From the Guidelines
It is strongly recommended to restrict alcohol intake when taking iron supplements, especially during the iron depletion phase of treatment, as alcohol can interfere with iron absorption and potentially worsen gastrointestinal side effects. According to the most recent and highest quality study, the EASL clinical practice guidelines on haemochromatosis 1, patients with iron overload and/or liver abnormalities should avoid or consume very little alcohol, and those with cirrhosis should abstain from alcohol consumption. This guideline provides a strong recommendation with a consensus, emphasizing the importance of restricting alcohol intake in these patients.
When considering iron supplementation, it is essential to prioritize the potential interactions with alcohol and other substances. The AGA clinical practice update on management of iron deficiency anemia 1 provides best practice advice on oral and intravenous iron therapy, but it does not directly address the interaction between alcohol and iron supplements. However, the EASL guidelines 1 clearly recommend restricting alcohol intake, which takes precedence in this context.
To minimize potential interactions, it is advisable to take iron supplements either 2 hours before or 4 hours after consuming alcohol. Additionally, taking iron supplements on an empty stomach with water or orange juice (which contains vitamin C that enhances iron absorption) can help optimize absorption, although they can be taken with food if stomach upset occurs. Nevertheless, the primary concern is to restrict alcohol intake to prevent interference with iron absorption and potential exacerbation of gastrointestinal side effects, such as nausea, constipation, or stomach pain.
From the Research
Interaction between Alcohol and Iron Supplements
- There is evidence to suggest that alcohol consumption can increase body iron stores 2.
- However, the effect of alcohol on iron absorption from oral iron supplements is not directly addressed in the provided studies.
- A study on the effect of dietary factors and time of day on iron absorption from oral iron supplements found that coffee and breakfast decreased iron absorption, but did not investigate the effect of alcohol 3.
- Another study reviewed the literature on oral iron supplements, but did not discuss the interaction between alcohol and iron supplements 4.
- A review of iron deficiency in adults discussed the causes and diagnosis of iron deficiency, but did not address the interaction between alcohol and iron supplements 5.
Guidance on Taking Iron Supplements
- Guidelines generally recommend taking iron supplements in the morning, away from meals, and with ascorbic acid to increase iron absorption 3.
- It is recommended to consume ferrous iron supplements in the morning, away from meals or coffee, and with an AA-rich food or beverage to maximize efficacy 3.
- However, there is no direct evidence to suggest whether alcohol can be taken with iron supplements, and it is unclear whether alcohol would interact with iron supplements in a way that would affect their efficacy or increase the risk of side effects.
Effects of Alcohol on Iron Stores
- Alcohol consumption has been shown to increase serum iron and ferritin levels, indicating an increase in body iron stores 2.
- The effects of alcohol on iron stores may be beneficial or harmful, depending on the circumstances, and may have implications for the diagnosis and treatment of iron deficiency 2.