Iron Dosage For Anemia

The dosage for iron supplements varies from person to person. Talk with a doctor about how much you need to take.

Understanding Iron Supplements for Anemia

Iron is a mineral that produces red blood cells and helps carry oxygen around the body.

When your iron levels are low, it can lead to iron deficiency anemia, which decreases the flow of oxygen to your organs and tissues.

Iron deficiency anemia is one of the most common nutritional disorders in the world, affecting as many as 25 percent of people globally.

Taking daily iron supplements can be an important part of managing iron deficiency anemia, although a doctor may also recommend boosting your iron intake by eating more iron-rich foods.

In this article, we’ll review the different types of iron supplements available and their dosage recommendations. We’ll also look at the relationship between anemia and pregnancy, and explore some natural solutions that may help boost your iron levels.

Most people get all the iron they need from food. But when you have iron deficiency anemia, your levels are too low to meet your nutritional needs. You can try to get back up to typical iron levels through diet alone, but for most people with very low iron reserves, getting iron from food isn’t enough.

Iron supplements allow you to get the iron your body needs with an easy-to-take, high dose tablet or liquid. Iron supplements have more iron than you find in a multivitamin, and your doctor can monitor the dose you take.

If your body has difficulty absorbing iron from food, a supplement can help you get the dose you need of this essential nutrient.

Oral supplements

Oral iron supplements are the most common treatments for anemia. You can take them as a pill, a liquid, or as a salt.

You can find a variety of different types , including:

• ferrous sulfate
• ferrous gluconate
• ferric citrate
• ferric sulfate

Intravenous supplements

Certain people may need to take iron intravenously. You may need this method if:

• your body cannot tolerate oral supplements
• you experience chronic blood loss
• your gastrointestinal (GI) tract has trouble absorbing iron

There are several different types available, including:

• iron dextran
• iron sucrose
• ferric gluconate

High doses of oral iron supplements may lead to GI symptoms such as:

• nausea
• vomiting
• diarrhea
• constipation
• dark stools

Intravenous iron can cause a hypersensitivity reaction (HSR) . People may experience a mild, moderate, or severe HSR:

• Mild HSR: itching, flushing, hives, heat sensation, slight chest tightness, hypertension, back pain, joint pain
• Moderate HSR: cough, flushing, chest tightness, nausea, hives, shortness of breath, hypotension, rapid heart rate
• Severe HSR: rapid symptom onset, eye swelling, wheezing, bluish skin, loss of consciousness, cardiac or respiratory arrest

If you experience an HSR during an iron infusion, your doctor may stop the treatment.

The dosage for iron supplements varies from person to person. Talk with a doctor about how much you need to take.

The doctor may recommend a daily dosing regimen. However, some research suggests taking iron once every other day may also be effective and has better absorption. Talk with the doctor about which dosing strategy is best for you.

Certain foods like dairy, eggs, spinach, whole grains, and caffeine can block iron absorption. Try to avoid having these foods at least 1 hour before and after you take your supplements. You should also take antacids and calcium supplements at least 1 hour apart from your iron.

If you have iron deficiency anemia, your doctor may recommend supplements at a much higher dose than the recommended daily allowance (RDA).

You can use the guidelines provided by the National Institutes of Health that show the RDA for most people. However, if your iron stores are low, eating just this amount may not be enough.

Children

Females

Males

During Pregnancy

During Lactation

If you’re a vegetarian, the RDA is 1.8 times these amounts. That’s because plant-based sources of iron are harder for your body to absorb than meat sources.

If you’re living with mild iron deficiency anemia, it may be possible to treat your symptoms naturally through a nutrient-dense, balanced diet that includes iron-rich foods.

There are two main types of iron in your diet:

• Heme iron is found in red meat, poultry, and seafood.
• Non-heme iron is found in nuts, beans, vegetables, and whole grains.

Heme iron is easier for the body to absorb than non-heme, although both types can be part of a balanced diet. Some foods high in iron, such as spinach, also have components that make it hard for the body to absorb.

Vitamin C can help increase non-heme iron absorption. It’s a good idea to include items high in vitamin C in a plant-based meal.

Here are some iron-rich foods you can include in your diet:

During pregnancy, a person’s body needs much more iron to help supply oxygen to the baby. This extra demand increases the risk of developing iron deficiency anemia.

If left untreated, iron deficiency anemia can cause pregnancy complications like premature birth, low birth weight, and postpartum hemorrhage.

