Iron deficiency in the body is a rather serious condition, which leads to a decrease in hemoglobin. In the future, this condition adversely affects the functioning of many body systems. For the prevention and treatment of iron deficiency, medications containing ferritin should be taken. But this element is not always absorbed well. Side effects of iron preparations can seriously overshadow the patient's life. The article lists the main problems from taking iron-containing drugs, contraindications to taking them, and also gives tips on how to minimize the likelihood of developing an overdose.
Symptoms of Iron Deficiency
Iron deficiency is extremely detrimental to the composition of the blood. This, in turn, entails many pathologies and chronic diseases, as well as a deterioration in appearance. The latter is especially true for women, as they want to maintain a youthful appearance for as long as possible. The simplest and most effective way to combat this condition is to take iron supplements. Side effects do not develop if you select a medicine that is suitable for the individual characteristics of the body, and follow the instructions for its use.
How to understand that the body lacks iron? There are symptoms that eloquently testify to this:
- pallor of the skin, while dark circles around the eyes can heal;
- brittle nails and increased hair loss (ferritin deficiency, which is synthesized from iron);
- unusual taste habits: there is a desire to try the taste of chalk, lick a nail file, etc .;
- shortness of breath, arrhythmia, decreased performance and physical stamina, increased sweating and heart palpitations even with scanty loads.
Causes of iron deficiency anemia
But why does such a condition arise? If you know the cause, then you can easily prevent the imbalance of iron in the body. So, the most common causes of iron deficiency:
- Heavy bleeding (can occur due to wounds, surgery or in the case of heavy menstruation in women). You should be on guard for those people who, for one reason or another, have experienced uterine, pulmonary, gastrointestinal, and nosebleeds.
- Conditions accompanied by an increased need for hemoglobin, which is synthesized just from iron in the human body. This is pregnancy, the growth period in children and adolescents, the recovery period after illness and after surgery.
- Hereditary predisposition to impaired absorption of this element, as well as the intake of certain iron antagonist drugs. Against the background of treatment with such drugs, iron-containing preparations should be taken in parallel.
- Strict diets, vegetarianism, veganism, raw food diet. An unbalanced diet often causes a deficiency not only of iron, but also of many other minerals, vitamins, amino acids.
Varieties of medicines
The pharmacological market offers many iron preparations. Almost everyone has side effects when taken orally. Much depends on what kind of drug a person takes. All iron-containing drugs can be classified depending on which substance they contain.
Modern medicine distinguishes iron deficiency and iron deficiency anemia proper. The second state is much more difficult to correct. The sooner you begin to make up for the deficiency, the less unpleasant symptoms the patient will find.
The variety of pharmacological agents designed to make up the level of this element can be divided into two large groups:
- containing ferrous iron - Fe 2+;
- containing ferric iron - Fe 3+.
Means with an active substance in the form of ferrous iron in the composition have better bioavailability. This allows the active substance to be absorbed almost completely. As a rule, the cost of preparations with ferrous iron in the composition is lower than preparations with ferric. However, they are not always available at the pharmacy.
Ferric iron is synthesized in the human body into ferrous only if an oxidizing agent is present. The most suitable for this purpose is the familiar ascorbic acid.
Once in the small intestine, iron interacts with transferrin. This is a special protein that promotes the movement of molecules of this element directly into the tissues that form the composition of the blood. This is the bone marrow and liver cells, in which there are areas of accumulation of iron.
You should be careful when taking iron supplements. Side effects can take you by surprise. The body can not remove the excess of this substance (or makes it very limited). This means that if the dosage is incorrectly selected, there is a risk of serious side effects. Iron preparations for oral administration may contain either a divalent or a trivalent element - the consequences await the patient in any case.
The most popular iron preparations
List of drugs that contain ferrous iron:
- "Sorbifer Durules" (release form - tablets);
- "Ferretab", "Fenyuls" (release form - capsules);
- “Totem” (ampoules with solution for intramuscular injection);
- "Hemofer Prolongatum" (release form - dragee).
