When Is Bloating Serious
Bloating isnt usually anything to worry about, but can sometimes be a sign of more serious health conditions.48
See your GP if your bloating continues or you also have unexplained weight loss, blood in your stools or persistent diarrhoea.49,50
The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.
17 February 2022
What Are The Side Effects Of Iron Supplements
Like all medicines, iron supplements can cause side effects, although not everyone gets them. Often effects improve as your body gets used to the new medicine.
|Did you know that you can report a side effect to a medicine to CARM ? Report a side effect to a product|
What Dose Of Iron Would I Need
- The dose needed will vary depending on whether the iron supplement is used to treat or prevent low iron levels.
- It is usually prescribed between 1 to 3 doses a day.
- Always take your iron supplement exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it and any special instructions. Talk to your doctor or pharmacist if you have any questions regarding your medication or dosage.
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Aim For Moderation And Diversity
Overloading your diet with any of these foods is unlikely to help. It could in fact make your bloating worse.
For example, increasing fibre and not increasing water can worsen constipation. This is because water is needed to help fibre to pass through the digestive tract.
Another example is, for people with digestive conditions like irritable bowel syndrome, eating large quantities of allium vegetables can trigger gas, bloating, diarrhoea and constipation.
Tone Down The Bubbles And Booze
Bubbles are gas by definition, so go easy on carbonated things like champagne and beer to lower your chances of a bloated stomach. At Parsley Health, our most frequent recommendation for consuming alcohol is to cut wine and beer altogether and stick to vodka, white tequila, and mezcal instead. This is especially important for people who have digestive issues, imbalances in gut bacteria, food sensitivities, or blood sugar issues, as these forms of alcohol have very little residual sugar or toxins.
I also recommend two days off of drinking for every one day that you drink so your body has time to repair and detoxify and so that you do not become dependent on alcohol.
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Intestinal Reaction To Iron Supplements
Taking an iron supplement isnt necessary for everyone. If your iron intake is low, if you have digestive issues that limit iron absorption or if you have iron-deficiency anemia, your doctor could suggest taking iron. While iron is crucial for carrying oxygen around to all the cells in your body, when you take in a lot of it at once, as with taking an iron supplement, it can wreak havoc on your intestinal tract.
Individual Gastrointestinal Symptoms Reported
Thirty three of the 43 studies reported incidences of individual gastrointestinal symptoms . The most commonly reported symptoms were constipation, nausea and diarrhoea. For the 27 studies that reported constipation, the pooled estimate of incidence in the FeSO4 arm was 12% . Similarly, for the 30 studies that reported nausea the pooled estimate of incidence in the FeSO4 arm was 11% and for the 25 studies that reported diarrhoea the pooled estimate of incidence was 8% .
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How To Take Iron Supplements
- Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about the iron supplement and will provide you with a full list of the side-effects which you may experience from taking it.
- Iron is absorbed into your bloodstream best if the supplement is taken about an hour before a meal. If, however, you feel queasy after taking iron, having some food in your stomach can help to reduce stomach irritation and feelings of queasiness. So in this case, it may be better for you to take your iron supplement just after a meal.
- Take the iron preparation exactly as your doctor tells you to. You will be told how much to take and how often to take it. Your dose will also be on the label of the pack to remind you. It is usual to be prescribed between 1-3 doses a day. Taking your doses at the same times each day will help you to avoid missing any.
- If you do forget to take a dose, don’t worry, just leave out the missed dose and take the next dose when it is due. Do not take two doses together to make up for a forgotten dose.
Side Effects Of Taking Iron Pills
Before taking iron supplements, its important to have your iron levels checked first. Otherwise, when taken unnecessarily, they could harm your health, mainly because they typically contain high doses of iron, which can cause excess iron levels and damage the organs, especially the heart, liver, and pancreas.
Frequently taking iron supplements that contain more than 20 mg of elemental iron at a time, even when healthy, can cause nausea, vomiting, and stomach pain, especially if the supplement is not taken with food.
Large amounts of iron can result in the inflammation of the stomach lining and cause ulcers to appear. Taking these supplements unnecessarily may also cause cell damage and, in severe cases, result in organ failure. A study found that severe iron overdose can cause acute hepatic necrosis and lead to multi-organ failure and death.
Iron supplements may sometimes interact with other drugs you might already be taking such as tetracycline, penicillin, ciprofloxacin, and certain medications used for Parkinsons disease and seizures. You should also avoid taking milk, dairy products, calcium, and antacids simultaneously as iron supplements since they could prevent its absorption.
