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General Medical Questions
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Question : I am anemic and the doctor wants me to take 325 mg of iron sulfate a day. Is that dangerous? The recommended daily dose is only 18 mg a day.
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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December 27, 2012
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A:

If you don’t have enough iron in the body, it can lead to a low red blood cell count. Doctors call this iron-deficiency anemia. This condition affects up to 15% of menstruating women in the United States.

It helps to eat iron-rich and iron-fortified foods. Examples include red meat, beans, vegetables, grains, and some cereals. But it’s hard to correct anemia with dietary changes only.

The best supplement is what your doctor recommended, iron sulfate.

You are right that the recommended dose of iron is much lower than 325 milligrams per day. However, each 325-milligram iron sulfate tablet contains only about 60 milligrams of actual iron. And your intestine only absorbs a fraction of it.

Therefore, the usual recommended dose of iron sulfate is 325 milligrams, taken by mouth one to three times a day. This should lead to an increase in the number of your red blood cells within 1 to 2 weeks.

Your doctor likely prescribed the lower dose of only one 325-milligram tablet per day to decrease the risk of side effects. The most common ones are upset stomach and constipation.

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