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If coffee absorbs iron by 50%, can't I just take 2 iron pills?

I am battling hard to get my iron levels up (anemia), but despite taking 150mg of iron multiple times a day it's not having such a great effect. I drink a lot of coffee and tea and eat frequent meals (I am hardcore into weight training and fitness), all of which inhibit iron absorption.

I keep reading that coffee and tea especially can reduce iron absorption by 50-70%, what I don't read however is what to do about it besides "quit coffee".

If drinking coffee and taking iron at the same time inhibits iron absorption by 50%,then...uh...can't I just take 2 pills? 50% + 50% = 100%!
3 Responses
Avatar universal
First, are you certain you have anemia?  It would be very hard to be a hardcore fitness and weight trainer if you were truly anemic enough to need iron supplementation -- you would be fatigued.  I suppose an individual could do this, but when you're anemic, your blood is weak and when that happens energy goes way down.  Have you been tested repeatedly, or just once?  So, let's assume you're just incredibly strong and can function this way without strong blood cells, that you don't have bags under your eyes, and you're not tired all the time, but you're still after repeated testing -- not just once, which might have been an aberration -- low enough in iron to be considered to be anemic.  When doctors prescribe iron, it's not usually in a form that is well-absorbed.  High levels aren't usually needed, what's needed is absorption.  Plant based iron is much better absorbed generally in supplement form than the ones your docs prescribe, which are very poorly absorbed.  The best two ways to get iron levels up is to eat a variety of foods high in it, which would include beets, leafy greens such as parsley, nettles, dandelion greens, and watercress as examples.  There's also the older way, which is to eat organ meats.  There is a supplement called Floradix that is plant based -- but it has very low levels of iron in it.  It is, however, usually considered the best absorbed supplement.  Another way to battle anemia is to focus on hemoglobin.  Chlorophyll has almost the same structure as hemoglobin, and the body can take it up and use it to strengthen blood cells.  Foods like spirulina and wheat grass are very high in chlorophyll, so that can help as well.  Now, the coffee and tea thing I don't know anything about and don't have time to research it -- but it would seem the two would not have the same effects.  Coffee is a very limited food with few nutrients.  The only reason to consume it is because you're addicted to caffeine and would go into withdrawal for awhile without it, which would include feeling tired.  Tea, on the other hand, is a very complex plant with tons of antioxidants, relaxants, and other nutrients along with the caffeine, so I'm wondering if they truly have the same effect in any way on anything.  And, of course, if you must have your coffee, you can consume it at a different time than you take your iron.  Iron, as with minerals generally, is best taken with a meal.  Minerals are hard and need an acidic stomach to break them down, so that's the reason for that.  You can drink coffee anytime you want and still get a caffeine high.  But keep in mind that coffee is a very popular drink while anemia is quite rare, so if it was that inhibiting of iron absorption one would expect all those several cups of coffee a day folks would all be anemic to some degree, and I don't think that's true.  That doesn't do you a lot of good because you might just have a problem absorbing iron that others don't have, but it's probably not the coffee having a large impact.  If it did, again, there would be a lot more anemia going around then there is.  And consider tea -- it's even more widely consumed than coffee, but I don't remember reading that Asians who drink it all the time are not absorbing their iron.  Something more is going on.  My main advice, though, is if you're taking a supplement and not showing results, it might be the supplement you're using, not all supplements.  Don't know, just an idea for you to consider.  And if all else fails, if quitting coffee is necessary to stay alive, then it seems the choice is an easy one.  I'm just not sure it's the issue here.  And note that taking too much iron increases the risk of heart problems and digestive problems, especially for men, so take care.  Hope you work this out.
Avatar universal
Thanks for detailed response. Yes, I have been tested repeatedly throughout my life. My father and mother are also anemic-- cause never found. That's what they are saying about me too-- idiopathic; "that's just how I am".

It's true I've not necessarily felt any of the symptoms of anemia, but how can I really know since I've been this way my entire life.  I feel like I constantly have bags under my eyes and pale skin.

RBC: 3.99 (ref. range = 4.2-5.4)
Hemoglobin: 118 (ref range = 135-170)
Hematocrit: 0.35 (ref range = 0.4-0.5)
Ferritin: 85 (ref range = 24-444)

That ferritin level is after 4 months of me taking approximately 450 mg of iron a day.

