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If you take a multivitamin, there are good reasons to consider one without iron. The body tends to hold onto extra iron -- and if you take too much, that can be dangerous. Over the long run, an excess may lead to liver damage and even diabetes. So if you’re already consuming a sufficient amount of the mineral, you may not need the extra dose in your multivitamin. Limit your intake to 45 milligrams a day. Men and postmenopausal women shouldn't take extra iron without telling their doctor.
If your doctor has told you that you do need extra iron, you should take it on an empty stomach, since that's how it's best digested. (You can also take it with a glass of orange juice, since vitamin C improves absorption.) If iron makes your stomach hurt, you may need to pair it with a small amount of food. Don't take it with milk, calcium or whole grains, all of which reduce absorption.
There is a very small percentage of people who should not take a multivitamin and mineral formula (MVM) that contains iron because of a condition called hemochromatosis (an inherited disease that leads to iron-overload, affecting 0.5 percent of the population). The other scare, though unsupported, is that any amount of supplementing with iron (unless prescribed due to classic iron deficiency) may lead to oxidative damage (acting as a pro-oxidant), thereby increasing the risk of heart and other aging diseases.
If you are getting more than the recommended DRI of 15-18 mg/day, then there may be a case for the latter warning, but our advisory board believes iron insufficiency is a much bigger problem than any possibility of an iron overload or causing negative pro-oxidant issues. This is especially at the low amounts we recommend a good MVM should contain, such as the dotFIT MVM formulas (which contain 5-10 mg based on activity, age and gender) -- i.e. enough iron to make a positive impact on improving common insufficient levels but not enough to harm since low iron can also cause oxidative damage. This level of iron in the products we recommend is designed to provide a moderate intake for physically active individuals (or soon to be more active) who are attempting to select a healthful diet that typically is not very high in iron. Both very high and low to deficient iron status can cause oxidative stress.
The goal is to maintain normal iron status -- not low iron status. Regular exercise can increase iron needs via sweat loss. One of the highly respected researchers with a balanced understanding of this iron issue is Dr. Bruce Ames. One of his key publications (and there are others) is Ames BN. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. A few sentences pulled from the section on iron:
- “Iron deficiency also is associated with diminished immune function and neuromuscular abnormalities.”
- “The effects of iron deficiency occur along a continuum, and subclinical iron deficiency may have deleterious effects on heme biosynthesis.”
- “Dietary iron deficiency in the absence of anemia decreases aerobic capacity and physical work performance, which are improved by iron supplementation.”
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.