Fatigue is touted as a normal part of pregnancy, but if it doesn’t go away, it could be an iron problem. Iron is an essential mineral and perhaps the unsung hero of pregnancy. Necessary for hormonal regulation and to support your baby’s physical and neurological growth. Iron supports the production of hemoglobin, an important protein in red blood cells that provides oxygen to cells in the body. Iron requirements increase during pregnancy This is because a pregnant person’s blood volume increases significantly to maintain proper circulation and deliver enough oxygen to their own tissues, placenta, and baby. Iron deficiency during pregnancy may affect baby’s cognitionTherefore, properly addressing iron deficiency during pregnancy is important for mom and baby.
It is estimated that Iron deficiency affects 1 in 10 pregnant women and 1 in 4 in the third trimester. Iron deficiency can increase the risk of low birth weight, preterm delivery, and impaired fetal cognitive and behavioral development. Iron supplementation can be an effective strategy to reduce the risk of iron deficiency and iron deficiency anemia during pregnancy.
To select our top iron supplements for pregnancy, our nutritionists analyzed the latest research and top products on the market, evaluating dosage, form, ingredient quality, safety, and independent verification. To determine your individual iron needs, we recommend working with your health care provider to assess your iron status through blood tests.
Before adding any supplements to your daily routine, be sure to consult a health care professional to ensure that the supplement is appropriate for your personal needs and to confirm the dosage you should take.
Our favorite iron supplements during pregnancy
Should I take iron supplements during pregnancy?
Usually, if your iron levels are normal before pregnancy and you continue to maintain your iron levels as your pregnancy progresses, you do not need to take supplements. However, if your iron needs are not met by your diet or prenatal multivitamin, taking an iron supplement may help. Ayla Barmmer, MS, RD, LDN recommends checking your iron levels before deciding whether to add an iron supplement. The following groups may require iron supplements:
- Anyone who has had one Heavy bleeding before pregnancy include heavy menstruation, surgery, or frequent blood donations.
- athletes, They often pass through iron stores faster than non-athletes.
- person who has Celiac disease, inflammatory bowel disease, resection, hemorrhoids, or bariatric surgery The risk of iron loss is high and iron absorption may be difficult.
- Those who eat vegetarian or vegan diet; or who experience an aversion to meat pregnant
Professor Barmer warns about iron supplements for people receiving blood transfusions or suffering from conditions of hemochromatosis, which can cause an excess accumulation of iron in the body. Also for iron supplementation It may reduce the absorption of drugs such as levodopa, levothyroxine, and proton pump inhibitors. All of these can be taken during pregnancy, so be sure to talk to your healthcare provider about potential interactions before taking iron supplements.
Reason for recommendation
Thorne’s iron bisglycinate Checks all the boxes for a high-quality prenatal iron supplement. Independently validated, it is a well-tolerated and well-absorbed form of iron that delivers just the right amount. It meets many needs during pregnancy. I like that Thorne’s iron supplements utilize a form of iron that is less likely to cause nausea or constipation. The bisglycinate form means the iron is bound to the amino acid glycine, aiding gentle and optimal absorption. This unique form of ferrous bisglycine (iron) is in the form of ferrochel and is “ionically neutral,” meaning it does not compete with other nutrients for absorption.
The recommended amount of iron during pregnancy is 27 mg, and Thorne’s Iron Bisglycinate provides 25 mg. Therefore, even if your diet is very low in dietary iron, this supplement may be a useful tool to meet your needs and prevent or treat iron deficiency during pregnancy.
This supplement is approved by ConsumerLab.com and NSF sports certified, so you can trust that purity, quality, and safety have been independently verified. Gluten-free, dairy-free, soy-free, and contains no artificial colors or flavors.
But please be careful
If you have a more severe iron deficiency, your healthcare provider may recommend a higher dose of iron than provided in this supplement, or may recommend taking multiple capsules. Do this only under the supervision of your health care provider.
Product details:
- shape: capsule
- type: Iron bisglycinate (Ferrocel)
- dose: 25mg
- Recommended usage: Once a day with a meal
Reason for recommendation
Adequate intake of iron is important not only during pregnancy, but also during pregnancy and after childbirth. Low iron status before pregnancy can increase the risk of iron deficiency and anemia during pregnancy. Women who are vegetarian or vegan, or who have heavy or irregular menstrual cycles, may be at higher risk of becoming iron deficient in preparation for pregnancy. Therefore, in such situations, it may be helpful to take an iron supplement before pregnancy to meet the recommended intake of 18 milligrams per day. It may also be effective after childbirth. The RDA for iron decreases from 27 milligrams during pregnancy to 9 milligrams during lactation, but it may take some time for iron levels to rise after birth, and childbirth can result in significant blood loss, so it may be beneficial to continue iron supplements postpartum.