Again, that's way more iron than an ordinary individual would require.  I'm guessing again that the form of the supplement isn't working for you and an alternative approach might help.  Or might not, but it's worth a try.  I'd ignore my doctor on anything having to do with nutrients and see a holistic nutritionist and see if you can't find something that shows results.  Best of luck.
Thanks I appreciate the response, but there is no way on Earth I would listen to a holistic nutritionist.
May I ask why?  It's someone with a nutrition degree just like anyone else with a nutrition degree who has gone further to explore more than what is taught by allopathic practitioners -- you just get more for your money.  Regular nutritionist are the people, along with dieticians, who devise menus for hospitals -- ever eaten at one?  That's why I recommend a holistic nutritionist, they actually study nutrition.  But the main point is, if you're stuffing yourself with iron and it's not showing up on your tests, it's not being absorbed.  If you keep doing the same thing, you'll keep getting the same results.  All the best.  It's your choice.
Because if a discipline doesn't hold itself to the highest of scientific rigour, it's pseudoscience. https://csnn.ca/industry/holistic-nutrition-industry/
I would never be able to trust anyone's opinion who thinks that homeopathy is a thing. Anyways, I really don't want to get into a an online debate about "mainstream" science vs...whatever else these people are doing. I look forward to the homeopath's groundbreaking presentation at the Royal Society. I appreciate the response anyways.
  Main point is to anyone is do your own homework. Some people come on here looking for solutions, and some just come on to vent.  What I want to counter is the notion that "science" equals "fact," which it doesn't.  Science is a process of seeking facts.  But we use a lot of technology that preceded the development of the modern scientific method.  We don't throw them all out because we have developed new methods of research.  Anyone out there not using the wheel because it was invented before the scientific method?  The aqueduct?  The road?  The lever?  Aspirin?  Agriculture?  We have lots of modern research that has produced largely medical technologies that haven't worked.  The main factor is our extended life spans is from cleaning up the water supply.  Very little has come from medicine.  Much good has been done, and much harm.  If you can fix a problem by eating better or using a plant, it's a lot safer than if you have to take a medication or undergo a procedure both of which are attempts by humans to make a better being than you were born being.  Maybe they can, maybe they can't.  Don't throw out the baby with the bath water, basically, it just limits options.  Much of modern medicine is just people selling things to us.  It's marketing, not scientific fact.  Much of it is scientific fact.  But you have to do some work to tell which is which.  My only point to the poster is and remains, if you keep doing what doesn't work, it will continue to not work.  If one professional can't help you, another might.  Peace, all.  
You didn't actually answer my question. Very little has come from medicine?  How about the discovery of antibiotics? My spine was horribly deformed and thanks to medicine I now can deadlift 300 lbs. I'm not coming here to vent, I'm just a dude who refuses to let the internet become a cesspool of misinformation. I have a feeling I'm screaming into an echo chamber anyways.

Anyone else out there actually know the answer to the question? If we can quantify the amount that certain foods inhibit iron absorption, certainly I can just equally up the dosage of iron?
What I said was that the length of our lives has not been influenced much by modern medicine, unless you consider, and this is a big consideration, that it was modern doctors in England who bombed the holding pools there forcing the adoption of our modern water treatment system.  That is the largest reason for increased lifespan.  The second reason is the invention of refrigeration, allowing for the year long availability of antioxidant rich foods.  Antibiotics have been both blessing and curse, which is what I was trying to get others to see so they would have a more complete picture of the health care scene.  While lifesavers, the over-marketing of them led to overuse by both large animal vets and doctors, so that now we have a huge problem of harmful bacteria having adapted to them.  They have been prescribed more for uses for which they are both unnecessary and ineffective, such as for viruses, then for uses for which they are necessary.  The huge downside has been that when you take them you destroy part of your immune system and mental health system, which has led to epidemic levels of yeast infections, digestive problems, and many other problems.  So what I said was, in all forms of medicine, there has been both good and bad.  It was modern doctors who told women when I was young that they should use formula rather than breastfeed, leading to immune system problems.  It was modern doctors who took the money and allowed both tobacco and air pollution sources to claim they were not harmful, delaying for decades necessary controls and killing untold numbers of people.  Again, good and bad.  If I have a broken leg, I see a doctor.  If I have a digestive problem, probably not, as the drugs they prescribe are probably more harmful in the long run than helpful.  It just depends.  I'm guessing you've never used a homeopathic remedy, but I have, and as I said, sometimes they work, sometimes they work.  I have also been on a lot of medication, and some has worked, some has not, and one drug destroyed my health.  Good and bad.  And yes, I did answer your question -- you are talking about two of the most commonly used substances on Earth, coffee and tea, and you're the only one on here complaining about iron absorption from it.  That's because your problem is your problem, not the problem of those who don't have your inherent problem absorbing iron.  Again, if you're supplementing as much as you are, and you are taking a ton more iron that is medically recommended, and you're still showing as anemic, you need a  better approach.  Again, nutrition isn't homeopathy -- homeopathy is a distinct modality that will do nothing for you.  A good nutritionist might.  Or might not.  The answer to me is, you need to find a way to get the iron you're consuming to be taken in, because you're taking so much of it in excess of what a normal person would need that it should be overriding anything you could do to prevent it from being absorbed.  We have the exact same problem going on here, so we're on the same team -- I'm only in this conversation because I'm trying not to let misinformation spread on the internet and deter others who might be reading his exchange from not trying something that might help.  Or might not.  I'm not trying to get you to do anything you feel is not right for you.  But it might be right for someone else. All the best.
973741 tn?1342346373
@ MedicalHelpUser.  I really like the logic of your question.  lol.  You are using math to solve and outsmart an iron absorption problem!  What I've read about coffee and iron absorption is that it prevents it BUT if you take the iron pill an hour before you drink your coffee or an hour plus adding any time you can after you drink coffee, that effect is likely negated.  I like coffee too but I could reasonably do that at some point during the day.  

