Can You Take Iron With a Multivitamin?

Quick answer

The question is mostly one of totals. A multivitamin with iron typically gives 18 mg and iron-only supplements often give 65 mg, so the two together reach 83 mg against a 45 mg upper limit for food and supplements combined. Many multis for men and older adults hold little or no iron, as our Men's Multi does.^1,2

Key facts

Multivitamins with iron, especially those made for women, typically give 18 mg, while iron-only supplements usually give more, often 65 mg.¹
The upper limit for iron is 45 mg a day from food and supplements for anyone aged 14 or older, set to avoid stomach and bowel side effects.^1,2
Men need 8 mg of iron a day, women aged 19 to 50 need 18 mg, and women over 50 need 8 mg.²
Supplements with 25 mg of iron or more can lower zinc absorption, and almost all multivitamin and mineral supplements contain zinc.^1,3
Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6.^1,2

How much iron each one brings

Multivitamins with iron, especially those made for women, typically provide 18 mg, 100% of the Daily Value. Iron-only supplements usually provide more, often 65 mg, which is 360% of the Daily Value.¹

Multis with iron, especially those designed for women, typically provide 18 mg, 100% of the Daily Value. Multis for men or seniors often contain less iron or none.⁴

Multivitamins made for men or older adults often contain less iron or none.¹

So a multi can mean anything from no iron to a full day's amount for a woman of reproductive age, and the label is the only guide. An iron-only product starts above that.^1,5

How the totals stack up

Iron from products and from average food, against the 45 mg limit^1,2
Combination	From products	With average food
A women's multi with 18 mg	18 mg	About 31 mg
Our Men's Multi, which has no iron	0 mg	16 to 18 mg, from food alone
A women's multi plus a 65 mg iron pill	83 mg	About 96 mg
Our Men's Multi plus a 65 mg iron pill	65 mg	About 81 to 83 mg
Upper limit, food and supplements	45 mg	45 mg

Average food supplies 12.6 to 13.5 mg of iron a day for women and 16.3 to 18.2 mg for men. A single 65 mg pill is above the 45 mg limit by itself. Doctors sometimes prescribe more than the limit for a while to rebuild low stores, which is a decision to make with one.^1,2

What iron is graded for

Iron's strongest grade is narrow. It rests on a Cochrane review in women who menstruate, and it does not cover men or women past menopause, who need 8 mg a day. The multivitamin claim is about filling gaps, which is a different question.^5,6

Helps women who menstruate build hemoglobin and iron stores*^1,2,6

Strong evidence

A Cochrane review of 67 randomized trials in 8,506 women who menstruate found that daily iron raised hemoglobin (51 trials, 6,861 women, high-quality evidence) and iron stores, and made low iron less common. Women aged 19 to 50 need 18 mg a day, against 8 mg for men, because menstruation adds to their iron losses. Iron also roughly doubled reports of stomach and bowel side effects in these trials.

Amount studied: Daily iron tablets taken at least five days a week; the amount varied between trials

Needed to make hemoglobin, which carries oxygen in red blood cells, and myoglobin, which supplies oxygen to muscles*^1,2

Moderate evidence

A long-established role of the mineral, described by NIH. Iron is also needed for growth, development and making some hormones. This does not mean extra iron helps people who already get enough, and most people in the US do.

Amount studied: Recommended intake: 8 mg a day for men and for women over 50, 18 mg for women aged 19 to 50

Absorption and timing

High doses of iron taken on an empty stomach are the most likely to upset it, and taking iron with food can lessen these effects.^1,2

What you take the iron with matters. In a study of 34 women with low iron stores, a 100 mg iron dose taken with 80 mg of vitamin C was absorbed 30% better, while coffee cut absorption by 54% and a breakfast with coffee and orange juice by 66%.⁷

Calcium might reduce iron absorption, although this has not been firmly established, so experts suggest taking calcium and iron supplements at different times of day.^1,2

