Iron supplement Side effects

The most common side effects of oral iron therapy are diarrhea or constipation and upper abdominal discomfort.When taken with food, side effects are reduced, but the risk of interactions with other substances increases. Side effects are dose-dependent, and doses can be adjusted.Patients may notice that their stools have turned black.This is completely harmless, but patients must be warned to avoid unnecessary worry.When iron supplements are taken in liquid form, reversible discoloration of teeth may occur (this can be avoided by using a straw).Intramuscular injections may be painful and a brown discoloration may be noticed.Iron(II) sulfate treatment had a higher incidence of adverse events than iron hydroxide polymaltose complex (IPC) or iron bisglycinate chelate.Iron overdose remains one of the leading causes of poison-related death in children under 6 years of age.Iron poisoning can lead to death or short and long-term morbidity.

Infection risk 

Since one of the functions of ferritin, an acute phase response protein, that is elevated in acute infection is thought to be to sequester iron from bacteria, it is generally believed that iron supplementation should be avoided in patients with viable bacteria (bypassing this mechanism) infection.Replacing iron stores is rarely an emergency and cannot wait for any such acute infection to be treated.Several studies have found that iron supplementation leads to increased rates of infectious disease in areas where bacterial infections are common.For example, children receiving iron-rich foods showed increased rates of overall diarrhea and excretion of enteric pathogens. Iron deficiency prevents infection by creating an unfavorable environment for bacterial growth.However, while iron deficiency may reduce infection in some pathogenic diseases, it can also lead to reduced resistance to other strains of viral or bacterial infection, such as Salmonella typhimurium or E.histolytica.Overall, it is sometimes difficult to decide whether iron supplementation will be beneficial or harmful to an individual in an environment that is prone to many infectious diseases; however this is a different question than the question of supplementation in individuals who are already ill with a bacterial infection.Children living in areas prone for malarial infections are also at risk of developing anemia.It was thought that iron supplementation given to such children could increase the risk of malarial infection in them.A Cochrane systematic review published in 2016 found high quality evidence that iron supplementation does not increase the risk of clinical malaria in children.

Contraindications

Contraindications usually depend on the substance in question.All preparations had documented hypersensitivity to any ingredient and anemia without proper testing (ie documented iron deficiency).Some can be used for iron deficiency, others require the presence of iron deficiency anemia.Some are also contraindicated in rheumatoid arthritis.

Hemochromatosis

Individuals may have a genetic predisposition to iron hyperabsorption, such as patients with HFE hereditary hemochromatosis.In the general population,1 in 400 people has the homozygous form of this inherited trait,and 1 in 10 people has its heterozygous form.Individuals with either the homozygous or heterozygous form should not take iron supplements.