We love Needed Prenatal Iron as a pre- and postpartum option because of its shape and flexible dosing. One Needed iron capsule contains 13.5 mg of iron bisglycinate (as ferrochel), the same well-tolerated and well-absorbed form of iron as our top pick. This is a relatively low dose, making it effective before pregnancy and postpartum, when iron needs are low. Of course, this supplement is also effective during pregnancy, and you only need to take one or two tablets daily, depending on your diet and iron needs. The Needed website also provides a table that you can refer to to determine your dosage if you know your ferritin level (an indicator of iron status done through a blood test).
This supplement is vegan, allergen-free, non-GMO, and contains no preservatives or additives. Needed is a woman-owned company that began with its founder’s personal commitment to nutrition and fertility.
But please be careful
Needed says its products are independently verified, although it has not been tested by NSF, USP, or ConsumerLab.com, but there is limited information available on its site regarding testing.
Product details:
- shape: capsule
- type: Iron bisglycinate (Ferrocel)
- dose: 13.5mg
- Recommended usage: Take 1 to 4 capsules per day as advised by your doctor.
Reason for recommendation
Prescribing prenatal vitamins can be expensive, so if you need to add additional iron supplements, you may want to look for budget-friendly options.
Fortunately, CVS Health Ferrous Gluconate is a budget-friendly option that doesn’t sacrifice quality. CVS Pharmacy’s supplements adhere to trusted, tested standards that require independent verification by one of the leading verification companies. This supplement is tested for purity and potency, including testing for heavy metals, pesticides, microorganisms and other contaminants. It contains 27 milligrams of iron, the required intake for pregnant women.
This supplement can be purchased at your local CVS retail store or online for just a few cents per pill. It comes in 100 tablets, so it can be taken throughout the third trimester, when iron deficiency often occurs during pregnancy.
But please be careful
This supplement contains a type of iron called ferrous gluconate, which has low bioavailability. Additionally, the gluconate form is known to cause more gastrointestinal (GI) upset than other forms of iron. These tablets also contain artificial colors.
Product details:
- shape: tablet
- type: iron gluconate
- dose: 27mg
- Recommended usage: 1 tablet daily with meals
Reason for recommendation
If you’re tired of taking prenatal vitamins, liquid options may be more appealing. Mary Ruth’s is a well-known supplement brand that makes vegan supplements for all stages of life. It is non-GMO, free of all major allergens, and free of sugar, which can be difficult to obtain in liquid supplements. Another thing we appreciate is that Mary Ruth’s independently verifies all of their products for ingredient levels, contaminants, and heavy metals.
This liquid iron uses iron bisglycinate in the form of ferrochel. Highly absorbent and well-tolerated foams are also included in our other top picks. Therefore, this liquid can be taken with prenatal vitamins, for example, as it does not compete for absorption with other vitamins and minerals that normally interact with iron (including calcium, zinc, and magnesium). It is recommended to take 1 tablespoon daily during pregnancy and 1 teaspoon during breastfeeding. Natural flavors and stevia extract provide a pleasant berry flavor that can be taken neat or mixed with water.
But please be careful
Liquid supplements can be difficult to measure, so be sure to administer this supplement carefully. It also contains xanthan gum (a thickener and stabilizer) and the non-nutritive sweetener stevia. Although both ingredients are recognized as safe by the FDA, some people may choose to avoid these food additives.
Product details:
- shape: liquid
- type: Iron bisglycinate (Ferrocel)
- dose: 27mg
- Recommended usage: During pregnancy, take 1 tablespoon daily. While breastfeeding, take 1 teaspoon daily.
Reason for recommendation
For pregnant women diagnosed with iron deficiency or iron deficiency anemia, a health care professional may recommend high-dose iron supplements. we love Because Nature Made Iron 65 mg offers a high dose and comes from a trusted supplement brand. independently verifiedIncludes ConsumerLab.com approval and USP certification.
The RDA for iron during pregnancy is 27 mg, but your iron needs increase dramatically if you’re pregnant with twins, triplets, or quadruplets. Usually 30 mg in the first trimester, then 60 mg in the second and third trimesters. This Nature Made supplement provides 65mg of iron in high doses, making it an excellent choice for treating iron deficiency in singleton pregnancies and meeting the needs of women with multiple pregnancies.
But please be careful
Please note that this supplement contains iron in the form of ferrous sulfate, which may cause gastrointestinal discomfort in some people. To reduce discomfort, it is recommended to take this supplement with meals.
Product details:
- shape: tablet
- type: iron sulfate
- dose: 65mg
- Recommended usage: Take 1 tablet daily with water or food.
