What are some ways to improve oral iron absorption for patients with iron-deficiency anemia? — Name withheld upon request

A variety of oral iron supplements are available over-the-counter (OTC). Iron is best absorbed on an empty stomach (ie, take 2 hours before or 4 hours after a meal); however, if patients experience GI upset, it may be taken with a small amount of food. Avoidance of dairy products, calcium supplements, fiber supplements, coffee, and tea are important as these reduce iron absorption from the GI tract. Some medications, such as antacids and certain antibiotics (eg, tetracycline or fluoroquinolone antibiotics such as levofloxacin [Levaquin]) can reduce absorption, as well.

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Iron absorption is enhanced by vitamin C, thus taking these supplements with some orange juice (or a vitamin C supplement) can also improve absorption. Some data suggest that taking oral iron every other day can improve absorption; this strategy is best in patients receiving a limited course of iron supplementation rather than those taking it indefinitely. Oral iron supplements can cause constipation; increasing water and fiber intake can help to mitigate this. In patients who are unable to achieve adequate iron stores despite optimal supplementation, parenteral iron products may be necessary.

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