Iron deficiency is the main cause of anaemia, which is the most prevalent nutritional deficiency worldwide, according to the World Health Organization[i]. While it is possible to increase iron levels by eating iron-rich foods, many people still remain deficient. For these groups of individuals, iron supplements can help to prevent iron deficiency.
There are many different brands of iron supplements on the market, and we often get asked about the differences between OptiFer® and Feramax® or Proferrin®. You can read more information about OptiFer® and Proferrin® at https://www.optiferalpha.comoptifer-vs-proferrin.
Heme And Non-heme Iron Difference
In order to understand the difference between OptiFer® and Feramax®, it is important to understand that there are only 2 types of oral iron supplements in the market, heme iron and non-heme iron. Heme iron is derived from meat sources. Non-heme iron (such as Feramax®) can be derived from eggs and iron-rich vegetables.
As per Health Canada’s guidance relating to iron, [h]eme iron is more easily absorbed by the body than non-heme iron.”[ii]
The term heme is not to be confused with the term “Hematinic”. All iron supplements are hematinic. A hematinic is a nutrient required for the formation of blood cells in the process of hematopoiesis.[iii] This term is found on many iron supplements and often causes confusion as to which supplements contain heme and non-heme iron.
Read more about heme and non-heme iron at, https://www.optiferalpha.comheme-iron-vs-non-heme-iron-in-food/.
There are many types of non-heme irons, such as Polysaccharide/Polydextrose Iron Complex (PIC), Ferrous fumarate, Ferrous sulphate, and Ferrous gluconate. Feramax® is a PIC, therefore it is a non-heme iron.
Heme irons consist of only heme iron polypeptides. OptiFer® and Proferrin® are heme irons. More information on OptiFer® and Proferrin® at https://www.optiferalpha.comoptifer-vs-proferrin/
The food you eat may impact the absorption of non-heme iron. Foods containing phytic acid (like breads, nuts, and cereals) and polyphenols (found in tea, coffee, and chocolate) can hinder the absorption of non-heme iron[iv].
There are ways you can enhance non-heme absorption. Vitamin C has been shown to increase the bioavailability of non-heme iron[v]. Taking non-heme iron while eating heme rich foods (meat, poultry, and seafood)[vi] may also increase the bioavailability of non-heme supplements.
Most dietary components do not affect heme iron.[vii] However, calcium (such as some dairy products and calcium supplements) at levels greater than 300 mg may decrease the bioavailability of both heme and non-heme iron.[viii] Take calcium either an hour or so before or after taking your iron supplement.
The differences between these two types of iron do not end there. Heme iron is absorbed into your body by the Heme Carrier Protein 1 (HCP1) receptor. This is a receptor that is dedicated to absorbing heme. Non-heme iron is absorbed through the Divalent Metal Transporter 1 (DMT1). The DMT1 also absorbs other metals such as cobalt (Co2), manganese (Mn2) and zinc (Zn2). The DMT1 only accepts iron in the Ferrous (Fe2) state. PICs, such as Feramax®, are a ferric iron[ix] which is Fe3, thus it requires your body to convert the iron to Fe2 state for absorption. In other words, your body has a more efficient mechanism for absorbing heme iron compared to non-heme iron.
The DMT1 receptor works best in an acidic state thus, the need for Vitamin C (ascorbic acid). This also means you should avoid taking medications that reduce the acidity of stomach contents, such as proton pump inhibitors[x] and antacids, when taking non-heme iron supplements[xi]
OptiFer® Alpha Vs Feramax® Dosage
Now that you know the key differences between heme and non-heme iron, you are better equipped to understand the dosage of iron supplements.
Iron supplements list elemental iron on the label. This is the amount of iron that is available in the supplement. However, this does not necessarily mean that the entire amount of the listed elemental iron is absorbed by your body. Both OptiFer® and Feramax® are 100% elemental iron. The daily maximum dose of Feramax® products ranges from 40mg to 150mg of elemental iron and OptiFer® has a daily maximum of 33mg.
Health Canada’s daily Tolerable Upper Intake Level (UL) for iron is 45 mg for an adult and 40mg for children (ages 1-13)[xii]. What this means is that intake levels higher than 45mg/day may increase the chances of adverse health effects.[xiii]
It is important to read the labels of your iron supplement. Just because a supplement has more milligrams of elemental iron, it does not mean your iron levels will increase quickly or you are absorbing more per tablet. Check the label of your supplement to see what type of iron it contains.
OptiFer® Alpha Vs Feramax® Costco®
Since iron supplementation needs to be ongoing, the price and availability of supplements can become an important factor. Both OptiFer® Alpha and Feramax® are available at Costco® and are behind the counter. Consult the pharmacist about your iron supplement needs. You can speak to your local pharmacist about OptiFer® Alpha and Feramax®.
Although numerous sources state that heme iron is absorbed at a higher rate and/or more efficiently than non-heme iron, this is not to assume that Feramax® is not a great product. In fact, there are numerous reviews from individuals who have had great success with Feramax®. Keep in mind that it isn’t what you consume but what your body can absorb. As per Biosyent®, makers of Feramax®, “…the absorption of both heme and non-heme iron may be impacted by the serum iron level status and differ in the presence of iron deficiency anemia as well as from one individual to the other.”[xiv]
More iron is not better.[xv]
It is recommended that you talk to your health care practitioner if you are experiencing any of the symptoms of iron deficiency. As always, the best sources of iron are found in nutrient dense foods. However, getting iron from food may not always be adequate and therefore you may require an iron supplement. Do your research and always consult your healthcare practitioner to determine which iron supplement is best for you.
All product names, logos, and brands are the property of their respective owners.
[i] This publication has been archived here: https://apps.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/WHO_NHD_01.3/en/index.html
New reference link: https://www.who.int/news/item/20-04-2020-who-guidance-helps-detect-iron-deficiency-and-protect-brain-development
[xiv] Correspondence from Biosyent to Volo Healthcare Inc. Letter on file.