Reason for recommendation
Ferrous sulfate is a form of iron commonly used in supplements because of its absorbability and affordability, but it is not suitable for everyone who takes it. Thankfully, Slow Fe has designed ferrous sulfate tablets that use a controlled delivery system to minimize nausea and abdominal discomfort caused by iron supplements.. We also appreciate that this supplement is approved by ConsumerLab.com and included on their Top Picks list as a good choice for high-dose iron supplements, with 45 mg of iron per serving.
But please be careful
If you’re looking for a supplement with limited use of artificial ingredients, Slow Fe may not be for you. Among the ingredients list are artificial colors and some preservatives. One coloring agent, Red 40 Lake, is generally considered safe for use, although there is limited research regarding consumption during pregnancy.
Product details:
- shape: tablet
- type: iron sulfate
- dose: 45mg
- Recommended usage: Take 1 tablet per day
Reason for recommendation
If you are getting iron through your diet or prenatal vitamins, but it’s not enough to meet your needs, you may want to consider a low-dose iron supplement. we like Perelel Daily Iron Ease contains 15 milligrams of iron per serving as iron bisglycinate, a well-tolerated and well-absorbed iron supplement. Developed by a team of obstetricians and gynecologists (including fertility experts) and registered dietitians, Perelel supplements are backed by research and independently verified.
In addition to iron, it also contains vitamin C, vitamin B12, and magnesium, which help absorb iron. This supplement is gluten-free, dairy-free, soy-free, non-GMO, and contains no colors or synthetic fillers.
But please be careful
This supplement contains other vitamins in addition to minerals, so be sure to check the nutrition facts label on any other supplements you’re taking (such as prenatal multivitamins) to make sure they don’t exceed the Tolerable Upper Intake Level (UL) for any nutrient as outlined by the NIH.
Product details:
- shape: iron bisglycinate
- type: capsule
- dose: 15mg
- Recommended usage: Take 1 capsule daily with food or water.
Our Supplement Review Process
In reviewing and researching prenatal vitamins, we consult experts and in-house registered dietitians. We support evidence-based supplements and emphasize specific product characteristics that we believe are associated with the highest quality products. To find the best iron supplement for pregnancy, we closely consider several factors, including ingredient quality, independent certification, and comparisons of different forms and doses. For prenatal supplements in particular, we prefer products that have been independently verified for purity and efficacy, as the FDA does not review dietary supplements for safety and efficacy before they are placed on the market.
Additionally, we also consider a range that will meet every budget, as iron supplement prices can vary widely and higher price does not necessarily mean higher quality.
We hope this serves as a guide, but we recommend that you consult your healthcare provider before taking any supplements.
our experts
- Mackenzie Caldwell, MPH, RD is a registered dietitian and founder of the body-positive fertility and prenatal nutrition program Fully Nourished Preparation.
- Ayla Barmmer, MS, RD, LDN is a registered dietitian, founder and CEO of FullWell, and owner of Boston Functional Nutrition.
- Anne Cook Carroll, MS, RD, CDN is a registered dietitian who works with patients, including prenatal and postpartum women, to achieve their health goals. She educates her patients on the proper use of supplements to optimize their nutrition and overall health. She also specializes in supplement research and analysis.
Dosage and safety of iron supplements
dosage
The Institute of Medicine has established the Recommended Daily Allowance (RDA) for iron. This is an average daily intake that is sufficient to meet the nutritional requirements of almost all (97% to 98%) healthy people.
For pregnant women, the RDA for iron is 27 milligrams per day. Please note that this RDA is for non-vegetarians only. If you follow a vegetarian or vegan diet, your RDA is 1.8 times higher than a meat-eater because heme iron from meat is better absorbed than non-heme iron found in plant foods. For breastfeeding women, the RDA is 9 milligrams per day. For women ages 19 to 50 who are not pregnant or breastfeeding, the RDA is 18 milligrams per day.
Knowing your iron status before and during pregnancy is most helpful in determining when to supplement with iron and how much you should take. To determine the right dose for you, “I always stress that hemoglobin and hematocrit (two standard blood test markers) are insufficient. Ferritin is at least necessary, but running a full list of complete (blood) panels is ideal, especially for women near the end of pregnancy,” says Barmer.
Barmmer and Caldwell agree that 25 mg of elemental iron can effectively treat iron deficiency anemia during pregnancy, but be sure to consult your health care professional for a complete iron evaluation and individualized dosage recommendations.
of The established tolerable upper intake level (UL) for iron during pregnancy is 45 mg. However, if you are iron deficient, medical professionals recommend taking iron supplements above the UL until your iron levels return to the normal range.