Wait for at least 2 hours before or 2 hours after having these medications/foods before taking them to prevent possible interactions or side effects.
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Selection And Data Extraction
Titles of all records retrieved were initially screened by ZT. All potentially relevant studies were then further screened as abstracts by three independent assessors. Three authors independently screened full texts of all potentially relevant papers to ensure they met the inclusion criteria.
The generated database for all of the above is available upon request.
Cut Back On The Snacking
As snacking throughout the day typically leads to consuming more calories, a healthy habit can quickly become harmful. Though its second nature for many, it often leads to overeating and short term weight gain. To avoid this, try to reduce grazing and give yourself at least 3 hours between meals.These quick fixes will help you combat bloat this season, but it doesnt have to stop there. Avoiding white flour, eating more fiber, skipping carbonated beverages, and supplementing for digestive health can be practiced year round to prevent belly bloat.
If you still frequently experience bloating, you may need to further adjust your diet, or address other potential digestive issues or hormonal imbalances. Speak to a Parsley Health doctor to get back on track.
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Ferrous Sulfate Versus Placebo
For the 20 trials that included placebo as the comparator a significant increase in the incidence of gastrointestinal side-effects was observed with ferrous sulfate OR = 2.32 . Nineteen of these 20 placebo-controlled trials were conducted in healthy non-anaemic individuals and therefore hemoglobin repletion was not a primary outcome. The only placebo-controlled trial in anaemic participants was carried out in patients who became anaemic following joint replacement surgery and reported an average increase in hemoglobin of 1.94 g/dl following 6 weeks of ferrous sulfate therapy compared to an increase of 1.63 g/dl with placebo .
Forest plot for the effect of daily ferrous sulfate supplementation on the incidence of gastrointestinal side-effects in placebo-controlled RCTs.
Data for random-effects meta-analysis are shown. For each study the closed diamond represents the mean estimated effect and the horizontal lines the 95% CI. The grey shaded area surrounding each closed diamond represents the weight of each study in the analysis. Weight was assigned based on the the sum of the within-study variance and between study variance. Open diamonds represent the subgroup mean difference and pooled overall mean differences as shown. Test for overall effect: z-score = 7.54 , 0.20 , 5.79 p-value < 0.0001 , = 0.8 , < 0.0001 . OR, odds ratio CI, confidence interval. Data shown for 20 RCTs .
What Are Iron Supplements
Iron supplements are used to treat or prevent low levels of iron in your blood . They increase the amount of iron stores in your body. Most people get enough iron from a healthy, balanced diet. However, some people may need iron supplementation, such as:
- pregnant women or teenage girls, who have higher iron requirements
- those who do not absorb iron normally, such as people with renal failure or gut problems that cause malabsorption
- anyone with ongoing or excessive blood loss, such as in women with heavy periods .
Some babies and children may need iron supplements. Read more about iron supplements for babies and children.
If you have low iron levels, your doctor may prescribe, or your pharmacist may recommend, iron supplements to be taken by mouth . In certain circumstances if oral iron supplements are not effective or if they cannot be tolerated, iron supplements can be given by injection. Read more about iron injection.
|Note: Iron supplements should not be used by people with haemochromatosis, a rare condition that occurs when too much iron builds up in the body. The excess iron can cause damage to their organs.|
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Withdrawing From Iron Pills
Strictly following the doctors prescribed time and frequency of taking medications is a standard rule in all medications, especially for iron pills. But some people, after seeing certain improvements or feeling recovered, tend to gradually drop the habit and stop taking them altogether. But is it a good practice?
According to data from the NHS, iron supplements, particularly ferrous sulfate, tend to give the impression of recovery within a week of supplementation, but it may take up to a month for the medication to have its full effect on the body, so its important to still take them continuously and consistently as recommended.
The Anemia Guidelines for Family Medicine recommends that after the initial period of supplementation is over and the IDA is corrected the doctor will recommend another 3 months of medicating to replenish lost iron stores and, in some cases, may need to monitor the hemoglobin and red blood cell levels for an additional 3 to 6 months.
How To Reduce Bloating
When you feel bloated, these tips could help reduce the discomfort:
- Try activated charcoal 1g of activated charcoal at least 30 minutes before a meal and another 1g after the meal can ease excess gas, says the European Food Safety Authority36
- Try peppermint oil a 2014 review by Italys University of Salerno reported it may help reduce bloating in people with IBS37
- Exercise regularly a 2006 study in American Journal of Gastroenterology reported that pedalling on an exercise bike reduced bloating, but you could try walking or jogging, too38
- Consider digestive enzymes a 2014 Belgian study found digestive enzymes may help with bloating39
Around 100 trillion bacteria live in your gut. Maintaining the diversity of this bacteria is important to gut health. For example, to ease bloating.