Some other factors that increase the risk of developing iron deficiency anemia during pregnancy can include:

• being pregnant with multiple babies
• having two closely spaced pregnancies
• having frequent episodes of morning sickness

It can sometimes be hard for pregnant people to tell if they have iron deficiency anemia. Many of its common symptoms are similar to those of pregnancy. They can include:

• weakness
• fatigue
• shortness of breath
• dizziness
• headache
• pale skin
• chest pain

The Centers for Disease Control and Prevention (CDC) suggests that pregnant people start taking a low dose oral iron supplement ( around 30 mg per day ) and get screened for iron deficiency anemia during their first prenatal visit.

They also encourage people with lab-confirmed anemia during pregnancy to increase their dosage to 60 to 120 mg per day. Pregnant people should talk with their doctor to determine their specific recommended dosage.

Most people will start to feel the benefit of an iron supplement within a few days.

According to the U.K.’s National Health Service (NHS), it takes about 1 week to feel better after starting a ferrous fumarate supplement.

However, it takes much longer to build up your iron reserves. That’s why many doctors recommend keeping up your iron supplementation for as long as 3 to 6 months if you have iron deficiency anemia, according to Australia’s National Blood Authority.

Can over-the-counter iron pills help anemia?

Over-the-counter iron pills, along with eating iron-rich foods, may help people with anemia caused by iron deficiency. However, it is important to discuss your recommended intake with a doctor. Sometimes, doctors may recommend a higher dosage for people with an anemia deficiency. Other factors such as age, sex, the severity of the deficiency, and whether or not you’re pregnant can affect your recommended dose.

How long does it take to recover from anemia with iron supplements?

It can take about 1 week to start feeling better after beginning iron supplementation for iron deficiency anemia, according to the U.K.’s NHS. That being said, it can take longer to increase your iron reserves. It’s important to discuss dosage with a doctor to determine how long you should take supplements.

Is it OK to take an iron supplement every day?

Some doctors may recommend taking iron supplements daily. Research from 2017 suggests that taking iron supplements every other day may better help with absorption. If you have iron deficiency anemia, talk about dosage with your doctor to help ensure you get the amount of this essential nutrient that you need.

Iron is an essential mineral for maintaining good health. Iron supplements are an excellent way to prevent complications of iron deficiency anemia.

If you think you may have iron deficiency anemia, talk with your doctor about whether iron supplements are right for you.

Last medically reviewed on April 7, 2022

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Api O, et al. (2015). Diagnosis and treatment of iron deficiency anemia during pregnancy and the postportem period: Iron deficiency anemia working group consensus report.
  ncbi.nlm.nih.gov/pmc/articles/PMC5558393/
• Bloor S, et al. (2021). Oral iron supplementation — gastrointestinal side effects and the impact on the gut microbiota.
  mdpi.com/2036-7481/12/2/33
• Ferrous fumarate. (2019).
  nhs.uk/medicines/ferrous-fumarate/
• Iron: Fact sheet for health professionals. (2022).
  ods.od.nih.gov/factsheets/Iron-HealthProfessional/
• Iron deficiency anemia. (2022).
  nhlbi.nih.gov/health-topics/iron-deficiency-anemia
• Lim W, et al. (2019). Canadian expert consensus: Management of hypersensitivity reactions to intravenous iron in adults.
  onlinelibrary.wiley.com/doi/full/10.1111/vox.12773
• Malinowski A, et al. (2021). Iron deficiency and iron deficiency anemia in pregnancy.
  cmaj.ca/content/193/29/E1137
• Managing my iron [Fact sheet]. (2015).
  blood.gov.au/system/files/documents/managing-my-iron-factsheet.pdf
• Ru Y, et al. (2016). Iron deficiency and anemia are prevalent in women with multiple gestations.
  pubmed.ncbi.nlm.nih.gov/27581469/
• Stoffel NU, et al. (2017). Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: Two open-label, randomized controlled trials.
  thelancet.com/journals/lanhae/article/PIIS2352-3026(17)30182-5/fulltext
• Your guide to anemia. (2021).
  nhlbi.nih.gov/health-topics/all-publications-and-resources/your-guide-anemia

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Ferrous Sulfate Dosage

Medically reviewed by Drugs.com. Last updated on Jun 8, 2021.

