To ask about Ferrous Fumarate (iron)tablets

[MrsShawnHatosy]

Sorry, this is a bit icky, apologies in advance.

Has anyone been prescribed these and found they make your bum really itchy? And how long before you started feeling a difference in terms of tiredness etc?

Made me shit myself on day 1 - couldn’t be more than one room from the bathroom. Ugh!

I think they're well known for causing constipation!

Really? They’ve had the opposite effect on me!

NHS lists both diarrhea and constipation as the number #1 side effects - so it can go either way! But I think digestive system side effects are at the root of the itchy bum problem!

NHS ferrous fumarate

Thanks for this. Under the section about taking it with other medicines it says that levothyroxine may affect how it works. I have an underactive thyroid and therefore take levothyroxine, surely the doctor should have known this.

They make my stools go like tar - black and sticky.

In terms of working - they’ve never worse for me. I’ve had a reason of 13 for the best part of a decade - I’m just left to drag myself though life

I've needed to take it several times over the years and never had an itchy bum! It makes stools black, but I don't recall diarrhoea or constipation from it.

At my worst, my Hb was 86 and ferritin 2. I was getting recurrent UTI's, tired, dizzy on exertion and having unusual food cravings- all common side effects. Red blood cells take 3mths to replicate, so its not an instant fix to anaemia. I started feeling better within a month and continued to improve. My nails had a visible ridge growing out where they were stronger. Take the meds with Vit C or a Vit C rich food such as peppers/orange juice etc. Avoid tannin rich foods which can affect absorption of the iron.

Iron tablets are notorious for causing digestive problems. I lasted about three days on ferrous funarate.

try other iron tablets. I take spatone now. Not as high in iron but not so many nasty complications

I've been taking them for a couple of weeks. I've been very lucky and had no signifant side effects but also no impact on my anaemia symptoms yet.

Another thing OP, you will get people say things like spatone/floradix are 'gentle' iron and causes less symptoms. That is because they contain such very little iron and cannot correct an actual deficiency. They are ok to use once your iron is back to a normal level, as a supplement to a good diet. A daily iron amount for a non anaemic woman is 14.8mg a day.

This is the daily iron content of these products:
Spatone 5mg
Multivitamin with iron 14mg
Floradix 15mg
Ferrous fumerate 140mg-300mg depending on the dose

As you can see, ferrous fumarate is to correct a deficiency, the others are not. If you get getting symptoms, you can try starting slow and then upping to the full dose over a week etc.

The evidence suggests taking every other day is as effective for supporting your iron levels but less disruptive to your digestive system. I have never got on with them as already had IBS so I have just suffered the low ferritin unfortunately. There is iron bisglycinate you can get over the counter, called 'gentle iron'. Yes much lower doses as PP says but slightly better than the other gentle options. Might be worth starting with that they trying Ferrous fumarate again in a few weeks. Also good advice to take with vit C and avoid taking within 2 hours if tea/coffee/dairy I think it is.

Iron infusion is another option but hard to get on NHS.

The pharmacist said take it 4 hours apart. So I take Levi in morning and iron at night.

If you can afford it, Three Arrows heme iron is great, doesn’t cause any nasty gastric side effects and you can take it any time. You have to order it from the US though and it takes about a week to arrive. GPs always seem to start you off on the cheapest option that’s renown for causing stomach upsets.

I take 210mg ferrous fumerate long term, life long for persistent lupus related anaemia. I also have thyroid issues and many other autoimmune issues, I’m on a lot of medication. I take most of my tablets first thing - including the thyroxine and then the iron tablet in the evening with my evening meal. I do find it tend to give me an upset stomach at times but having had severe anaemia before I know which I’d rather! I was so anaemic when having both my dc (now aged 14 and 23) that I had to have daily iron injections.

Please do NOT listen to people coming to this thread to recommend over the counter iron supplements instead - especially Spatone. The amount of iron in them compared to prescription strength ferrous fumerate etc is tiny and you could end up seriously unwell.

@5289843DM beat me to it - if you are actually deficient, unless you're drinking it by the litre (!), spatone is not going to give you enough iron to be effective. If you're really suffering, the last thing you need is to take such a low dose it will be months before you make any inroads at all!

If you give it a few days to a week and are still struggling, go back to the GP as there are other formulations which might suit you better (fumerate vs sulphate for example), and I'd probably query the levothyroxine interaction too. Also make sure you take iron with some vitamin C for maximum absorption.

Good luck, it's a slow process but you will feel so much better!

Yes so do I. I tried Floradix once but it did absolutely nothing except stain my teeth.

In defense of spatone, it's far more bio available than other irons so you need less, see studies on pubmed. However it's not suitable for real deficiency.

OP, I told gp I wouldn't take iron tablets due to digestion issues, they prescribed Sodifer liquid instead which raised by ferritin from 8 to 85 in 2 months. You can buy it without prescription.

I prefer ferrous sulphate. It is coated and doesn't block me up as much.

Iron bisglycinate is gentler on the stomach as its chelated iron so is absorbed better in the gut. The % absorbtion is higher than traditional iron tablets as well.
It costs more so its not on the NHS prescription lists.

Dd has iron deficency anemia and was prescribed a couple of different iron tablets but she struggled swallowing and made her sick. The pharmacy suggested iron bisglycinate. We spoke to the doctor who said it was fine to take but she couldn't prescribe it. Its easier to take and dd has had no side effects. Shes been feeling alot better.

im not a doctor so you should check with your doctor OP before trying anything.

You could try ferrous bisglycinate. It's less likely to give you GI side effects. But I think you generally won't get it on the NHS - probably cheaper to give you constipation and then treat that, than give you something that doesn't give you constipation.

Another vote for bisglycinate, and for taking it alternate days with vit C. That's what's shown to be best for absorption. And it's not expensive to buy yourself - not much more than the prescription cost would be

I'm currently looking into getting an iron infusion in Germany (~€150 as opposed to ~£590-790 here), as I'm still not at the levels I'd like to be. But you'll need recent blood test results to prove need for an infusion.

Yes I’ve been down that route too. But the tabs. I couldn’t drink the drink.

I was prescribed ferrous fumarate for iron deficiency anaemia and low ferritin in 2022. I was prescribed 3 tablets a day. I had no problems with nausea or upset stomach.

It took around three weeks to start feeling better. My worse symptom had been restless legs in the evenings and that resolved after three weeks. I had also had a rash on one leg for around 6 months which would not heal and that did finally clear up after a few weeks on iron tablets.

I think the recommendations now, if you don't tolerate 3 tablets a day, is to take one tablet a day or even every other day as some of what you take on 3 tablets a day isn't absorbed.

It's difficult to get iron infusions in England on the NHS - you need to meet certain criteria.

I was anaemic before my planned hip replacement which I was having done in a private hospital, self-funded. A couple of weeks before my operation, I attended a pre-op assessment for fitness for surgery and my bloods were only just at the level that the private hospital would operate with. A couple of points less and they would have wanted me to have postponed the operation or paid privately for an iron infusion, which would have cost an additional £790 plus blood test costs.

I can't tolerate ferrous fumarate any more, even one tablet every other day makes me nauseous and loose stools (I have an ibd as well).

Gastroenterology consultant at hospital has referred me for an iron infusion but also given me a prescription for Ferric maltol to try for maintenance which they say some find gentler (to not start until a month after infusion).

I used to have no issue with FF daily and was on it long term, but for some reason can't now annoyingly - I'm presuming it's the least costly for GP prescription.