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Liver Disease Bulletin: Should Iron Be in Your Multi-Vitamin?


To avoid a worsening of their condition, individuals with chronic liver disease should know which circumstances mandate taking a multi-vitamin with iron.

Based on their ability to support the body’s wellness, there are many reasons why someone with chronic liver disease would take a multi-vitamin. Upon first glance, most multi-vitamins appear to be similar. However, closer inspection reveals that quite a few multi-vitamins contain iron. Unless specifically struggling with an iron deficiency, those with chronic liver disease are advised to double-check their multi-vitamin to make sure iron is not listed as an ingredient.

Well-constructed multi-vitamins promote healthfulness by supplying the body with essential building blocks, defending against cellular damage and strengthening valuable systems. For anyone with a chronic illness, such as chronic liver disease, multi-vitamins help the body better contend with the everyday stress that can worsen their condition. For more information on why someone with chronic liver disease could benefit from a multi-vitamin, click here.

As a necessary component of red blood cells, humans need a small amount of iron every day. However, the amount of iron the body needs is usually satisfied by food. Too much iron can be hard on the digestive system and be toxic to the liver. Thus, experts warn that supplements containing iron should only be taken by those who are specifically deficient in iron.

Iron deficient anemia is a common type of anemia, a condition in which blood lacks adequate healthy red blood cells. Red blood cells are needed to carry oxygen to the body’s tissues. There are several reasons someone with iron deficient anemia might need to supplement with iron:

•    They are not getting sufficient iron in their diet.

•    They are not able to absorb iron during digestion.

•    They have a chronic bleeding problem.

•    They are suffering from lead poisoning.

These individuals are candidates for benefitting from the 10 to 20 mg of additional iron found in many multi-vitamins. Unfortunately, anyone who does not fall into one of these iron deficient categories could have unwanted effects from supplemental iron – especially those with chronic liver disease.

The human body has a limited ability to eliminate excessive quantities of iron. Experts estimate that only about 1-2 mg of iron can be excreted each day. In healthy individuals, excessive dietary iron is not properly absorbed and is excreted in the stool. In the presence of chronic liver disease, there is a propensity for extra iron to accumulate in the liver. Regrettably, the liver is particularly susceptible to iron’s toxicity. For the millions of Americans living with chronic liver disease, avoiding unnecessary iron supplementation is a crucial step in maintaining their liver’s health:

•    There is growing evidence that even mildly increased amounts of iron may cause or enhance the amount of injury to the liver in the presence of alcoholic liver disease and chronic Hepatitis C.

•    Iron overload has been found to worsen the prognosis of alcoholic liver disease and chronic Hepatitis C – and to decrease the responsiveness to treatment.

•    Liver scarring and liver cell damage appear to be directly related to the iron content of the liver cell.

Taking a daily multi-vitamin is a simple, commonsense way to support health – especially when living with a chronic illness. However, most individuals with chronic liver disease must avoid multi-vitamins that contain iron. Unless iron deficiency has been specifically confirmed, taking any supplemental iron could easily expedite the advancement of and worsen the prognosis of any chronic liver disease., How do I choose an adult multivitamin?, Retrieved September 16, 2011,, inc., 2011., Cirrhosis in Chronic Hepatitis C Infection, Jorge L. Herrera, MD, Retrieved September 17, 2011, Hepatitis C Support Project, 2011., Preventive Care in Chronic Liver Diseases, Thomas R. Riley, Retrieved September 17, 2011, Hepatitis C Support Project, 2011., Calcium, Sodium, Iron and Liver Disease/Hepatitis, Retrieved September 17, 2011, Melissa Palmer, MD, 2011., High Iron Levels and Liver Damage, Jessica Bruso, Retrieved September 17, 2011, Demand Media, Inc., 2011.

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About the Author

Nicole Cutler, L.Ac., MTCM, Dipl. Ac. (NCCAOM)®

Nicole Cutler, L.Ac., MTCM is a long time advocate of integrating perspectives on health. With a Bachelor's degree in Neuroscience from the University of Rochester and a Master's degree in Traditional Chinese Medicine from Five Branches Institute, Nicole has been a licensed acupuncturist since 2000. She has gathered acupuncture licenses in the states of California and New York, is a certified specialist with the National Acupuncture Detoxification Association, has earned diplomat status with the National Commission of Chinese and Oriental Medicine in Acupuncture and Chinese Herbology and is a member of the Society for Integrative Oncology. In addition to her acupuncture practice that focuses on stress and pain relief, digestion, immunity and oncology, Nicole contributes to the integration of healthcare by writing articles for professional massage therapists and people living with liver disease.

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