
Iron is an essential mineral that helps carry oxygen through red blood cells to every organ and cell in the body. It is also involved in energy production. Anemia is a common side effect of iron deficiency, which can lead to weakness and fatigue. While poor diet, blood loss, trauma, and surgery can cause iron deficiency, it can also be caused by laxative abuse.
Laxatives are available over the counter and are used to trigger bowel movements by softening stools or drawing fluid into the bowels to create healthy stools. While occasional laxative use usually doesn't have consequences, long-term use can lead to complications such as anemia and vitamin deficiencies. This is because when laxatives are used to quickly rid the body of food after eating, the nutrients are not given enough time to be absorbed, leading to deficiencies. Additionally, excessive laxative use can cause tears in the oesophagus and create ruptures in the intestines and bowels, leading to blood loss and iron deficiencies.
Magnesium laxatives, such as magnesium oxide, can inhibit iron absorption. However, taking oral iron supplements with magnesium laxatives is not considered a clinical problem. Nevertheless, clinicians should be attentive to the interactions between iron and magnesium laxatives.
Characteristics | Values |
---|---|
Can laxatives cause iron deficiency? | Yes, overuse of laxatives can cause iron deficiency. |
How does this happen? | When laxatives are used to quickly rid the body of food after eating, the nutrients are not absorbed, leading to deficiencies. |
What are the symptoms of iron deficiency? | Tiredness, weakness, heart palpitations, dizziness, fainting, headaches, leg pain, chest pain, brittle hair, difficulty swallowing, mouth sores, dry mouth, and a burning sensation on the tongue. |
What are the treatment options? | Stopping laxative use, iron supplements, dietary changes, and psychological counseling. |
What are the recommended dietary sources of iron? | Liver, oysters, poultry, lean red meat, beans, seeds, whole grains, and foods high in vitamin C like berries and broccoli. |
What You'll Learn
Magnesium laxatives inhibit iron absorption
Magnesium laxatives can inhibit iron absorption, leading to iron deficiency. While oral iron supplements can be taken with magnesium laxatives, the overuse of magnesium laxatives can result in iron deficiency anaemia (IDA). This occurs when the body cannot produce enough red blood cells or loses iron faster than it can be absorbed.
A case study published in the *Biopsychosoc Med* journal in 2019 reported that a 28-year-old woman with anorexia nervosa was admitted to a hospital to evaluate her refractory IDA. Despite having taken oral iron replacement therapy for nine months, her condition persisted. It was discovered that she had been overusing magnesium laxatives, taking between 50 to 200 tablets (16.7 to 66.7 g) of magnesium oxide daily, which is equivalent to approximately 10 to 40 g of elemental magnesium. As a result of the overuse of magnesium laxatives, the patient's body struggled to absorb iron, leading to a deficiency.
Magnesium laxatives, such as magnesium oxide, can inhibit iron absorption. This interaction between iron and magnesium can lead to IDA, especially if the magnesium laxatives are overused or taken in high doses. However, it is important to note that taking oral iron supplements with magnesium laxatives at lower doses is not typically considered a clinical problem.
The overuse of magnesium laxatives can have serious health consequences, including IDA and even fatal hypermagnesemia. Therefore, it is crucial to use these medications as directed and be aware of the potential interactions and side effects. Clinicians should also pay close attention to the interactions between iron and magnesium laxatives and provide appropriate patient education to prevent overuse and potential complications.
In summary, magnesium laxatives can inhibit iron absorption, leading to iron deficiency and, in severe cases, IDA. While oral iron supplements can be taken concurrently with magnesium laxatives, overuse or high doses of magnesium laxatives can disrupt iron absorption and result in IDA. It is important for individuals to consult with healthcare professionals before taking any medications or supplements and to be mindful of the potential risks and benefits associated with their use.
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Laxatives can cause blood loss
Stimulant-type laxatives, such as Ex-Lax, Correctol, and Senokot, are known to cause blood in stools. Laxatives can also cause tears in the oesophagus and create ruptures in the intestines and bowels, which can lead to blood loss and iron deficiency.
The risk of blood loss is particularly high in patients with atrial fibrillation and heart failure. A study found that constipation requiring laxatives was a significant risk factor for major bleeding in these patients.
The first line of treatment for iron deficiency caused by laxatives is to stop taking laxatives and allow the body to absorb necessary nutrients from food. Iron supplements may also be needed.