Question--  do you work with a doctor?  Are you self treating your anemia/low iron or is this under doctor supervision?  They may change your dose, allow two pills depending on the strength of the iron, etc. if you still are low on iron even with one pill supplementation.   Remember, drink a glass of orange juice with your supplement for better absorption.  And what about the other things that help with iron? Are you a meat eater, eat dark leafy greens and vegetables, beans, quinoa, dried fruits, etc?  (there is a healthy cooking forum here and that would be a great topic!  I'll add a post to share iron rich food ideas). And here is something else to do if you can . . . drink a glass of prune juice a day if you can stomach it.  Helps digestion too!   I personally have a hard time with prune juice as . . . well, ick. (to me).

But the big thing is to wait that hour before or after coffee and maybe that would help. And it can take several months to right low iron/anemia.  If you are drinking coffee for more energy due to caffeine, by the way, that may compound the fatigue.  Did for me when I drank more than I do now.  Caffeine is a vicious up and down cycle when you depend on it for energy.  That's off topic but am throwing it in.

Here is a really easy read on iron supplements https://www.webmd.com/vitamins-and-supplements/features/iron-supplements#1

So, and this is just for MedicalUser as I don't debate, but there is definitely mixed opinion about homeopathy.  I personally have my own viewpoint based on my experience and reading and learning.  Which makes me an expert as much as it does anyone.  I think some'practicing' it and selling products for it can be highly suspect in taking advantage of people. Not all but some. Believed this but realized it for sure when my mother in law was bilked out of thousands of dollars believing her homeopathic doctor was going to save her from stage 4 cancer. It was ridiculous. She was a believer though as she owned and ran a health food and holistic medicine store for many years.   I had many years in the homeopathic/holistic/health food store environment through my in laws.

What I loved about my mother in law who was a very difficult person in some ways was that she loved to discuss respectfully with me the topic of homeopathic medicine verses traditional as I worked at the time in a traditional medicine environment. She respected where I was coming from and I respected where she was coming from.  I appreciated her ability to be interested in what others have to say and to learn things even if she had her very set beliefs.  We had conversations from totally different points of view in the start where we came together in the end as we could actually listen to one another.   As I've gotten older, I have found some homeopathic things that I do really believe work.  Arnica is great for muscle ache, for example. I'm a believer in nutrition and have seen some who visit a nutritionist (take out the word holistic if that makes you feel better, true nutritionists have 4 year, science based university degrees in the field) see improvement in health conditions. Or at least feel better.  If you get GERD, you lose weight and change your diet and it gets better (I'm proof of that).  

The one time I was very anemic was when I was a work out junkie. I could hardly climb the stairs to my bedroom at night (and we're taking like 7 pm here because I could NEVER stay up later than that due to fatigue).  I went to my doctor and one of my issues was working out and caloric intake and foods I was eating in general.  This was a regular MD doctor and nothing holistic about it.  Diet change boosted my energy. I've read that B vitamins can also boost energy.  (in fact, have you ever had your B 12 level checked?)

