I first learned I had low iron levels when I was around 18 or 19. Like most people, I was told to take iron supplements, so I started with the typical capsules. Simple enough, right?

Except it didn’t really stick.

I hated them. The pills only made my stomach hurt and me feel awful. Between the nausea, bloating, and that heavy, sluggish feeling, it became convenient to forget to take them. 

Iron supplements felt like a burden, something I had to force myself to take. And that’s never sustainable. 

So I did what many people do: I took them only when I absolutely had to. When I started feeling fatigued, I’d take them for a little while, just long enough to feel better. But the moment I thought I was in the clear, I’d stop. And the cycle would repeat.

After a few years, I discovered liquid iron. It wasn’t perfect (the taste gets a bit strong over time), but it was easier on my stomach, and I could tolerate it much better than capsules.

Since then, it’s been my go-to form of supplementation.

This issue is about finding the go-to iron supplement for you.

Choosing the Right Iron Supplement

Iron supplements come in all shapes and forms, and the right one for you depends on absorption, side effects, and personal preference.

Oral Iron: The Classic Option (But Not Always the Best)

Oral iron supplementation makes sense for you if you have mild or moderate iron deficiency, if you can tolerate iron tablets without major side effects, and if you don’t have conditions that impair absorption (like celiac disease or inflammatory gut issues).

It’s the most widely used form of supplementation, but different formulations have different tolerability and effectiveness.

You can learn which formulation is in your tablets by checking out the ingredients list or “Supplemental Facts” label on the bottle. Look for:

1. Active Ingredient — This will list the specific form of iron, such as:

   • Ferrous sulfate: The standard option, highly effective but known for causing stomach issues.

   • Ferrous gluconate: An option that’s milder on digestion but contains slightly lower iron content per dose.

   • Ferrous fumarate: This one is high in elemental iron and may cause constipation.

   • Ferric maltol & sucrosomial iron: These newer forms are easier on digestion while still increasing blood iron levels effectively.

   • Ferric iron compounds (e.g., ferric citrate, ferric sulfate): These may be generally less absorbable, but again, milder.

   • Liquid iron supplements: A gentler option for those with sensitive stomachs. Liquid iron absorbs faster and is gentler on digestion, but it may stain teeth and can have a strong taste.

2. Elemental Iron Content — This tells you how much actual iron in milligrams is present. This is the number that matters when determining dosage.

   • Example: Ferrous sulfate (325 mg) - providing 65 mg of elemental iron

3. Other Ingredients — Some brands add vitamin C to help with absorption or include calcium, which can reduce absorption.

Oral iron supplements can be tough on digestion leading to constipation, diarrhea, bloating, nausea, and increased gut inflammation. This is because unabsorbed iron can sit in your gut, feeding certain bacteria.

🦠 Supporting your gut health while taking iron can support absorption and make the whole ordeal easier on your stomach. Drink plenty of water, take a probiotic, and eat fiber-rich foods (long after taking iron).

Intravenous Iron: A Fast-Track Solution

For some people, oral iron just isn’t enough. If you have severe iron deficiency, absorption problems, or struggle with extreme fatigue, IV iron infusions could be the answer.

🚀 Why Choose IV Iron?

• Works much faster than oral iron.

• Completely bypasses the gut, eliminating digestive side effects.

• Ideal for people with inflammatory gut conditions or those who need a rapid increase in iron stores.

IV infusions need to be done by a healthcare provider and can either require only a single dose or multiple sessions.

Most people tolerate IV iron well and feel an energy boost within days to weeks.

The Future of Iron: Emerging Alternatives

Beyond traditional supplements, innovative new sources of iron are gaining popularity:

🌱 Certain probiotics – Certain strains¹ of gut-friendly bacteria help boost iron absorption naturally.
🌿 Algae-based iron² – A plant-powered alternative that’s easy on digestion.
🍄 Mushroom-derived iron – A promising newcomer with potential benefits for absorption and gut health.

