Non constipating iron supplement
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Non-Constipating Iron Supplements: A Comprehensive Review
Introduction to Non-Constipating Iron Supplements
Iron deficiency is a common nutritional issue, often addressed through supplementation. However, traditional iron supplements, such as ferrous sulfate, are frequently associated with gastrointestinal side effects, including constipation. This article explores various iron supplements that aim to mitigate these side effects while effectively improving iron levels.
Low-Dose Liquid Fermented Iron-Bisglycinate Supplement (LIS)
Efficacy and Gastrointestinal Tolerance
A study on premenopausal women with iron deficiency without anemia (IDWA) evaluated the effectiveness of a low-dose liquid fermented iron-bisglycinate supplement (LIS). The results indicated that LIS significantly improved serum ferritin, total serum iron, and mean corpuscular volume without causing significant gastrointestinal distress, including constipation. This suggests that LIS is a viable option for those seeking to avoid the common side effects of iron supplementation.
Iron-Enriched Aspergillus Oryzae (ULT)
Comparative Safety and Compliance
Iron-enriched Aspergillus oryzae (ULT) has been studied as an alternative to ferrous sulfate (FeSO4). Research involving female participants showed that ULT maintained iron status effectively while causing fewer gastrointestinal side effects, such as nausea, constipation, and diarrhea, compared to FeSO4 . Compliance was also higher with ULT, making it a preferable option for long-term iron supplementation.
Intermittent Iron Supplementation
Reducing Side Effects with Intermittent Dosing
Intermittent iron supplementation, administered one to three times a week, has been proposed as a safer alternative to daily supplementation. Studies have shown that intermittent dosing reduces the risk of gastrointestinal side effects, including constipation, while still effectively improving hemoglobin and ferritin levels . This approach is particularly beneficial in settings where daily supplementation is impractical or poorly tolerated.
Ferric Citrate
Efficacy in Chronic Kidney Disease (CKD) Patients
Ferric citrate has been evaluated in patients with non-dialysis-dependent chronic kidney disease (NDD-CKD) and iron deficiency anemia. The study found that ferric citrate significantly improved hemoglobin levels with a similar incidence of gastrointestinal side effects, including constipation, compared to placebo. This indicates that ferric citrate is an effective and well-tolerated option for iron supplementation in CKD patients.
Vitamin C with Iron Supplementation
Enhancing Absorption and Reducing Side Effects
Combining vitamin C with iron supplements is hypothesized to enhance iron absorption by increasing gastrointestinal acidity. A systematic review and meta-analysis found that this combination resulted in a small but significant increase in serum hemoglobin and ferritin levels without a significant increase in gastrointestinal side effects, including constipation. This suggests that adding vitamin C to iron supplements can improve efficacy without exacerbating side effects.
Nonionic Trivalent Iron (FeIII) Complexes
Tolerance in Preterm Infants
A study comparing the effects of divalent iron (Fe2+) and nonionic trivalent iron (FeIII) complexes in preterm infants found that both forms were well-tolerated. However, gastrointestinal symptoms such as vomiting, diarrhea, and constipation were slightly more common with Fe2+ supplementation. This indicates that nonionic trivalent iron complexes may be a better-tolerated alternative for iron supplementation in sensitive populations.
Conclusion
Several iron supplements have been identified as effective alternatives to traditional ferrous sulfate, with fewer gastrointestinal side effects, particularly constipation. Low-dose liquid fermented iron-bisglycinate, iron-enriched Aspergillus oryzae, intermittent iron supplementation, ferric citrate, and nonionic trivalent iron complexes all show promise in improving iron levels while minimizing adverse effects. These options provide valuable alternatives for individuals who experience gastrointestinal distress with conventional iron supplements.
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