Can Herbal Supplement Be a Suitable Alternative of Ferrous Iron Oral Therapy to Bypass Gastrointestinal Side Effects

INTRODUCTION: Iron deficiency anemia (IDA) is one of the most common nutritional problems. Although it works, traditional oral ferrous iron therapy frequently causes gastrointestinal (GI) side effects such as diarrhea, nausea, constipation, and abdominal discomfort, which makes patients less likely to comply. OBJECTIVES: This review aims to evaluate whether herbal supplements can serve as suitable alternatives to conventional oral ferrous iron therapy for reducing GI side effects. This review addresses the possible mechanisms of GI side effects of ferrous iron and reasons underlying GI side effects in traditional ferrous iron therapy. Additionally, evidence of potential clinical application of herbal alternatives in the treatment of IDA is discussed. MATERIALS AND METHODS: The available literature regarding GI side effects of conventional oral ferrous iron therapy, and the possible impact of herbal supplements on IDA was surveyed with a focus on iron absorption, oxidative stress, gut microbiota, bioactive compounds, and GI tolerability. RESULTS: Herbal sources date palm extracts, Hygrophila auriculata, Moringa oleifera Lam., Spinacia oleracea L., and Withania somnifera (L.) Dunal are high in bioavailable iron and bioactive components that may improve iron absorption while lowering toxicity. These herbs' flavonoids, polyphenols, and antioxidant components can also reduce oxidative stress caused by free iron. CONCLUSIONS: Research limitations include the need for mechanistic studies on gut microbiota interactions, a lack of long-term data, and a lack of studies on dose optimization. By filling these gaps, standardized, optimized herbal formulations and carefully planned clinical trials may provide herbal supplements as safe palatable substitutes or additions to oral ferrous treatment.