Anyway, I feel for you.  I know the kind of tired you are feeling and it's rough.
Thanks SpecialMom for actually answering my question! :-) I am indeed trying these things. It's really tough for me to find a window in which to take iron because I eat frequent meals in order to maintain my athleticism. I'm consuming close to 4000 kCal a day! I was just curious if there was something foolish about my double up theory (i.e. perhaps the absorption inhibition rate is non- linear). You can always up the dose of any medication, but you also increase the chance of side-effects. I am indeed working with a doctor. What I think I will do is try my "double up theory" for 2-3 weeks, retest my iron, and if it's still not budging ask to be investigated for celiac disease.
I also get tired of online debates about this stuff., but I think of it as a moral question so I feel compelled to respond. It seems in this day and age it's whomever shouts the loudest wins, so shout louder, I shall. Consider this: If “alternative medicine” could be shown to work, doctors would use it and it would just become part of regular medicine, thus eliminating any need for such distinctions between “regular” and “alternative”. Which means that the definition of alternative medicine is…“crap that doesn’t work”.
Here again, I'm not, Mom, trying to debate with the poster.  He's not reachable by me.  He has a dogma and he's sticking to it and he's as entitled to that as I am or you are to ours.  But every time he comes on here and says something that might discourage someone else -- again, not him, he's made up his mind and I'm really not trying to change it -- from getting help for a problem by misconstruing reality, I have always in the many years I've been on here stood up for reality.  Our society is really divided now, but it has always had a problem in that people have a very hard time differentiating between marketing or propaganda and actual science.  The term "alternative" medicine has always bothered me as it does the poster, but for a different reason -- "alternative" medicine is the one people have the most experience with, so we have a very good idea of at least some of what works and what doesn't over centuries of use.  Now, that excludes new forms of medicine that claim to be "natural" but aren't, such as taking amino acids or isolated nutrients (like iron).  That's a much newer way of doing things as it took modern lab techniques to isolate these nutrients.  But aspirin has been around since either ancient Greece or ancient Egypt, depending on who you believe, so even the ancients figured out to isolate certain things.  Aspirin is an acid derived from white willow bark.  They wouldn't have done this if they hadn't already known that white willow bark helps to reduce pain.  But aspirin also has possibly killed more people than any other medication, as it's so much stronger than using white willow bark, which contains lots of substances other than just the acid that makes up aspirin.  Most of our medications are either derived from plants they already knew worked but wanted to make work better, faster, and make more money off of -- you can't patent a plant.  Statins came from research on mushroom used in traditional Chinese medicine, for example.  So the term "alternative" is a slur made up by those who make up our medical industrial complex, meaning the AMA, the pharmaceutical industry, etc.  Until the 20th century, when you saw an allopathic practitioner you took your life in your hands.  These were the people who bled you, who used leeches, who basically tortured people.  In those days, homeopathy and herbal medicine were much more reliable, safer, and worked better.  Most people don't know this because they don't know their history.  In the robber baron days, a group of them got together at a time when a few very wealthy people controlled almost all of our economy (this was in part addressed by Teddy Roosevelt) and they decided to back allopathic medicine with their money because it would have the greatest returns.  This led to an outpouring of marketing and propaganda which led to the system we have now, but that system isn't the convention one, it's the alternative one.  I wouldn't personally wish to live without it -- I'd much rather have a world with modern surgeons and modern medication and universities researching disease.  I also wouldn't want to live in a world where gentler, less intrusive alternatives were not available as well.  It is definitely incorrect to say allopathic medicine is "regular" medicine and all else is "alternative."  Again neither is alternative and neither is regular, they both co-exist and both have their best uses and their quacks.  The poster clearly doesn't know this history because he is dogmatic, which again, is fine for him to be.  What isn't fine and what I'm trying to get him stop doing is to stop others from making up their own minds by saying not that no that's not something I'm going to try but instead saying that's something nobody should try.  I also am trying to move the focus away from homeopathy, which it appears the poster doesn't actually know much about.  It's only one form of medicine, and it may well be all placebo.  There is some scientific research done in France and India that shows antibody reactions to using homeopathic remedies, but for the most part, this is also a relatively new form of medicine and there's very little if any proof that it works.  But as you have said before, Mom, placebo ain't all that bad as long as you're not trying, as you say, to cure cancer.  But I can see how someone who has tried the allopathic way to decide enough torture, enough making me so weak I can't live any kind of life, just let me use these other methods.  If they don't work, I'll die, but I'm going to die anyway so let me go strengthening my body rather than tearing it down.  It's a hard decision to make, and not for the faint of heart.  I managed health food stores for many years, and I've seen the good and the bad of natural medicine.  I've seen the rise of multilevel traded products that are just con jobs.  I had a customer who was left for dead by doctors who researched natural medicine, set up a regimen, and was still alive 30 years later.  I've seen people die after giving up on suffering with what doctors do to you, but who lived happily until their death.  And for minor problems, often natural medicine actually works better than anything allopathic medicine has to offer.  But the roots of all medicine lie in our distant history.  Psychology comes largely from Hinduism and Buddhism, or what we refer to as ********* medicine.  Again, most of our drugs come from plants -- if we didn't know garlic was a pretty effective antibiotic we might never had chased down pharmaceutical antibiotics.  We learn, we grow,  And many doctors practice both forms of medicine and are called integrated medicine.  Most homeopaths are MDs who got tired of torturing people.  So for anyone out there who still follows this forum, keep an open mind.  Be careful no matter what form of medicine you use.  If what you're doing isn't working, try something else.  Peace, all.      
Sorry, automatic censor thinks the traditional form of medicine in India is a dirty word.  It's ayur veda.  But just one word.  
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