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Oral iron supplements may cause constipation
Oral iron supplements may cause or worsen constipation by making stools harder. Constipation affects around 16 in every 100 adults and 33 in every 100 individuals over 60 years old. People with constipation may have hard stools that are difficult to pass and fewer than three bowel movements a week. They may also feel that they have not completely emptied their bowels.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) advises that iron supplements may worsen constipation. According to a 2021 review, oral iron is the most common treatment for iron deficiency anemia due to its low cost, high bioavailability, and effectiveness. However, the review authors noted that iron supplements may cause gastrointestinal side effects, such as constipation, abdominal pain, and bloating, in up to 60% of people who take them. The type of oral iron that doctors prescribe most is ferrous sulfate, but this has a high frequency of side effects compared to ferric iron sources.
The review further explains that iron supplements typically contain more iron than the body can absorb. Therefore, a large amount remains in the gut, affecting the balance of gut bacteria. In addition, older research suggests that oral iron may generate free radicals and cause inflammation. A 2020 review notes that the mechanisms by which iron causes constipation are unclear. However, scientists think that excess iron ions in the stomach cause more water transportation into the intestines. This water is then distributed from the lower part of the gastrointestinal system to other areas of the system to maintain the acid-base balance. This may result in stool hardening and constipation as water helps soften stools and make them easier to pass.
To manage constipation, a person may:
- Eat more fiber by including foods such as vegetables, whole grains, legumes, fruits, and nuts in their diet.
- Drink plenty of water.
- Avoid processed foods, fast food, and foods with little or no fiber, such as meat.
- Stay physically active.
- Try bowel training by aiming to have a bowel movement at the same time each day.
- Ask a doctor which supplements or medications worsen constipation and if it may be safe to stop taking them.
- Consult a healthcare professional about whether taking laxatives may be suitable.
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Iron deficiency can lead to anaemia
Iron is an essential mineral that helps carry oxygen through red blood cells to every organ and cell in the body. It is also involved in energy production. Iron deficiency can lead to anaemia, which is a condition in which the blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues.
Iron deficiency anaemia is the most common type of anaemia. It occurs when the body does not have enough iron to produce a substance called haemoglobin, which is found in red blood cells and enables them to carry oxygen. As a result, iron deficiency anaemia may cause fatigue and shortness of breath.
The signs and symptoms of iron deficiency anaemia include:
- Chest pain, fast heartbeat, or shortness of breath
- Headache, dizziness, or lightheadedness
- Inflammation or soreness of the tongue
- Unusual cravings for non-nutritive substances, such as ice, dirt, or starch
- Poor appetite, especially in infants and children
Left untreated, iron deficiency anaemia can lead to severe health problems, including:
- Heart problems: Iron deficiency anaemia may lead to a rapid or irregular heartbeat, and possibly heart failure or an enlarged heart.
- Problems during pregnancy: Severe iron deficiency anaemia has been linked to premature births and low birth weight babies.
- Growth problems: In infants and children, severe iron deficiency can lead to delayed growth and development, as well as an increased susceptibility to infections.
To treat iron deficiency anaemia, it is important to first identify and address the underlying cause, such as blood loss or an inadequate iron intake. This may involve stopping laxative abuse and allowing the body to absorb iron from food. In some cases, iron supplementation or intravenous iron may be necessary. A doctor may also recommend dietary changes, such as increasing iron-rich foods like red meat, poultry, leafy greens, and iron-fortified foods, as well as vitamin C to enhance iron absorption.
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Iron supplements may cause side effects
Many people taking iron supplements experience changes in their stool colour and calibre, which can be distressing. The stool may turn green or 'tarry black'.
Some people also experience an upset stomach when taking iron supplements. It is recommended to take the supplement with a small amount of food to help with this, although this may decrease absorption.
Other, less common side effects include infusion reactions and anaphylaxis.
Iron supplements can also decrease the absorption of other medications by forming an insoluble complex with those agents. These medications include methyldopa/levodopa, fluoroquinolones, penicillin, or tetracyclines.
It is important to note that accidental iron ingestion in children under the age of six has been a leading cause of fatal poisoning.
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Frequently asked questions
Yes, laxatives can cause iron deficiency. Long-term use of laxatives can lead to a host of complications, including anemia and vitamin deficiencies. This is because when laxatives are used to quickly rid the body of food after eating, the nutrients are not given enough time to be absorbed, leading to deficiencies.
At first, you may feel tired and weak, with intermittent heart palpitations. This can then progress to dizziness and fainting, as well as headaches and leg pain. As the condition worsens, you may experience angina (chest pain), brittle hair, difficulty swallowing, sores in the mouth, and an altered state of touch.
The first line of treatment is to stop taking laxatives and allow your body to absorb the necessary nutrients from food. You may also need to take iron supplements, but you should talk to your doctor before doing so.