Thyroid UK

Iron deficiency anaemia

I need advice about iron supplements for iron deficiency . I cannot take the tablets that my GP prescribed, as they make my IBS worse with terrible stomach cramps. I have been taking Spatone for a year and at first my levels were increasing slowly, but have just had my latest results and my level has dropped to 13. Can anyone recommend any other natural remedy. I have just had my Thyroxine dose taken down to 50mcg, which I fear is too low, but my GP thinks otherwise. I also suffer from Fibromyalgia and am feeling pretty low. Thanks for reading this.

17 Replies

My usual response - try ferritin or haem iron.

In general there are three forms of iron supplement -

• The simple substances like ferrous sulphate through ferrous fumarate, ferrous gluconate, ferrous bisglycinate, and so on

• Various forms of haem iron (also spelled heme)

• Ferritin

The simple substances do vary with the more complex molecules often regarded as being gentler and less constipating than the basic - that is, bisglycinate is usually preferred to sulphate.

Haem iron and ferritin both wrap the iron up in more complex molecules and they have much less impact on the gut.

Haem and ferritin will be more expensive than the cheapest supplements but compared to some, such as Floradix, they are not particularly expensive. Don't forget that black pudding is still available as a good dietary source!

Simple supplements, haem and ferritin are each absorbed by different mechanisms. These three mechanisms appear not to interfere with each other at ordinary dose levels.

As I do not need to take iron, this is all based on reading and not personal experience.

Supplement Sources:

Haem -

Ferritin -

Results may vary over time.

A snippet about why ferritin and haem might be particularly important:

Ferritin iron is absorbed by a different mechanism than iron salts/chelates or heme iron. Recognition of a second, nonheme iron absorption process, ferritin endocytosis, emphasizes the need for more mechanistic studies on ferritin iron absorption and highlights the potential of ferritin present in foods such as legumes to contribute to solutions for global iron deficiency.

Storing iron supplements

If you have young children, it is very important to store your iron supplements out of their reach. This is because an overdose of iron supplements in a young child has a toxic effect, which can be fatal.

BNF: Oral Iron Supplements

Brief summary of the products listed in the British National Formulary (not all variations, not all brands) and NHS prices. Some products cannot be prescribed on the NHS, or only in specific circumstances. Data looked up 25/04/2015

Ferrous sulphate

Tablets, coated, dried ferrous sulfate 200 mg (65 mg iron), net price 28-tab pack = £1.08

Ferrous sulphate with ascorbic acid (Ferrograd)

Tablets, f/c, red, dried ferrous sulfate 325 mg (105 mg iron) for sustained release, ascorbic acid 500 mg (as sodium salt), net price 30-tab pack = £3.20.

Ferrous fumarate

Tablets, ferrous fumarate 210 mg (68 mg iron), net price 84 = £2.30

Ferrous gluconate

Tablets, red, coated, ferrous gluconate 300 mg (35 mg iron), net price 28 = £1.95

Polysaccharide-iron complex

Elixir, brown, sugar-free, polysaccharide–iron complex equivalent to 100 mg of iron/5 mL, net price 240-mL pack = £6.06

Sodium feredetate

Elixir, sugar-free, sodium feredetate 190 mg equivalent to 27.5 mg of iron/5 mL, net price 100 mL = £1.07

Other References:


USA Office of Dietary Supplements (ODS)



1 like

Thank you Hellvella. It will take a time for me to read, learn and inwarsly digest ! x


Chris, do you know why you are iron deficient? I think this makes a difference in regards to recommendations.


I only found out that I was anaemic after a routine blood test prior to surgery. After that I had a colonoscopy and endoscopy, but nothing nasty found. I always used to have good haemaglobin results, so the doctors don't know why I am not absorbing iron, as I have a good diet.


Have you done an occult blood stool test? Sometimes it needs to be done several times because guts can bleed and not bleed. You can be bleeding from the small intestine as opposed to the stomach or colon. The endoscopy and colonscopy don't check the jejunum and illeum. This IBD thing is not always because of the colon.

Does eating something like chicken liver upset your guts too? Or just taking iron tablets?


I have had an occult blood stool test; all ok. Liver doesn't upset me, but I can't tolerate spicy food. But the iron tablets cause awful cramps etc. if my next test results are still low, I will ask my GP to refer me to a specialist, or even go private as this has been going on too long and am so tired of feeling so tired !!!


In reference to occult blood stool tests - be aware that things like polyps in the colon can bleed intermittently. So, if you have any hint that you got a false negative, ask your doctor for another test kit and testing form and do the test when the evidence is there to be seen.


Many thanks. I'll this in mind and speak with my GP next time I see her.


Do you eat gluten? My iron levels improved a lot when I went wheat free and then eventually gluten free!

1 like

Thank you for replying. Yes, I do eat gluten. My diet hasn't altered at all over recent years and I was tested and found to be fine. I guess I'll keep on investigating.


I've been tested for coeliac disease and it came back negative.

However, I decided to try going gluten-free as an experiment early this year because it is so often recommended. My ferritin, which had been crawling up very slowly for about 20 months, suddenly shot up to be 68% of the way through the reference range. I've had other benefits from going gf, but strangely enough they were not gut-related.

It really is worth experimenting for three months. Then get your iron/ferritin tested to see if it has helped. If it really makes no difference to you, you can always start eating it again.


Thank you so much for your reply. So much to think about now!


Chrissiep have you had any tests for anitbodies? If you have raised TPO it could explain why you don't feel too good and often if you have raised TPO's it's best to avoid gluten. be aware that a negative test for coeliac doesn't mean you don't have aproblem! good luck.


Thank you Crimple. Much appreciated. x


That's what is so good about this forum. You can get plenty of advice and you can decide for yourself which is best or be a guinea pig and do your own research!!


I have had good results in raising my Ferritin level (with no stomach upset) by taking the following two supplements (can find both on Amazon):

Ferrex-150 (150 mg elemental iron) and

Cardiovascular Tesearch Ferritin Bioavailable Iron 5 mg

I started off taking 1 each per day then went to 2 each per day (split dose - am and afternoon) along with 1,000 IU vitamin C to aid absorption.

No other supplements worked for me. Ferritin is slow to rise so you have to hit it hard. I'm guessing the Spatone doesn't contain enough elemental iron per serving to make much of a difference when your numbers are so low.

Good luck!


Many thanks. I'll do some investigating. Everyone on this site have been so helpful. I feel as an auto immune illness, not very much is being done to help thyroid sufferers and all the attendant problems, whereas diabetes is much better understood and controlled.


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