Applies to the following strengths: 300 mg/5 mL; 300 mg; 160 mg; (as elemental iron) 45 mg; 525 mg; 325 mg; 195 mg; (as elemental iron) 15 mg/mL; 75 mg/0.6 mL; 90 mg/5 mL; 190 mg; 250 mg; 220 mg/5 mL; 159 mg; 324 mg; (as elemental iron) 15 mg/1.5 mL; 200 mg

Usual Adult Dose for:

• Iron Deficiency Anemia
• Anemia Associated with Chronic Renal Failure
• Vitamin/Mineral Supplementation

Usual Pediatric Dose for:

• Iron Deficiency Anemia
• Vitamin/Mineral Supplementation

Additional dosage information:

Usual Adult Dose for Iron Deficiency Anemia

Initial dose: 600 mg/day ferrous sulfate (120 mg/day elemental iron) for 3 months

• Give in divided doses (1 to 3 times daily)

Usual Adult Dose for Anemia Associated with Chronic Renal Failure

Initial dose: 1000 mg/day ferrous sulfate (200 mg/day elemental iron) orally in divided doses (1 to 3 times daily)

• If goals are not met with oral iron after 1 to 3 months, consider IV iron supplementation.
• Smaller daily doses may be better tolerated.

Usual Adult Dose for Vitamin/Mineral Supplementation

Initial dose: 1 tablet orally once a day

Initial dose: 30 to 90 mg/day ferrous sulfate (FeSO4) (6 to 18 mg/day elemental iron) orally, in divided doses (1 to 3 times daily)

51 and over: 25 to 40 mg/day FeSO4 (5 to 8 mg/day elemental) orally, in divided doses (1 to 3 times daily)

Usual Pediatric Dose for Iron Deficiency Anemia

0 to 5 years: 15 to 30 mg/kg/day ferrous sulfate (FeSO4) (3 to 6 mg/kg/day elemental iron)
5 to 12 years: 300 mg FeSO4 (60 mg/day elemental)
12-18 years male: Two 300 mg FeSO4 (60 mg elemental) tablets orally daily
12-18 years female: 300 to 600 mg/day FeSO4 (60 to 120 mg/day elemental)

• Give in divided doses (1 to 3 times daily)

Usual Pediatric Dose for Vitamin/Mineral Supplementation

Preterm infant (less than 37 weeks gestation), 0 to 12 months: 10 mg/kg/day ferrous sulfate (FeSO4) (2 mg/kg/day elemental iron)
0 to 6 months: 1 to 1.35 mg/day FeSO4 (0.2 to 0.27 mg/day elemental)
7 to 12 months: 35 to 55 mg/day FeSO4 (7 to 11 mg/day elemental)
1 to 3 years: 20 to 45 mg/day FeSO4 (4 to 9 mg/day elemental)
4 to 8 years: 20 to 50 mg/day FeSO4 (4 to 10 mg/day elemental)
9 to 13 years: 30 to 40 mg/day FeSO4 (6 to 8 mg/day elemental)
14 to 18 years: 40 to 75 mg/day FeSO4 (8 to 15 mg/day elemental)

• Give in divided doses (1 to 3 times daily)

Tablets (325 mg FeSO4, 65 mg elemental iron)
12 years and older: 1 tablet orally once a day

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Dose Adjustments

Vitamin supplementation/Prevention of anemia:
14 to 18 years: Pregnancy: 115 to 135 mg/day ferrous sulfate (FeSO4) (23 to 27 mg/day elemental iron)
14 to 18 years: Lactation: 35 to 50 mg/day FeSO4 (7 to 10 mg/day elemental)
19 to 50 years: Pregnancy: 110 to 135 mg/day FeSO4 (22 to 27 mg/day elemental)
19 to 50 years: Lactation: 32.5 to 45 mg/day FeSO4 (6.5 to 9 mg/day elemental)
Maximum dose: 225 mg FeSO4 (45 mg/day elemental)

Treatment of anemia:
Pregnancy: 300 to 600 mg FeSO4 (60 to 120 mg/day elemental)

Precautions

US BOXED WARNING:

• Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.
• Keep out of reach of children.
• In case of accidental overdose, call a doctor or poison center immediately.

Dialysis

Iron supplementation is routinely provided to peritoneal dialysis and hemodialysis patients for prevention or treatment of anemia associated with chronic renal failure.

Administration advice:

• Coffee, tea, milk, cereal, dietary fiber, and phosphate containing carbonated drinks decrease iron absorption.
• Supplements containing calcium, zinc, manganese, or copper decrease iron absorption.
• Antacids, H2 blockers, and proton pump inhibitors decrease iron absorption; do not use within 1 to 2 hours of iron administration.
• Vitamin C and acidic foods increase iron absorption.
• Delayed release and enteric coated formulations are better tolerated, but are not as well absorbed.

• Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.
• Keep out of reach of children.
• In case of accidental overdose, call a doctor or poison center immediately.

Frequently asked questions

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Related treatment guides

• Iron Deficiency Anemia
• Anemia Associated with Chronic Renal Failure
• Vitamin/Mineral Supplementation and Deficiency
• Vitamin/Mineral Supplementation during Pregnancy/Lactation

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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