Contraindications For Using Ferrous Sulfate Iron Supplement

Patient/caregiver was educated on contraindications for using Ferrous Sulfate iron supplement as below-

  1. Do not take Ferrous sulfate, if you ever manifested any allergic responses to intake of the ferrous sulfate iron supplement. In the event of history of an allergic response with ferrous sulfate or any preparations containing iron, check with your physician regarding your safety with intake of ferrous sulfate iron supplement.
  2. Phenylalanine is an amino acid used by your body to build  Deficiency of enzymes needed to metabolize phenylalanine in your body can result in a metabolic disorder called phenylketonuria. Individuals with this disorder will be placed on a diet restricted on phenylalanine, as they cannot metabolize it. Chewable ferrous sulfate contains artificial sweetener called aspartame. Intake of high amounts aspartame can significantly elevate phenylalanine levels in the body. So, chewable ferrous sulfate is contraindicated in individuals with history of phenylketonuria. Discuss with your physician regarding history of phenylketonuria, if any, and your safety with chewable ferrous sulfate.
  3. Ferrous sulfate iron supplement intake must be avoided in individuals with anemias, not associated with iron deficiency. Deficiencies of vitamin B12, vitamin B6, and folic acid, despite having their individual pathologies, can present with a basic finding of anemia. These individuals could be having a normal iron content, despite presenting with anemia. Administering Ferrous sulfate in these individuals, to offset anemic symptoms, does not fix the problem. But, it can result in toxicity with iron overload and so, must be avoided. Discuss with your physician regarding your history of deficiencies with vitamin B12, vitamin B6, and folic acid, if any, for appropriate treatment measures to be considered.
  4. Ferrous sulfate iron supplement must be avoided or administered with extreme caution in individuals with history of hemochromatosis, an inherited condition that results in the body absorbing dietary iron in significantly large amounts than normal. Excess of dietary iron absorbed results in iron overload and accumulation in various vital organs, such as, nervous tissues, liver, skin, pancreas, and heart, leading to the symptoms of tissue iron toxicity. This results in compromised organ function and debility. Toxic iron overload and accumulation in the liver can result in long-term changes like chronic abdominal pain, hepatitis, cirrhosis, liver failure, and even hepatocellular carcinoma. Iron overload and accumulation in the heart can result in arrhythmias and congestive heart failure. Deposition of iron in the pancreas can lead to inflammation of pancreas, deficient secretion of digestive pancreatic enzymes with compromised digestion and overall metabolism, and reduced insulin secretion, leading to diabetes. Accumulation of iron in nervous tissues can result in neuropathy with pain, altered sensation, and tingling and numbness in the extremities. Individuals with iron accumulation in the nervous tissues can also present with altered cognition, reduced memory, episodes of confusion and loss of consciousness, and in severe cases can result in seizures. Administering Ferrous sulfate iron supplement in these individuals can worsen the toxicity with iron overload.
  5. Ferrous sulfate iron supplement must be avoided or administered with extreme caution in individuals with prolonged history of multiple blood transfusions. Individuals with this history can also present with iron overload and accumulation of iron in various vital organs, leading to the symptoms of tissue iron toxicity. Also, individuals with history of taking ferrous sulfate in excess to their prescribed amount have the risk for iron overload and toxicity. Administering Ferrous sulfate in these individuals can worsen the toxicity with iron overload.
  6. Ferrous sulfate iron supplement intake must be avoided in individuals with history of porphyria. Porphyria is a condition resulting from accumulation of porphyrins, which are natural chemicals in the body. Porphyrins bind to iron forming the heme. Heme in association with globin forms the hemoglobin of red blood cells, which binds and carries the oxygen to tissues. The association of porphyrins with iron and synthesis of heme is a multi-step process, mediated by many enzymes. Deficiency of these enzymes can be inherited, which results in poor association of porphyrins and iron, leading to compromised synthesis of heme. Deficient heme synthesis leads to poor hemoglobin and red blood cell synthesis and individuals present with findings of anemia. The deficiency in individuals with history of porphyria is with the enzymes needed for synthesis of heme, but not iron, as it manifests to be. As heme synthesis is compromised, unused porphyrins and iron in these individuals accumulate in the body in various vital organs, leading to the symptoms of porphyria and tissue iron toxicity. Administering Ferrous sulfate in these individuals, to offset anemic symptoms, can worsen the toxicity with iron overload and so, must be avoided.
  7. Ferrous sulfate iron supplement must be administered with extreme caution in individuals with history of hemolytic anemias, such as, sickle cell or thalassemia. Hemolytic anemias usually are inherited genetic defects, resulting in poor structural stability of the red blood cells. Structurally deficient red blood cells are prone to damage and lysis, before completion of their lifespan. Hemolytic anemia can also be secondary to autoimmunity, when individuals can develop antibodies acting against their own red blood cells, thus resulting in damage of lysis of the cells. Irrespective to the basic pathology, individuals with history of hemolysis can present with findings of anemia. As blood cells are lysed in these individuals, the released heme and iron accumulate in the body in various vital organs, leading to the symptoms of tissue iron toxicity. Administering Ferrous sulfate iron supplement in these individuals, to offset anemic symptoms, can worsen the toxicity with iron overload and so, must be done with extreme caution.
  8. Ferrous sulfate iron supplement must be administered with extreme caution in individuals with chronic history of severe alcoholism. Alcohol consumed in excessive amounts can result in the body absorbing dietary iron in significantly large amounts than normal. Excess of the iron absorbed results in iron overload and accumulation in various vital organs, contributing to iron toxicity.
  9. Toxic accumulations of iron in vital organs can compromise the function of these organs, resulting in multiple organ failure. Patients can present with findings such as, hepatitis, cirrhosis, liver failure, hepatocellular carcinoma, arrhythmias, congestive heart failure, diabetes, neuropathy, diffuse arthritis, cognitive deficits, and seizures.
  10. Chewable ferrous sulfate iron supplement contains artificial sweetener called aspartame. Chewable ferrous sulfate is contraindicated in individuals with history of allergy to aspartame. Notify your physician regarding any history of aspartame allergy.
  11. Ferrous sulfate iron supplement must be avoided or administered with extreme caution in individuals with history of organ failure, such as, cirrhosis and congestive heart failure. Any amount of iron supplement administered in excess in these individuals can result in increased accumulation of iron in these end organs and lead to further deterioration of liver and heart functions.

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