If you have irritable bowel syndrome (IBS), including IBS with constipation (IBS-C), you may have certain nutrient deficiencies. One nutrient you may be lacking is iron.
People with IBS are more likely to have lower levels of iron than people without the condition, according to a review.
IBS doesn’t directly cause iron deficiency or anemia. But people with IBS may be more likely to avoid certain foods to manage their symptoms. Those restrictive diets can make it harder to get enough iron.
Red meat, for instance, is a top source of iron, but the high fat content can trigger gas and bloating for people with IBS. Beans, dried fruit, and whole grains are also high in iron, but the fiber can cause similar symptoms — namely, bloating, constipation, or gas, says Alyssa Simpson, RDN, a certified gastrointestinal nutritionist and owner of Nutrition Resolution in Phoenix, Arizona.
Over time, regularly falling short on iron can lead to anemia, a condition where your blood doesn’t make enough hemoglobin (healthy red blood cells). Hemoglobin is responsible for delivering fresh oxygen to your tissues. Without a steady supply of hemoglobin, your tissues get less oxygen than they need, which can lead to dizziness, fatigue, lightheadedness, a rapid heartbeat, or shortness of breath.
Because many people with IBS already struggle with fatigue, having anemia on top of it can exacerbate the problem.
Anemia can be diagnosed with a simple blood test that checks your hemoglobin levels, according to Mayo Clinic. If you’re anemic, you and your doctor can come up with a plan to bring your iron levels back up.
Managing Anemia With Diet
If your iron deficiency isn’t too severe, eating more iron-rich foods might be enough to solve the problem. The trick is finding options that don’t irritate your IBS. An IBS-focused dietitian can help you put together a high-iron eating plan that’s free of your trigger foods.
Here are some iron-rich foods to try, along with their iron content:
The recommended daily intake of iron ranges from 8 to 15 mg per day, depending on your age and sex. To boost your body’s iron absorption, pair iron-rich foods with good sources of vitamin C, says Simpson, such as bell peppers, broccoli, kiwi, and oranges. Make a beef and pepper stir-fry, for instance, or have a handful of cashews with an orange.
You may also want to avoid taking calcium supplements at the same time as an iron-heavy meal, as calcium and iron compete for absorption when you have them together, adds Simpson.
Supplements and Other Non-Dietary Treatments
If diet alone isn’t enough to correct your iron deficiency, you might need to take additional measures. Oral supplements are one option, but many people (with IBS or not) find that iron pills can trigger or worsen gastrointestinal side effects such as bloating, constipation, nausea, and pain.
Intravenous iron infusions are another way to go. “If iron pills make you constipated or queasy, that might be the better option,” Simpson says. Your doctor might also recommend an infusion if your iron levels are very low, because it can bring your levels up faster than food or supplements can.
The Takeaway
If you have IBS, it can be hard to get enough iron, especially because certain iron-rich foods can worsen your symptoms. Try eating foods such as eggs, fortified cereals, lean beef, and quinoa to boost your iron intake without irritation. You can also pair iron-rich foods with good sources of vitamin C to boost absorption.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Na W et al. High-Fat Foods and FODMAPs Containing Gluten Foods Primarily Contribute to Symptoms of Irritable Bowel Syndrome in Korean Adults. Nutrients. April 15, 2021.
Norlin AK et al. Fatigue in Irritable Bowel Syndrome Is Associated With Plasma Levels of TNF-a and Mesocorticolimbic Connectivity. Brain, Behavior, and Immunity. February 2021.
Lynn Grieger is a registered dietitian-nutritionist, certified diabetes care and education specialist, certified personal trainer, and certified health and wellness coach. She completed requirements to become a registered dietitian at Valparaiso University in 1987 and completed a dietetic internship at Ingalls Memorial Hospital in Harvey, Illinois, in 1988.
Lynn brings her expertise in nutrition, exercise, and behavior change to her work in helping people reach their individual health and fitness goals. In addition to writing for Everyday Health, she has also written for websites and publications like Food and Health Communications, Today's Dietitian, iVillage.com, and Rodale Press.She has a passion for healthy, nutrient-dense, great-tasting food and for being outdoors as much as possible — she can often be found running or hiking, and has completed a marathon in every state.
Marygrace Taylor is a health writer and editor based in Philadelphia. Her work has appeared in publications including Parade, Glamour, Women's Health, Prevention, Redbook, Men's Health, and O, The Oprah Magazine. She's also the coauthor of Eat Clean, Stay Lean: The Diet and Prevention Mediterranean Table.