List of preparations containing ferric iron:
- "Maltofer", "Biofer" (release form - chewable tablets);
- "Maltofer", "Fenyuls" (release form - drops);
- "Ferrum Lek", "Venofer" (form of release - ampoules with a solution for intravenous or intramuscular injection).
The lists list iron supplements with minimal side effects. It is these drugs that are prescribed most often for the treatment of iron deficiency anemia. This does not mean that in a particular patient, a drug from the list will not provoke any of the side effects that will be listed below. The medications prescribed for the treatment of anemia are not dietary supplements, namely medicines. Any drugs can at any time provoke one or another change in the state of the blood or stool. Each person is individual, and it is simply impossible to say with accuracy how a particular drug will affect him.
Iron supplements without side effects are not a myth. If a patient with a divalent element is not suitable, then it is worth trying a trivalent or changing the form of the drug. Do not think that iron-deficiency anemia is incurable - millions of people around the world are convinced of the opposite thanks to the modern pharmacological industry.
The effectiveness of preparations containing ferrous iron has been proven in numerous studies (level of evidence 1A). Preparations based on the trivalent element are better tolerated, but are not always effective to the same extent as the drugs of the divalent.
Rules for taking iron preparations
Possible side effects can be taken by surprise even if a person follows all the necessary rules. However, if the patient carefully reads the instructions and does not violate the features of the reception listed in it, then it is likely that the iron will be absorbed completely and the negative consequences will not be taken by surprise.
- Much depends on what form of release of the drug. The tablets with the shell should be swallowed whole (the instructions indicate - 30 minutes before eating or after eating). When it enters the intestine, the membrane gradually dissolves, which will contribute to the maximum absorption of drugs without possible side effects. Rules for taking iron preparations for chewing - after eating, drinking with water is not required. Ampoules with a solution should be used for administration intramuscularly or intravenously. This method is used for acute iron deficiency anemia.
- Even after the tests show a sufficient amount of ferritin and hemoglobin, the therapy should not be “curtailed”. It is necessary to continue taking the drugs, slightly reducing the dosage, for a few more months. Then switch to maintenance therapy - drink the selected drug once every six months.
- Particular attention should be paid to what other drugs the patient takes during treatment with iron preparations. Side effects can enhance the effects of medicines from the group of antacids (decreased bioavailability of iron and diarrhea), drugs with tetracycline (decreased appetite), chloramphenicol (decreased bioavailability, nausea, heartburn). It is impossible to take certain drugs on the background of anemia on their own. There is a high risk of side effects. Thyroid hormone preparations are also undesirable to combine with iron-containing drugs. In an extreme case, you can go on the introduction of them intramuscularly when taking thyroid hormones.
- For the most complete assimilation of the divalent element, it should be taken simultaneously with preparations of ascorbic acid, trivalent - to ensure sufficient intake of proteins and essential amino acids in the body. Otherwise, the medicine may not be fully absorbed, because of which side effects may develop. Iron preparations are not always fully absorbed. Therefore, subsequent tests may not show the effectiveness of treatment.
Side effects of iron supplements
Admission rules must be strictly observed by the patient. Otherwise (excess dosage, co-administration with other medicines, etc.), the following conditions may occur:
- heartburn and belching with a metallic taste (in the event that the patient violates the instructions and takes tablets of fasting ferrous iron on an empty stomach);
- stool staining in black (when the dosage is exceeded);
- decreased appetite;
- irritation of the gastric mucosa;
- constipation and exacerbation of hemorrhoidal disease;
- darkening of tooth enamel (with prolonged use of iron-containing preparations in large quantities);
- general weakness, dizziness, decreased performance.
