Yes. Superiron and stronger Iron syrup are recommended by Estonian Midwives Association. These are suitable products during pregnancy.
Yes. Products suitable for children and Children´s iron syrup and Iron. It is easier to give iron in syrup form to very small children, but also Iron 30 mg is suitable when crushed. Older children can also use Superiron and stronger Iron syrup.
Iron tablets contain very little chlorella, which is seaweed. we use chlorella as a natural filling ingredient for tablets. Several countries use chlorella for iron problems. Superiron is also recommended by Estonian Midwives Association.
No, Nôgel’s iron food supplements have been tested in the laboratory and do not contain iodine.
No, carnauba wax comes only from the leaves of a palm tree Copernicia prunifera wild harvested in Brazil. Palm oil comes from the pulp of oil palms and it is due to new oil palm plantations that large areas of rain forest are being cut down. Palms producing carnauba wax grow only in Brazil and to get the wax, leaves are shaken, trees are not cut down. These are two different trees.
Iron bisglycinate has been studied like other iron salts with usage doses of 3-6 mg/kg, i.e. a 10 kg child should get 30-60 mg dosage of elemental iron in bisglycinate form. Based on our experience we recommend to start with 3 mg/kg. In a randomized trial, iron(III)polymaltose complex and iron bisglycinate were compared on children aged 1-13 years. Both iron salts were given 3 mg/kg. Outcome: Both iron salts raised blood hemoglobin levels, but polymaltose complex did not significantly increase ferritin level. Iron bisglycinate increased significantly ferritin and MCH levels.
It was also found that iron bisglycinate acts in the same way as natural iron from food, i.e. absorption of iron decreases when iron stores are getting fulled. The absorption of iron with iron bisglycinate is negatively correlated with the rise in ferritin and hemoglobin levels.
Name JJ, Vasconcelos AR, Valzachi Rocha Maluf MC. Iron Bisglycinate Chelate and Polymaltose Iron for the Treatment of Iron Deficiency Anemia: A Pilot Randomized Trial. Curr Pediatr Rev. 2018;14(4):261-268. doi:10.2174/1573396314666181002170040
The bioavailability of iron bisglycinate is high, different studies have shown up to 90%. For example, the bioavailability of iron sulphate and fumarate isless than 30%. Scientific studies have found that iron in bisglycinate form absorbs 2-4 times better than iron sulphate and fumarate. Iron bisglycinate is also less irritable to the stomach – it does not usually cause gastrointestinal side effects like constipation, abdominal pain and nausea. People more sensitive to iron can use iron in bisglycinate form with small meal as bisglycinate does not react so easily with substances in food. Avoid tea, coffee and high calcium intake 1 h before and after iron consumption.
Rando Tuvikene. Tallinna Ülikooli keemia vanemteadur ja keemia dotsent. Rauddiglütsinaat. 2018.
Milman N, Jønsson L, Dyre P, Pedersen PL, Larsen LG. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. J Perinat Med. 2014 Mar;42(2):197-206.
Rossana B. et al. Efficacy of Supplementation with Iron Sulfate Compared to Iron Bisglycinate Chelate in Preterm Infants. Current Pediatric Reviews, 2018, 14, 00-00.
Szarfarc S. et al. Relative effectiveness of iron bisglycinate chelate (Ferrochel) and ferrous sulfate in the control of iron deficiency in pregnant women. Archivos Latinoamericanos de Nutricion, 2001, No. 51, p. 42-47.
Name JJ, Vasconcelos AR, Valzachi Rocha Maluf MC. Iron Bisglycinate Chelate and Polymaltose Iron for the Treatment of Iron Deficiency Anemia: A Pilot Randomized Trial. Curr Pediatr Rev. 2018;14(4):261-268.
The higher the bioavailability, the more iron is absorbed by the body. It is important to compare the iron salt used and product´s elemental iron content when choosing iron food supplements. For instance, Nôgel Superraud 60 mg (elemental iron content), iron bisglycinate (name of iron salt).
Iron sulphate pill of 100 mg of elemental iron
Bioavailable iron app. 26% i.e. 26mg
In case of iron problems, body increases non-heme iron absorption up to 20%, absorption of elemental iron is therefore 26 mg*0,2 = 5 mg.
Nôgel Superraud, iron bisglycinate pill of 60 mg of elemental iron
Bioavailable iron app 90% i.e. 54 mg
54 mg*0,2 = approximate absorption of iron is therefore 11 mg.
A. Aro, M. Mutanen, M. Uusitupa. Ravitsemustiede. 2017.
Iron food supplements containing heme iron contain usually either food albumin (e.g. hematogen) or hemoglobin (pill/capsule form supplements). In Estonia, hematogen bars usually contain 10 mg of heme iron for 100 g. From one 50 g bar you will get around 5 mg of heme iron. Nowadays hematogen bars contain a lot of sugar – usually at least 50% of the bar is made up from sugar as condensed milk and white sugar. Such bars are not suitable for diabetics and everyday use in case of iron deficiency (anemia).
In case of supplements containing hemoglobin, it is necessary to take into account the actual content of hemoglobin. 1 g of hemoglobin contains around 3,4 mg of heme iron, i.e. 500 mg of hemoglobin contains about 1,7 mg of heme iron, which is a rather low iron content. In case of iron problems, such low heme-iron content is not sufficient. Although body absorbs heme-iron better than non-heme iron (15–35% vs 1–20% based on nutrition sciences), vitamin C increases non-heme iron absorption manyfold, when consumed 20–60 mg at the same time with iron.
