iron in supplements designed for pregnant women.
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When should a pregnant woman start taking iron?

Should you take iron supplements during pregnancy? – An iron-containing in combination with sufficient dietary sources of iron throughout the day can provide many pregnant women with adequate amounts of the mineral. But iron-deficiency anemia is common, particularly after week 20 of pregnancy, and some moms-to-be do need a daily iron supplement in addition to their prenatal.

1. A blood test can check your iron levels and determine if you might need to take iron tablets during pregnancy that go beyond what’s supplied in your prenatal.
2. Anyone can develop anemia, but vegans and vegetarians have a higher risk, as do women carrying multiples, or those who have had or severe morning sickness.

If you fall into one of those categories and notice symptoms of anemia (such as feeling fatigued, dizzy or breathless), ask your doctor if you might need an iron supplement. Iron supplements come in various forms and amounts. Because iron can cause nausea and constipation, your practitioner may suggest slow release capsules or a different form of iron (like iron bisglycinate) that’s easier on the stomach.

If your doctor has also recommended supplementary calcium (or there’s calcium in your prenatal vitamin), you shouldn’t take it at the same time as an iron supplement, since calcium can interfere with iron absorption. Instead, plan on taking these supplements at least two hours apart. The bottom line: For most women, iron supplementation is safe during pregnancy.

However, not every mom-to-be needs extra iron, especially since the mineral is already found in most prenatal vitamins and certain common foods. As always, talk to your practitioner before adding any new supplements to your diet.

What to Expect When You’re Expecting, 5th edition, Heidi Murkoff.WhatToExpect.com,, April 2021.American College of Obstetricians and Gynecologists,, March 2022.Rachel Fine, R.D., New York, NY.Food and Drug Administration,, February 2022.Tarun Jain, M.D., Northwestern Medicine Fertility and Reproductive Medicine, Oak Brook, IL, and Member of the,National Institutes of Health, Office of Dietary Supplements,, April 2022.National Institutes of Health, National Library of Medicine,, December 2017.National Institutes of Health, National Library of Medicine,, December 2017.University of California San Francisco Health,,U.S. Department of Agriculture,,

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