Iron and Acid Suppressing Medications

Published on Monday, June 27, 2022 by Haley McGaha

Iron Absorption and Acid-Suppressing Medications: What You Need to Know

Have you been prescribed an acid-reducing medication and wondered what side effect it may have on nutrient absorption that is not commonly discussed?

Let’s talk about iron.

Why would taking an acid-suppressing medication possibly cause me to be deficient in iron?

Stomach acid helps to separate iron salts from food. Therefore, when acid-suppressing medications are used, there is less stomach acid to help break up iron salts from the food, and our bodies may then absorb less iron from the foods we consume.

Is there evidence to support that taking an acid-suppressing medication may interfere with iron absorption in the body?

Historically, some controversial opinions have been on whether acid-suppressing medications can lead to iron deficiency. Some studies show that longer use of PPIs (greater than two years) can lead to a risk of iron deficiency, and other studies show there is little data to support iron deficiency with acid-suppressing medication use.

However, numerous newer studies are linking iron deficiency with acid-suppressing medications. If you are ever concerned that an acid-suppressing medication may lead you to a diagnosis of iron deficiency, always talk to your healthcare provider.

What are signs that I may be deficient in iron?

Fatigue
Headache
Pale-colored skin
Shortness of breath upon exertion

If you are experiencing an iron deficiency, here are five tips to help increase your iron absorption:

#1- Try to include a source of iron at each meal. You can get iron from various foods; however, iron from meat, fish, and chicken is better absorbed than plant-based iron sources. Some plant-based sources of iron include dried beans (kidney, lentils, lima, navy), fortified oatmeal, potato with the skin on, soybeans, tofu, spinach, dried prunes, whole wheat bread, and nuts (cashews, walnuts).

#2- Pair vitamin C sources with iron sources to help your body absorb the iron from the foods you eat. For example, pair taco meat (ground beef, which would be your iron source) with salsa (tomatoes would be your vitamin C source).

#3- Try drinking milk, coffee, and tea in between meals (when you are not consuming iron) to help your body absorb iron from your meals. Milk, coffee, and tea may decrease iron absorption.

#4- Try cooking out of a cast iron skillet.

#5- If you take a multivitamin with calcium, you will want to take it separately from your iron supplement as it is recommended to take iron and calcium-containing supplements at least 2 hours apart. This is because calcium can interfere with the body’s ability to absorb iron.

If you have concerns regarding other nutrient malabsorption/deficiency while taking an acid-suppressing medication, check out this article on vitamin B12 and acid-suppressing medications!

_{Tran-Duy, A., Connell, N. J., Vanmolkot, F. H., Souverein, P. C., de Wit, N. J., Stehouwer, C. D., Hoes, A. W., de Vries, F., & de Boer, A. (2018). Use of proton pump inhibitors and risk of iron deficiency: A population-based case-control study. Journal of Internal Medicine, 285(2), 205–214. https://doi.org/10.1111/joim.12826}
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_{American Dietetic Association. Nutrition Care Manual®. Iron Deficiency Anemia Nutrition Therapy. https://www.nutritioncaremanual.org/client_ed.cfm?ncm_client_ed_id=94. Accessed [May 26, 2022].}