While these options are still being studied, they’re worth keeping an eye on, especially if you struggle with traditional supplements.

1. Assess Your Needs Before Buying

   • Know why you need iron supplementation. Are you taking it for mild deficiency, severe anemia, pregnancy, or general wellness? Your needs will impact your choice.

   • Pay attention to symptoms. If you're always tired, dizzy, or have brittle nails, you might need a higher-absorption supplement.

2. Choose a Supplement That Fits Your Body & Lifestyle

   • If you have a sensitive stomach 🤢 → Try ferric maltol, sucrosomial iron, or liquid iron to reduce nausea.

   • If you struggle with constipation 💩 → Avoid high-dose ferrous sulfate and consider ferrous gluconate or ferric maltol instead.

   • If you hate taking pills 💊 → Go for liquid iron (but be aware it can stain teeth).

   • If you need fast results ⚡ → Talk to your doctor about IV iron infusions if oral supplements don’t work for you.

3. Check the Label Before You Start

   • Look for the iron type: Ferrous sulfate, ferrous gluconate, ferric maltol, sucrosomial iron, etc.

   • Check the elemental iron content: Aim for 65 mg per serving (unless directed otherwise by your doctor).

   • Avoid blockers: Skip brands that contain calcium, as it inhibits absorption.

4. Start Taking Your Supplement & Adjust as Needed

   • Begin with a low dose if you're sensitive. Some people tolerate iron better when gradually increasing the dose.

   • Notice how your body reacts. If you experience nausea or bloating, try switching the timing or adjusting the formulation.

5. Track Your Progress Over the Next Few Weeks

   • Monitor your energy levels 🔋 

   • Pay attention to digestion 🦠 

   • Check your lab work 📊 If possible, follow up with a blood test in 3–6 months to measure your progress.

Your Top Iron Supplement Questions, Answered

💭 “How long does it take for iron supplements to work?”

You might feel more energized within a few weeks, but it can take 3–6 months for full iron replenishment. Blood tests will confirm progress.

💭 “How do I know if my iron supplement is actually working?”

Improvements in energy, focus, and reduced dizziness are good signs. Get your ferritin levels tested to track progress.

💭 “Why am I still tired even though I take iron?”

Possible reasons:

• You’re not absorbing it well (more on this in Part 2, coming next week!).

• You have low B12 or folate, which also impact energy.

• You have inflammation, which can block iron absorption.

💭 “Can you take too much iron?”

Yes! Excess iron can be toxic and cause organ damage. Hemochromatosis, however, is rare among pre-menopausal women and is typically driven by genetics. If you’re unsure, get your bloodwork done.

💭 “Do pregnant women need special iron supplements?”

Yes! Pregnancy increases iron needs. Look for a prenatal supplement with a gentle iron formulation.

💭 “Do I need to take iron forever?”

Not necessarily. Once your levels are restored, you may only need maintenance doses or dietary adjustments.

Finding the right iron supplement is the first step in boosting your energy and restoring your iron levels, but it doesn’t stop there.

Even if you’ve chosen the best iron supplement for your body, how you take it can make a considerable difference.

That’s what I’ll cover in Part 2.

💊 Not all iron supplements are created equal. By checking the supplement label, selecting a form that fits your needs, and considering absorption factors, you can get closer to finding an iron supplement that works for you.

💬 What’s been your experience with iron supplements? Have you found one that works for you, or are you still searching? Reply to this email and let me know!

😌 Think you're in the clear because you feel fine? Low iron can quietly drain your energy, brainpower, and heart health long before symptoms appear. Don’t miss next week’s deep dive on what that really means.

1  Recent research suggests that certain probiotics, particularly Lactobacillus plantarum 299v (Lp299v), may enhance iron absorption and improve iron status in humans.

2  Various microalgae species, including Spirulina, Chlorella, and Synechococcus, have demonstrated effectiveness in improving hemoglobin levels and iron absorption in animal models. Human trials have also reported increased iron absorption from marine algae such as Ulva, Sargassum, and Porphyra.