When it comes to iron supplements, strength is not necessarily in numbers. This means Canadians may not be absorbing as much iron as they think they are. This concept is especially frightening for those taking iron supplements to combat iron deficiency anemia, which according to the World Health Organization, is one of the most common nutritional problems in the world.

Non-heme iron supplements, derived from vegetable proteins, are the most common iron supplements in Canada. These supplements list a high measurement of elemental iron per dose, but do not offer as efficient iron absorption as heme iron supplements, derived from meat proteins. “Various iron supplements showcase high levels of elemental iron per dose without taking into consideration efficiency of absorption,” says Anil Radia, Ottawa Pharmacist. “As pharmacists, our number one concern when recommending iron supplements should be the rate of bodily absorption.”

The body absorbs up to 351 per cent of heme iron with fewer milligrams per dose as everyone is born with heme-specific receptors in their digestive system. With non-heme iron, the body can only absorb about two to 20 per cent of the elemental iron listed on the packaging. 2 The excess iron is stored in the body and can lead to side effects like constipation, nausea, cramping and diarrhea. 3 Excess iron ingested by the body may also increase one’s risk of toxicity.

With 90 per cent of Canadians relying on their pharmacists to help select an appropriate iron supplement, pharmacists play a large role in educating consumers. Unfortunately, pharmacists and consumer materials often do not communicate the differences between heme and        non-heme iron.

According to a recent survey conducted by Medical Futures Inc., 37 per cent of pharmacists identify absorption as their reason for recommending one supplement over another. Even though heme iron has been proven to have better absorption, only 16 per cent state they regularly recommend heme based iron supplements. Additionally, 83 per cent of pharmacists acknowledge a difference between various iron supplements but only 53 per cent of pharmacists communicate the difference between heme and non-heme iron supplements.

“Pharmacists need to do a better job educating consumers on the differences between iron supplements so that consumers can make informed decisions,” says Anil Radia, Ottawa Pharmacist.

Studies have proven oral heme iron supplements are as effective as intravenous iron.4 Unlike non-heme iron, heme iron supplements offer better absorption rates with less iron per dose, lower side effects and little to zero excess iron left in the body. The measure of an iron supplement is not in numbers, but in the absorption.

For more information about heme iron supplements, talk to your local pharmacist.

1 Office of Dietary Supplements. Dietary Supplement Fact Sheet: Iron – Health Professional Fact Sheet. Web Accessed 08.26.13 <http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/>
4 Proferrin Brand Plan 2013. Slide 18.
5 Office of Dietary Supplements. Dietary Supplement Fact Sheet: Iron – Health Professional Fact Sheet. Web Accessed 08.26.13 <http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/>
6 Statistics Canada. Iron Sufficiency of Canadians. Web Accessed 08.26.13 < >http://www.statcan.gc.ca/pub/82-003-x/2012004/article/11742-eng.htm>
7 Health Canada, Important Labeling Information for Iron-Containing Products. Web Accessed 08.27.13 <http://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2009/13391a-eng.php>


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