Taking too much iron during pregnancy can cause unpleasant side effects such as constipation, nausea, abdominal pain, diarrhea, and vomiting. Taking high doses of iron over a long period of time can cause more serious gastrointestinal problems and other health complications.
Ingredients and potential interactions
It’s important to read the ingredient list and nutrition facts label of your supplement carefully to find out which ingredients are included (and how much of each) compared to the recommended daily intake of that ingredient. Bring your supplement label to your health care provider to learn about the various ingredients in your supplement and potential interactions between these ingredients and other supplements or medications you may be taking.
Specific considerations when supplementing with iron include:
Take iron supplements separately from tea, coffee, and prenatal vitamins: Some forms of iron supplements can compete with other nutrients for absorption. For example, “zinc and calcium, even in highly bioavailable forms, can interfere with iron absorption. I always recommend spacing out prenatal and iron supplements,” says Barmer.
Tea and coffee can also interfere with iron absorption, so you should avoid taking iron supplements.
Work with your healthcare provider if you are taking certain medications: According to Barmmer, “Over-the-counter medications such as antacids and acid blockers can also reduce iron absorption, so if someone is experiencing heartburn or reflux, it’s ideal to work with a healthcare provider.”
Taking iron supplements separately from thyroid medication: Barmmer also notes that iron supplementation can interfere with the effectiveness of thyroid medications. Pregnant women may take the drug levothyroxine (Levothroid, Levoxil, Synthroid, Tyrosint, and Unithroid) to maintain healthy thyroid hormone levels during pregnancy. If you are taking this medication and also need to take iron supplements, be sure to wait at least 4 hours between doses to ensure that the iron does not reduce the absorption of your thyroid medication.
Take iron supplements along with vitamin C.: Taking iron supplements along with sources of vitamin C, such as orange juice, bell peppers, and vitamin C supplements, can further increase iron absorption.
Types of iron supplements
Iron supplements are available in a variety of forms, but it’s important to choose the one that you can tolerate best and that best suits your needs.
Iron exists in nature in two main forms: ferrous and ferric. These two forms are sometimes referred to as “heme” and “non-heme” iron, respectively. Heme iron is found in animal foods such as meat, poultry, and seafood. Non-heme iron is found in plant foods such as beans, grains, vegetables, and fortified foods. Heme iron is absorbed very efficiently by the body, while non-heme iron is absorbed at only about 1% to 7%. It is usually recommended to take supplements in the form of ferrous iron, or heme iron.. Although heme iron is only found in animal foods, many iron/heme iron supplements are 100% vegan.
One thing to note is that the amount of elemental iron varies depending on the form of iron. For example, ferrous sulfate contains only 20% elemental iron, while ferrous fumarate contains 33%. Only the elemental iron is listed on the supplement’s fact label, so you know exactly what you’re absorbing.
Below are some of the common forms of iron used in supplements.
- ferrous sulfate: This is an iron salt and is considered the “standard” treatment for iron deficiency, given its acceptable tolerability, high efficacy, and low cost.
- ferrous bisglycine: This is known as the “chelate type”. It usually has far fewer side effects and is absorbed as effectively as ferrous sulfate. This form may also better increase ferritin (the storage form of iron in the body). Both Barmmer and Caldwell prefer to use this form to treat iron deficiency during pregnancy in their own practices.
- Ferrous fumarate: Iron salts that can cause gastrointestinal problems.
- Ferrous gluconate: This is an iron salt that can cause gastrointestinal distress and is less bioavailable than other forms of iron supplementation.
There are also forms of ferric citrate and ferric sulfate, but these are not as easily absorbed as other forms of iron. Additionally, this form must be converted into the iron form in the body.
Iron supplements can have unpleasant side effects, such as nausea, heartburn, pain, constipation, and diarrhea, which can be alleviated by choosing a sustained-release formulation. Although the form of iron in this product may still be listed as “ferrous sulfate,” this preparation delays the release of iron and delivers it to the gastrointestinal system in a gentler manner.
Finally you can find iron supplements as tablets, liquid, or powder; Therefore, choose the management method that is most comfortable for you. Some pregnant women use liquids or gummies if they feel they are already taking many other prenatal supplements.
Note that if you have severe anemia during pregnancy, iron drips are often recommended rather than taken by mouth, as they are more effective and do not cause constipation.
who are we
Casey Seiden is a registered dietitian, nutritionist, Parents magazine writer, and certified diabetes care and education specialist based in New York City. Casey works at Maternal-Fetal Medicine Associates, a premier maternal-fetal medical practice in Manhattan, providing nutritional therapy and counseling to women with high-risk pregnancies. She is also the founder of Casey Seiden Nutrition, a virtual private practice specializing in non-dietary approaches to diabetes care and women’s health.