A multi that carries vitamin C could in principle help with the iron taken alongside it, but the study used 80 mg of vitamin C in women with low iron stores, and the sources we read do not test a multi. Alternate-day dosing is another pattern with data: 60 mg every second day was absorbed better than the same dose on consecutive days.^7,8

Where zinc comes in

Supplements with 25 mg of iron or more can reduce zinc absorption and blood zinc levels.¹

Almost every multi contains zinc, and our Men's Multi has 15 mg. That is below the 25 mg of iron at which the interference is described, so it matters only if an iron pill of that size is taken at the same time as the multi.^1,3

Who needs iron, and who does not

Women who menstruate need 18 mg a day, pregnancy raises it to 27 mg, and people who eat no meat, poultry or seafood need about 1.8 times the usual amount.^1,2
People who train hard might need 30% to 70% more, and frequent blood donors can end up with low iron, about 25% to 35% of them.^1,9
Men and women past menopause need 8 mg, and average food intake already exceeds it for men, and multis for men and older adults often leave it out.^1,2

What's in ours

What’s in ours

Men's Multi: Vitamin A, 600 mcg RAE per serving, from the label

Men's Multi is made without iron, so any iron you add would be the only iron in the day apart from food. It carries 150 mg of vitamin C and 15 mg of zinc.¹

Cautions, medicines and who should ask first

Accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6. Iron tablets and capsules must carry a warning to keep them out of children's reach and to call a doctor or poison control center after an accidental overdose.^1,2

High doses of iron supplements, especially on an empty stomach, can cause upset stomach, constipation, nausea, abdominal pain, vomiting and diarrhea. Doses of 45 mg a day or more are the most likely to cause them.^1,2

People with hereditary hemochromatosis absorb too much iron, which builds up to toxic levels. NIH advises them to avoid iron and vitamin C supplements.^1,2

Ask your pharmacist how far apart to take them

Iron supplements can reduce how much levothyroxine the body absorbs and make it less effective. The levothyroxine label lists ferrous sulfate among products that may bind the medicine and says to take them apart; ask your pharmacist how to space them.^1,2,10,11

On the medicine's label

Ask your pharmacist how far apart to take them

Iron can reduce the absorption of quinolone antibiotics such as ciprofloxacin. The ciprofloxacin label says products containing iron, calcium or zinc, multivitamins included, must be taken well apart from it, and sets out a schedule.¹²

On the medicine's label

Ask first if you are a man or past menopause and no one has told you that you need iron, or if you have been told you have anemia, because its cause needs to be found and extra iron does not help every type.^1,2
Ask first if you take levothyroxine, levodopa, an antibiotic, dolutegravir or a medicine that lowers stomach acid, or are pregnant or planning a pregnancy.^2,13
Keep every product that contains iron, a multivitamin included, out of children's reach.²

Questions people ask

Can you take iron and a multivitamin together?

No source we read says you cannot, but the iron adds up. A multi with iron typically gives 18 mg and many iron pills give 65 mg, against a 45 mg limit from food and supplements. Ask a doctor first if you are a man, past menopause or take levothyroxine or an antibiotic, and keep both away from children.^1,2

What is the best time to take iron with a multivitamin?

No source sets one time for the pair. Taking iron with food eases stomach upset, vitamin C raised absorption of a 100 mg dose by 30% in one study, coffee cut it by 54%, and experts suggest keeping calcium and iron supplements at different times of day.^1,2,7

Does a multivitamin with iron replace an iron supplement?

Usually not. A multi with iron typically gives 18 mg, while iron-only supplements often give 65 mg, and iron for low stores is a decision for a doctor to make with a blood test, since a serum ferritin below 30 mcg/L suggests low iron.¹

Should men take iron with a multivitamin?

Rarely without advice. Men need 8 mg a day, average food intake for men is 16.3 to 18.2 mg, and multis for men often contain little or no iron. NIH advises people who are men or past menopause to ask first if no one has told them they need iron.^1,2

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Sources

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

This page is information, not medical advice. Talk to your doctor or pharmacist about your own situation.