Iron absorption can be reduced by other vitamins and minerals found both in supplements and foods.
Multiple studies have found that calcium is a strong inhibitor of iron absorption, and avoiding the simultaneous use of calcium and iron supplements may be beneficial. In one study, calcium phosphate inhibited iron absorption from a ferrous sulfate supplement, whether taken with or without food. In contrast, calcium carbonate only inhibited iron absorption when both supplements were consumed with food, suggesting that if a combined iron and calcium carbonate supplement is required, it should be taken between meals.[1] Calcium citrate, on the other hand, reduced iron absorption both with and without food, but not to a statistically significant degree in one study[1], and reduced absorption of non-heme iron without food in another study.[2]. The impact of calcium chloride on iron absorption seems to vary depending on whether it’s taken with food[3] or without food.[4]
Furthermore, a wide variety of beverages with a high antioxidant content, including coffee and tea, have some acute inhibitory effects on non-heme iron absorption. Coffee may reduce iron absorption,[5] possibly due to the presence of chlorogenic acid, a known iron chelator.[6] This mechanism can be extended to green coffee extract, which is an even richer source of chlorogenic acid. Tea, whether green[7] or black,[5] might inhibit iron absorption, possibly due to the presence of catechins[7] and theaflavins.[8] Infusions of chamomile, lime flower, pennyroyal, peppermint, and vervain may also reduce non-heme iron absorption.[5]
Rosemary (a source of rosmarinic acid), rich in phytic and phenolic acid, has also been shown to reduce non-heme iron absorption.[7]
Additionally, in one randomized controlled trial, people with beta-thalassemia who took 500 mg of quercetin (a chelator of iron[9]) per day for 12 weeks alleviated iron overload (a common complication of beta-thalassemia), notably reducing serum iron, ferritin, and inflammatory markers.[10]
Lastly, although zinc has the potential to reduce the absorption of iron, the effect is inconsistent, and the strength of this effect is unclear, with different studies reporting varying results.[11][12][13][14][15] The interaction between zinc and iron seems to be linked to competition for transporters in the liver, such as divalent metal transporter 1 (DMT1), human copper transporter 1 (hCTR1),[16] and ZRT/IRT-like protein 14 (Zip14).[17] Taking zinc between meals is likely a good way to prevent any interference with iron absorption.
It’s important to note that the typical Western diet is complex and rich in both iron absorption enhancers and inhibitors, whose effects may both be attenuated when these substances are consumed simultaneously.[18]
References
- ^Cook JD, Dassenko SA, Whittaker PCalcium supplementation: effect on iron absorptionAm J Clin Nutr.(1991 Jan)
- ^Candia V, Ríos-Castillo I, Carrera-Gil F, Vizcarra B, Olivares M, Chaniotakis S, Pizarro FEffect of various calcium salts on non-heme iron bioavailability in fasted women of childbearing ageJ Trace Elem Med Biol.(2018 Sep)
- ^Hallberg L, Brune M, Erlandsson M, Sandberg AS, Rossander-Hultén LCalcium: effect of different amounts on nonheme- and heme-iron absorption in humansAm J Clin Nutr.(1991 Jan)
- ^Gaitán D, Flores S, Saavedra P, Miranda C, Olivares M, Arredondo M, López de Romaña D, Lönnerdal B, Pizarro FCalcium does not inhibit the absorption of 5 milligrams of nonheme or heme iron at doses less than 800 milligrams in nonpregnant womenJ Nutr.(2011 Sep)
- ^R F Hurrell, M Reddy, J D CookInhibition of non-haem iron absorption in man by polyphenolic-containing beveragesBr J Nutr.(1999 Apr)
- ^Kono Y, Kashine S, Yoneyama T, Sakamoto Y, Matsui Y, Shibata HIron chelation by chlorogenic acid as a natural antioxidant.Biosci Biotechnol Biochem.(1998-Jan)
- ^Samman S, Sandström B, Toft MB, Bukhave K, Jensen M, Sørensen SS, Hansen MGreen tea or rosemary extract added to foods reduces nonheme-iron absorption.Am J Clin Nutr.(2001-Mar)
- ^O'Coinceanainn M, Bonnely S, Baderschneider B, Hynes MJReaction of iron(III) with theaflavin: complexation and oxidative products.J Inorg Biochem.(2004-Apr)
- ^Leopoldini M, Russo N, Chiodo S, Toscano MIron chelation by the powerful antioxidant flavonoid quercetinJ Agric Food Chem.(2006 Aug 23)
- ^Sajadi Hezaveh Z, Azarkeivan A, Janani L, Hosseini S, Shidfar FThe effect of quercetin on iron overload and inflammation in β-thalassemia major patients: A double-blind randomized clinical trialComplement Ther Med.(2019 Oct)
- ^Andersen CT, Marsden DM, Duggan CP, Liu E, Mozaffarian D, Fawzi WWOral iron supplementation and anaemia in children according to schedule, duration, dose and cosupplementation: a systematic review and meta-analysis of 129 randomised trials.BMJ Glob Health.(2023-Feb)
- ^Olivares M, Pizarro F, Ruz M, de Romaña DLAcute inhibition of iron bioavailability by zinc: studies in humansBiometals.(2012 Aug)
- ^O'Brien KO, Zavaleta N, Caulfield LE, Yang DX, Abrams SAInfluence of prenatal iron and zinc supplements on supplemental iron absorption, red blood cell iron incorporation, and iron status in pregnant Peruvian womenAm J Clin Nutr.(1999 Mar)
- ^Nguyen P, Grajeda R, Melgar P, Marcinkevage J, Flores R, Ramakrishnan U, Martorell REffect of zinc on efficacy of iron supplementation in improving iron and zinc status in womenJ Nutr Metab.(2012)
- ^de Brito NJ, Rocha ÉD, de Araújo Silva A, Costa JB, França MC, das Graças Almeida M, Brandão-Neto JOral zinc supplementation decreases the serum iron concentration in healthy schoolchildren: a pilot studyNutrients.(2014 Sep 4)
- ^Espinoza A, Le Blanc S, Olivares M, Pizarro F, Ruz M, Arredondo MIron, copper, and zinc transport: inhibition of divalent metal transporter 1 (DMT1) and human copper transporter 1 (hCTR1) by shRNABiol Trace Elem Res.(2012 May)
- ^Liuzzi JP, Aydemir F, Nam H, Knutson MD, Cousins RJZip14 (Slc39a14) mediates non-transferrin-bound iron uptake into cellsProc Natl Acad Sci U S A.(2006 Sep 12)
- ^Iron Fact Sheet for Health Professionals. MedlinePlus. National Institutes of Health (NIH) Office of Dietary Supplements (ODS). Updated 2023 Jun 15; cited 2023 December 5