The ideal form of iron required by the bariatric patient should contain enough elemental ion, be highly bioavailable (easily absorbed) with low risk of gastro-intestinal (GI) side effects to promote adherence and reduce risk of iron deficiency anaemia after bariatric surgery.
Most multivitamins and bariatric multivitamins brands use ferrous fumarate, ferrous gluconate or ferrous sulphate in their formulation. Ferrous fumarate and ferrous sulphate has poor bioavailability and causes significant side effects. Ferrous gluconate does not contains enough elemental iron.
At Bariboost, we use Iron bisglycinate also known as ferrous bisglycinate as it is the superior form of supplemental iron and has shown greater benefit over other iron supplements in increasing haemoglobin concentration with reduced GI side effects.
Iron bisglycinate is an amino acid chelate. Chelated iron bisglycinate is formed by binding iron to two molecules of the amino acid glycine. Think about it like a chicken sandwich with two slices of bread (amino acid glycine) and a slice of chicken (iron). This unique structure is similar to complexes naturally occurring in our bodies and allows for improved absorption. Iron bisglycinate does not form insoluble compounds with iron absorption blockers like dietary phytates and tannins which means they are less affected by them. Phytates are mainly found in cereal grains, nuts and legumes while tannins are primarily found in coffee, tea, legumes and some cereal gains.
The chelated form is also more soluble, which means better absorption and better absorption in turn reduces gastrointestinal side effects like heartburn, nausea, constipation, diarrhoea and abdominal pain.
BOMSS Guidance recommends between 45 to 60 mg and 100 mg of elemental iron daily for menstruating women. Bariboost contains 50mg of elemental iron. As chelated ions are better absorbed, a lower doses can be used compared to ferrous fumarate and ferrous sulpate where the bioavailability of supplemented iron ions is very low.
Evidence suggests that ferrous bisglycinate 25 mg elemental iron is as effective as ferrous sulphate 50 mg elemental iron (ferrous sulphate 200 mg is equivalent to 65 mg elemental iron). Using a lower dose treatment simultaneously reduces the chances of side effects and increases the safety of therapy. A study of the tolerability of iron bisglycinate versus ferrous sulphate showed that more people preferred the bisglycinate form because it caused less GI upset.
BOMMS recommends regular bloods monitoring including monitoring of iron levels.