There are two main types of iron supplements: ferrous and ferric. Ferrous supplements tend to be less problematic than iron in a ferric form. Ferric iron can only be converted in the body to ferrous iron if there is plenty of vitamin C available.
After you take an iron supplement, it’s a complicated process for the iron to be broken down and absorbed by the small bowel. If the iron doesn’t break down properly, it will end up feeding pathogenic bacteria further down the GI tract. Iron-loving bacteria (also called siderophilic bacteria) can make some people very sick.
If you’re someone who feels quite sick and gets a lot of gas and bloating after taking iron, it’s worth having a comprehensive stool analysis or a SIBO breath test. Find out what kinds of bugs you have lurking in your gut.
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Ferrous supplements are generally not constipating. There are a lot of new iron supplements on the market that have been designed to minimize constipation as a side effect. In addition to tablets, there are liquid iron supplements that won’t slow down your bowel movements.
Some old-fashioned doctors will still prescribe ferric iron. This form of iron can be quite constipating as well as causing nausea and black stool. Some people even vomit from ferric iron supplementation.
If you need iron, take the ferrous form and make sure you’re getting enough vitamin C. You’ll benefit from the iron without suffering significant side effects.