Iron Supplements and Constipation
Last updated: October 2023
For the 20+ years that I have had IBS, I have mostly struggled with the IBS-D side of the spectrum, with one exception being alternating IBS-D and IBS-C in my very early 20s.
However, as I have mentioned more recently on this site, I have become more and more prone to constipation in the past couple of years. This has seemingly been exacerbated by a hysterectomy I had nearly 2 years ago.
My IBS constipation
While my constipation has improved from a few months post-op (it was pretty severe), it still seems to be a lingering issue. In particular, even if I "go" to the bathroom daily and initially feel emptied, by the end of the day or in the evening, I begin to feel bloated and like I have to "go" again but can't get much out, even though I have the impression there is more inside wanting to come out (the term for this is "incomplete evacuation" which makes it sound like a failed army drill or something like that).
This has also been a pain, and IBS is now leaning toward constipation. I am prone to and continue to struggle with anemia. The problem with that? The doctors suggest a daily dose of iron for anemia–in the form of a vitamin/supplement. But iron supplements usually cause constipation–and they do for me as well.
Anemia and constipation
So what can be done if one is anemic and needs iron supplements but also suffers from chronic constipation, and taking such supplements will likely worsen constipation? Here are a few potential options I am looking into–that may or may not work for you (always discuss with a healthcare professional before trying new supplements to get their input): Iron infusions. As the name suggests, iron infusions are when the iron is infused or injected straight into the bloodstream via an intravenous needle. It can take up to an hour.
These infusions bypass the gut, and since the iron isn't being processed through the digestive system, it seems a lot less likely to cause constipation. One doctor who suggested it to me also said it could more quickly and potently alleviate anemia than oral supplementation. However, I am unsure about how well that has been studied or if it's been proven.
Iron infusions for anemia
One con for me that has led to me (at least for now) not taking that option is that my health insurance does not cover iron infusions, and they are somewhat pricey (at least $80 per session), especially as compared to a bottle of vitamins. The other prospective negative is that if I have an adverse reaction, I am concerned unless with oral supplements, I won't be able just to stop taking it, but have to wait for the effects of the infusion to wear off (though I am guessing side effects, if any, would be mild and pretty temporary, I just don't know). Finally, with the pandemic still happening, I currently do not want to go and wait around in a doctor's office if I don't have to as I worry about contagion being immunocompromised (even being vaccinated, I am still at risk for catching it).
Iron supplements for anemia
Taking iron supplements is marked/labeled easy on the stomach and does not cause constipation.
I recently picked up a bottle of iron supplements making such a claim, and took them for a few days. At first, it seemed to live up to the claim, but after about the 4th or 5th day, my constipation did get a lot worse for a day or so. Was it due to this supplement or something else? It's hard to know for sure, but I did stop taking the supplement for a few days altogether and things resolved, and now I have changed the dosing, which leads to the next step.
Cutting down the dose or spacing out dosing. I now tend to cut my iron supplements by a third or half and take every other day or even every 3rd day (so if I take it on a Monday, I might not again till Thursday) instead of daily. So far, my constipation hasn't gotten worse on this lighter dosing method. I also add other supplements with it to counteract the constipating effect.
Other supplements for anemia with IBS
Adding Vitamin C and/or Magnesium
I recently wrote a post about how Magnesium and Vitamin C are good natural supplements for easing constipation. I already take a moderate dose of Magnesium almost every day, and it's been one of the most effective methods in helping alleviate my constipation. However, if I am still constipated more than usual, I will also add some Vitamin C, which will help move things along. So, now when I take my iron supplement, I try to take it with some form of Vitamin C. This is helpful too because Vitamin C aids the body in absorbing iron.
I used to have a supplement with an Iron/Vit C combo, but it also constipated me. But now that I take a gentler iron supplement at a lower dose, the Vitamin C helps. Sometimes I take it as a low dose supplement–splitting it in half (too much Vitamin C, and my guy goes in the other direction). Other times, I may opt just to wash down the supplement with some fruit juice. Suppose you are taking iron and find that it's constipating you. In that case, you should ask a health professional or nutritionist about adding Magnesium or Vitamin C to your daily dose of vitamins and how to do that in a healthy way that works for your body.
This is the last option I haven't tried yet, but one of my doctors suggested that I look into it soon. Simply put, the body can break down and absorb iron in a liquid form better, and so it reputedly does not cause constipation the way solid pills do.
Of course, it's always great to try to get iron into one's diet in more natural ways–eating iron-rich or fortified foods and cooking with an iron skillet can help. For me, especially as a vegetarian and especially as I get older, it's just been difficult to get it all from my diet naturally or to absorb it as well, so I need an extra boost.
Do you have constipation and struggle with anemia? If so, what iron supplementation treatment plan have you come up with to avoid more problems? Please feel free to share your experiences in the comments section below.
Which of the following symptoms of IBS do you experience most frequently?