One of several iron salts delivering iron in the readily absorbed form; white, mild-tasting and stable. Solid benefits are iron's own where stores are genuinely low: anaemia corrects, stores rebuild, tiredness eases. Stomach upset and constipation are common, iron binds several medicines, and the body cannot shed surplus. Where iron is already adequate, accumulation carries costs and no offsetting gain. (Full Review)

Protocol

Standard repletion protocol

60–120 mg elemental iron, alternate days

Fasting, with water; 8–12 weeks to correct haemoglobin, 3–6 months more to rebuild stores

Best time of day

Morning, before 10 a.m.

At least 30 minutes before food; later doses after a morning dose absorb poorly

Single versus split dosing

Whole amount at once

Twice-daily dosing did not increase total absorption

Time to effect

Haemoglobin

4–8 weeks

Reticulocytes (newly made red blood cells) rise within 5–10 days

Iron stores (ferritin)

8–12 weeks or more

Lags well behind haemoglobin; haemoglobin corrects months before stores refill

Fatigue

8–12 weeks or more

Tracks ferritin rather than haemoglobin

Benefits

High: Correction of iron-deficiency anaemia; restoration of depleted iron stores; reduced fatigue in iron deficiency without anaemia

Medium: Relief of restless legs syndrome symptoms; improved memory and anxiety measures in non-anaemic iron deficiency

Low: Iron delivery from fortified foods and beverages

Speculative: Topical antimicrobial action against Cutibacterium acnes

Contraindications

Hereditary haemochromatosis or HFE C282Y homozygous (unless a clinician directs otherwise)

Transfusion-dependent thalassaemia, sideroblastic and other iron-loading anaemias

Ferritin above 300 µg/L (men) or 200 µg/L (women), or transferrin saturation above 45%, without inflammation

Acute or untreated infection

Active peptic ulcer, oesophageal stricture, or inflammatory bowel disease flare

Anaemia not established as iron deficient

Key Interactions

Levothyroxine: 4 h separation

Tetracyclines, fluoroquinolones (doxycycline, ciprofloxacin, levofloxacin): iron 2 h before or 4 h after

Levodopa/carbidopa, methyldopa, mycophenolate, penicillamine, bisphosphonates (alendronate, risedronate): 2 h separation

Proton pump inhibitors, H2 blockers (omeprazole, famotidine): reduced iron absorption

Antacids, laxatives (calcium carbonate, magnesium hydroxide, aluminium): bind iron; magnesium peroxide defeats the dose

Calcium, zinc, copper, manganese: reduced uptake; separate meal

Vitamin C, probiotics (additive): raised iron absorption

Thyroid, blood pressure, Parkinson's regimens as a block: a stable dose can be destabilised

Tea, coffee, cocoa, red wine, high-phytate meals: can cut absorption by more than half if taken with the dose

Blood donation, endurance training: overload can be masked by a normal ferritin

Risk & Side Effects

High: Gastrointestinal intolerance

Medium: Reduced absorption of co-administered medications; iron accumulation in genetically susceptible individuals; diminishing returns and prolonged gut exposure from daily dosing

Low: Acute iron poisoning after overdose; higher body iron stores and type 2 diabetes risk; adverse shifts in gut microbiota

Speculative: Bone loss from sustained iron overload; eosinophilic gastrointestinal inflammation

Monitoring

Marker	Target	Why
Ferritin	50–100 µg/L (women), 60–150 µg/L (men)	The storage-iron gauge and the primary treatment target
Transferrin Saturation (TSAT)	25–35%	Iron actually available to the marrow right now
Haemoglobin	13.0–15.0 g/dL (women), 14.0–16.0 g/dL (men)	Confirms whether deficiency has progressed to anaemia
MCV	85–92 fL	Detects the small red cells of established deficiency
Soluble Transferrin Receptor (sTfR)	2.0–5.0 mg/L	Distinguishes true depletion from inflammation-driven low iron
hs-CRP	Below 1.0 mg/L	Indicates whether the ferritin reading can be trusted
Total Iron-Binding Capacity (TIBC)	250–350 µg/dL	Rises as stores fall, corroborating the ferritin picture
ALT	Below 25 U/L (women), below 30 U/L (men)	Screens for the liver injury that accompanies iron loading

Cadence: Baseline, then 4 weeks, 8–12 weeks and 6 months; every 6–12 months after stopping while losses continue

Qualitative Assessment

Daytime energy and the point in the day when fatigue arrives
Exercise recovery time and perceived effort at a fixed training intensity
Cold intolerance, particularly in the hands and feet
Restless or crawling sensations in the legs at rest in the evening
Hair shedding, brittle nails and the spooning of nail beds
Shortness of breath on stairs or moderate exertion
Concentration, short-term recall and word-finding
Stool colour, consistency and any abdominal discomfort after dosing

Ferrous Lactate for Health & Longevity

Protocol

Benefits

Risk & Side Effects

Monitoring

Qualitative Assessment