NB! For instance, in Estonia food supplement producer is not obliged to bring out the content of heme and non-heme iron. Check the content of hemoglobin! Usually food supplements containing hemoglobin also contain some non-heme iron (e.g. divalent iron sulphate or iron fumarate etc, which have lower bioavailability and often irritate the stomach). The elemental iron content on the label is the sum of all elemental iron in the product (heme+non-heme iron).
A. Aro, M. Mutanen, M. Uusitupa. Ravitsemustiede. 2017.
Tiiu Vihalemm. Raud – väga vajalik ja samas ohtlik mineraalaine. 2019.
Stanley L. Schrier. So you know how to treat iron deficiency anemia.Comment on Moretti et al, page 1981. 2015: 126:17.
Nôgel’s iron tablets should be consumed with liquid (i.e. water, lemon juice, orange juice) and preferably on an empty stomach. People more sensitive to iron can use iron also with small meal (avoid coffee, tea and high calcium intake 1h before and after iron consumption). Children´s iron syrup can be used directly preferably on an empty stomach but it can be mixed with food (not to consume calcium at the same time).
Tablets are not chewable.
New research has found that iron absorption is higher from single dose, when iron is taken every other day in single doses. Every second day consumption is suitable for people sensitive to iron or according to advice by medical personnel. Absorption of iron from single dose every second day is not significantly higher compared to daily administration to compensate daily use.
Stoffel NU, Zeder C, Brittenham GM, Moretti D, Zimmermann MB. Iron absorption from supplements is greater with alternate day than with consecutive day dosing in iron-deficient anemic women. Haematologica. 2020 May;105(5):1232-1239.
Stoffel NU, Cercamondi CI, Brittenham G, Zeder C, Geurts-Moespot AJ, Swinkels DW, Moretti D, Zimmermann MB. Iron absorption from oral iron supplements given on consecutive versus alternate days and as single morning doses versus twice-daily split dosing in iron-depleted women: two open-label, randomised controlled trials. Lancet Haematol. 2017 Nov;4(11):e524-e533.
Iron treatment usually lasts for 6-12 months because ferritin, i.e. iron stores, increase slowly. Based on our experience 3 months are not enough for successful iron stores fulfilling. In case of low hemoglobin, hemoglobin usually increases first. Ferritin starts to increase more effectively once hemoglobin has normalized. It is good to check iron related blood tests every 2-3 months during iron treatment that is performed by healthcare practioner.
Lääkärikirja Duodecim. Levottomat jalat.Yleislääketieteen erikoislääkäri Osmo Saarelma. 2022.
Iron stores (ferritin) and blood test are needed before using iron supplements.
Superiron and stronger Iron syrup are suitable from 12 years of age in case of low hemoglobin and during pregnancy and breastfeeding, both products are suitable during heavy menstruation. Both products are recommended by Estonian Midwives Association. In case of heavy menstruation consult with doctor.
Iron and Children´s iron syrup are suitable for children and adults (for infants Iron has to be crushed). Products can be used during menstruation as well in case stronger products are not needed.
The reference values for ferritin, i.e. iron stores, are wide and values depend on a child´s age. Ferritin´s laboratory reference values have been unchanged for decades and do not take into account recent studies about diagnosing iron deficiency (anemia).
Research carried out in 2018 investigated children´s hematological parameters of different age groups combining 11 years of pediatric iron study and hematology results for analyzing functional lower reference value for ferritin. Functional lower reference values of ferritin were analyzed in terms of limit, where ferritin threshold was reached and hematological parameters continued to be stable. Current research proposes that functional lower reference values for ferritin should be the following:
4-months– 13-years children 26 μg/l
13-years– 19-years (incl.) 39 μg/l
Just like adults every children is unique. Consult with your doctor first before you use iron for children.
Markus et al. Ferritin as a functional biomarker of iron status in children and young adults. 2019: 184:4.
Vitamin B12 in our blood is bound to two different transport proteins: haptocorrin and transcobalamin. Only 10-30% of vitamin B12 is bound to transcobalamin, which is also known as the active form of B12. The blood level of the active form declines in case of vitamin B12 low level already before symptoms occur. Vitamin B12 active form, i.e. transcobalamin test, is the primary analysis for testing for vitamin B12 problems and effectiveness of treatment.
General vitamin B12 test is a much cheaper analysis, but it is not the primary analysis for testing for vitamin B12 deficiency and effectiveness of treatment. General vitamin B12 test covers the total content of B12 – active and inactive form. Results below the reference value normally clearly indicate vitamin B12 problems. Results close to the lower limit of reference value, in case of adults <250 pmol/L, are often so-called gray area and difficult to interpret. Thus, it is necessary to perform active form, holotranscobalamin test.
Based on our experience infants and toddlers may have sleep problems with general B12 levels above lower reference value. Very often the test result is not below the lower value. We have seen many analysis results, where infants and toddlers with general vitamin B12 test values slightly higher the lower reference value have sleeping problems. After vitamin B12 treatment problems have disappeared. It is wise to consult with your doctor in case your infant or toddler has sleeping problems to test vitamin B12.
- vitamin B12 supplement should not be used before the analysis
- analysis should be taken as fasting blood sample
- analysis cannot be performed in case during last 8 hours, large amounts of biotin have been used (>5 mg/day)
Taking vitamin B12 supplement before the analysis may increase the content of vitamin B12 and therefore, interpretation of results is more difficult. Oral contraceptives and antibiotics may to some extent lower vitamin B12 level.
Often 1-2 weeks are left after vitamin B12 treatment and new test analysis to interpret results more trustworthy. Therefore, don´t rush for new analysis, consult with your doctor first.