For patients with anemia, the only way to get rid of the pathology is to take iron preparations. Side effects are especially noticeable in the first days of admission, in this case, you should consult your doctor about the advisability of reducing the dosage. You cannot quit taking medication yourself. Anemia will not go away without taking iron supplements. How to treat side effects if they do occur? This will be discussed below.
How to minimize possible side effects during treatment?
Completely getting rid of the negative effects of treatment will only help stopping the medication. But this cannot be done, as the symptoms of anemia will only worsen. If side effects are already observed in the first days of taking the medication, then the first thing to do is to reduce the dosage consumed by half. If after this the patient does not feel better, then you should think about changing the iron preparation.
Side effects and features of the application are often interrelated: once you deviate a little from the instructions, how the deterioration of well-being begins. Digestion is disturbed, the stool turns bright black (this fact is especially scary for patients, and this is the most harmless consequence of increasing the dosage).
How can nutrition affect the absorption of iron from drugs and the development of side effects? There are simple rules: while taking ferrous iron, you should consume as much vitamin C. as possible. It is found in vegetables and citrus fruits. It is also acceptable to take ordinary ascorbic acid, it has a low cost, and you can buy it without a prescription. If the patient takes ferric iron, then it is necessary to provide a sufficient amount of amino acids in the diet. For this purpose, you will have to regularly eat meat, fish, cottage cheese. It should be noted that when large doses of calcium are ingested with food, iron may simply not be absorbed, and with such a medicinal or nutritional combination, flatulence and diarrhea often develop.
Irritation of the gastric mucosa while taking iron-containing drugs
Irritation of the gastric mucosa and subsequent exacerbation of chronic gastritis are common side effects of iron preparations. Ways to correct them - a change of medicine or a complete abolition of the treatment of anemia. This is a fairly radical method, but only it will help to maintain the health of the gastric mucosa. As a rule, preparations with ferric iron in the composition are more aggressive towards the mucosa than preparations with divalent iron.
Often patients do not want to abandon the course of treatment with a drug already purchased. In an attempt to mitigate stomach irritation after taking the pill, patients go to various tricks. They try to take the drug only after a hearty meal consisting of fatty foods. Try to jam a pill with a huge amount of food. However, most often all these tricks do not lead to anything. The optimal way to solve the problem is to change the drug, which would include divalent iron.
Contraindications
The best iron preparations without side effects for a particular patient often have to be selected for a rather long time. Before you choose one of those that the doctor suggested, you should familiarize yourself with the list of contraindications in advance.
Do not take ferrous iron, if available:
- risk of developing internal bleeding;
- chronic pancreatitis in the acute stage;
- pregnancy period (only after consultation with a gynecologist);
- an intestinal or stomach ulcer;
- acute period of gastritis;
- esophageal ulcer;
- chronic liver diseases in the acute stage (during remission - only after consultation with a treating hepatologist).
There are fewer contraindications to the use of ferric iron. Typically, such drugs are recommended to drink after meals, as they can cause irritation of the gastric mucosa. Persons with chronic diseases of the stomach should take ferric iron, constantly listening to themselves. At the first signs of deterioration (pain in the epigastric region, nausea, vomiting, belching), you should immediately stop taking and change the form of the drug.
When should I urgently contact an ambulance
Many patients underestimate the danger and possible consequences of the development of side effects when taking iron-containing drugs. Meanwhile, some of them can provoke the development of conditions that threaten the patient's life. When is the time to sound the alarm and call an ambulance?
- Blood in vomit or feces after taking the pill. This is most likely a sign of internal bleeding. In patients with an ulcer, taking iron-containing drugs can aggravate the condition, which will lead to internal bleeding, which can lead to death.
- Loss of consciousness may indicate anaphylactic shock. This condition also requires medical attention and a thorough examination.
- The appearance of an allergic reaction atypical for the patient, a sensation of heat, redness of the face and limbs, a strong heartbeat - all these are also reasons to see a doctor as soon as possible. After such reactions, you should not continue to take the iron-containing drug.