Nothing is more influential to the balance of your gut microbiome than what you eat and drink.
The foods you eat are not just part of the cause of your digestive discomfort. They may also hold the answer to how to reduce bloating.
While some foods can trigger your digestive discomfort, others could help it.
Here we focus on four food groups that can help.
But a note of caution, rather than focussing on eating any one category, aim to get diverse nutrients from all of these gut-friendly food groups.
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How To Prevent Constipation Bloating
There are several lifestyle changes you can make that can help you prevent constipation-related bloating:
- Slowly increase your fiber intake. Fiber adds bulk to your stool, making it easier to pass. However, if you add too much too quickly, you can experience worsening bloating.
- Increase your water intake. Drinking more water can also add bulk to your stool, reducing constipation.
- Stop smoking. Smoking can increase many gastrointestinal symptoms, including constipation.
- Take part in regular physical activity. This will help keep your bowels moving.
You can also make dietary changes to help reduce bloating.
What Causes Bloating In Females
Does your stomach feel bloated around the time of your period? Oestrogen has a big role in deciding how women retain water.
Levels of this hormone fluctuate during a womans monthly cycle, with the body typically retaining more water when oestrogen is higher in the week or so leading up to the start of a period.
As a result, a common symptom of premenstrual syndrome is bloating.
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Managing Side Effects Of Iron Supplements
Side effects from iron supplements can make it difficult for some people to comply with treatment. Avoid taking iron pills on an empty stomach, which increases the risk of gastrointestinal side effects. To reduce the risk of side effects, start with a lower dose and gradually increase the dose as tolerated.
Try the following tips to prevent and manage stomach upset while taking iron supplements:
- Drink plenty of water to prevent constipation
- Eat more vegetables and fiber-rich foods to prevent or treat constipation
- Take a stool softener to treat constipation
- Take with food to minimize or prevent stomach discomfort
How Do I Know How Much Iron I Need In My Supplements
Our daily requirement for Iron depends on several factors Women of child-bearing age have the highest need for Iron with a daily requirement of 14.8mg. Whilst Men and post-menopausal women have a daily requirement of 8.7 mg .
It is important to ensure your supplement is giving you a sufficient amount of Iron. Some people experience side effects, especially from higher-dose iron pills resulting from poor absorption. The unabsorbed Iron becomes oxidised and causes gut irritation, resulting in side effects such as constipation and nausea.
Ferrous Sulfate Versus Iv Iron
For the 23 studies that included intravenous iron as the comparator a significant increase in the incidence of gastrointestinal side-effects was observed with ferrous sulfate with an OR = 3.05 . Furthermore, mean hemoglobin increase was reported for 20 of the 23 eligible IV iron-controlled trials . Overall, for these 20 trials, the mean increase in hemoglobin for the ferrous sulfate arm was lower than for the IV iron arm although formal comparative analysis was not undertaken being outside the a priori objectives of our analysis .
Effect of daily ferrous sulfate supplementation on the incidence of gastrointestinal side-effects and hemoglobin repletion in intravenous iron-controlled RCTs.
The IBD subgroup analysis also showed a significantly higher incidence of gastrointestinal side-effects in the ferrous sulfate arm than in the IV iron arm with OR = 3.14 . The same was observed in the pregnancy subgroup analysis , with OR = 9.44 .
Nine out of the 23 IV-iron comparator studies reported zero GI side-effects in the IV-iron arm so, as detailed in Methods, we added the standard correction of 0.5 of a side-effect to each arm to enable calculation of the study-specific log odds ratio. Nevertheless, when we excluded these 9 studies from the meta-analysis the same overall effect was observed with an OR = 2.41 for ferrous sulfate .
The Vicious Cycle Of Anemia
And thus begins what I like to call the Vicious Cycle of Anemia. This is how it goes: Your physician recommends oral iron supplements, you start taking the them but they make you feel worse so you stop taking them, you ignore your condition and your iron levels continue to plummet. Before you know it, you’re at rock bottom in terms of iron deficiency and you’re too foggy and depressed to even do anything about it. This is where you can really find yourself in the danger zone…even close to heart failure like I was!
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