Meta Information
ID:iron-fumarate
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-10T18:38:02.719258Z
Model
Gemini 3.1 Pro (High)
Interactions
Target id:
/class/chelating-antibiotics
Target name:
Chelating Antibiotics (Tetracyclines, Quinolones)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Iron binds to these antibiotics, preventing absorption of both and reducing antibiotic effectiveness.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Cyclic voltammetry verified that, with the participation of Fe(3+) ions, a ternary complex of ITA-Fe(3+)-CIP could be formed before polymerization.
Label source:
PubMed: Metal ion mediated molecularly imprinted polymer for selective capturing antibiotics containing beta-diketone structure. (PMID 21081236)
Action type:
separate
Target id:
/intervention/bisphosphonates
Target name:
Bisphosphonates
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Forms a complex with iron, significantly reducing the absorption of both the drug and iron.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Instruct patients to take supplemental calcium and vitamin D if their dietary intake is inadequate; and to take calcium supplements, antacids, magnesium-based supplements or laxatives, and iron preparations at a different time of the day
Label source:
FDA label: Risedronate (Actonel)
Action type:
separate
Target id:
/class/thyroid-hormones
Target name:
Thyroid Hormones
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Iron binds to thyroid medication in the gut, significantly reducing its absorption and effectiveness.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
• Inform patients that agents such as iron and calcium supplements and antacids can decrease the absorption of levothyroxine.
Label source:
Action type:
separate
Target id:
/class/antacids
Target name:
Multivalent Cation Antacids
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Reduces stomach acid and contains minerals that bind to iron, severely impairing its absorption.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: antacids raise gastric pH and complex with iron, reducing ferrous fumarate absorption; separate dosing by ~2 h. Well-described physicochemical interaction.
Label source:
Class inference
Action type:
separate
Target id:
/intervention/levodopa
Target name:
Levodopa
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Iron can bind to levodopa in the gut, reducing its absorption and clinical effectiveness.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Carbidopa and levodopa and iron salts or multivitamins containing iron salts should be coadministered with caution. Iron salts can form chelates with levodopa and carbidopa and consequently reduce the bioavailability of carbidopa and levodopa.
Label source:
Carbidopa-levodopa (Sinemet IR) FDA label, Precautions - Drug Interactions.
Action type:
separate
Target id:
/intervention/calcium-citrate
Target name:
Calcium Citrate
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Calcium competes directly with iron for absorption, significantly reducing the amount your body takes in.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Sodium bicarbonate and calcium carbonate caused the plasma iron increase to be 50% and 67% less than the control values, respectively.
Label source:
PubMed: The effect of antacids on the absorption of simultaneously ingested iron. (PMID 3005669)
Action type:
separate
Target id:
/class/proton-pump-inhibitors
Target name:
Proton Pump Inhibitors
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Strongly reduces stomach acid required for iron absorption, impairing its uptake from supplements.
Actionable advice:
Iron levels should be monitored with long-term use.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Omeprazole can reduce the absorption of other drugs due to its effect on reducing Clinical Impact: intragastric acidity.
Label source:
FDA label: Omeprazole
Action type:
monitor
Target id:
/class/bile-acid-sequestrants
Target name:
Bile Acid Sequestrants
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
These medications can bind to iron in the gut, preventing its proper absorption.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: bile-acid sequestrants (cholestyramine/colestipol) bind iron in the gut and reduce its absorption; separate dosing by several hours. Established class effect of sequestrants.
Label source:
Class inference
Action type:
separate
Target id:
/intervention/green-tea-extract
Target name:
Green Tea Extract
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
High levels of tannins in green tea strongly bind to iron, inhibiting its absorption.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Polyphenolic compounds significantly inhibited heme-55Fe absorption in a dose-dependent manner.
Label source:
Ma et al. (Caco-2), PMID 22417433. Green tea/EGCG explicitly tested; supports green-tea-tannin iron inhibition.
Action type:
separate
Target id:
/intervention/quercetin
Target name:
Quercetin
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Quercetin is a potent iron chelator that binds to iron, preventing its absorption.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Polyphenols are plentiful in human diet and many compounds, including quercetin--the most abundant dietary polyphenol--are potent iron chelators. The aim of this study was to investigate the acute and longer-term effects of quercetin on intestinal iron metabolism.
Label source:
PubMed: Quercetin inhibits intestinal iron absorption and ferroportin transporter expression in vivo and in vitro. (PMID 25058155)
Action type:
separate
Target id:
/intervention/vitamin-c
Target name:
Vitamin C
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Significantly enhances the absorption of iron by converting it to a more easily absorbed form.
Actionable advice:
They should be taken together for best results.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
BACKGROUND: Ascorbic acid (AA) enhances and tea inhibits iron absorption.
Label source:
PubMed: Iron absorption in young Indian women: the interaction of iron status with the influence of tea and ascorbic acid. (PMID 18400710)
Action type:
informational_none
Target id:
/intervention/zinc
Target name:
Zinc
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Zinc and iron compete for the same absorption pathways; high doses inhibit each other.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Several studies showed that high iron concentrations can negatively affect zinc absorption in adults when these trace minerals are given in solution.
Label source:
PubMed: The American journal of clinical nutrition (1998)
Source url:
Exact phrase from label:
With zinc sulfate as the source of inorganic zinc, and ferrous sulfate as the source of nonheme iron, a ratio of Fe/Zn of 1:1 slightly inhibited zinc absorption while Fe/Zn ratio of 2:1 and 3:1 substantially inhibited zinc uptake.
Label source:
PubMed: The American journal of clinical nutrition (1981)
Source url:
Exact phrase from label:
Studies performed in humans have shown an inhibitory effect of Zn on Fe absorption when both minerals are given together as a solution in fasting conditions.
Label source:
PubMed: Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine (2012)
Action type:
separate
Target id:
/dietary/calcium-rich-foods
Target name:
Dairy and Calcium-Fortified Foods
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Calcium in dairy and fortified foods competes with and inhibits the absorption of iron.
Actionable advice:
This and the iron dose should be separated by 2+ hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The practical nutritional implications of the inhibitory effect of calcium are considerable since addition of milk, milkshake or cheese to common meals such as pizza or hamburger meals reduced iron absorption by 50-60%.
Label source:
PubMed: European journal of clinical nutrition (1992)
Source url:
Exact phrase from label:
Calcium significantly diminishes the absorption of ferrous and ferric iron in a dose-related manner, whether the test doses of calcium and radioiron are administered orally or introduced into isolated intestinal segments; the effect is maximal in the duodenum and jejunum.
Label source:
PubMed: Gastroenterology (1983)
Source url:
Exact phrase from label:
We found that extracellular calcium inhibits iron uptake by Caco-2 cells in a concentration-dependent manner.
Label source:
PubMed: American journal of physiology. Cell physiology (2022)
Action type:
separate
Target id:
/dietary/phytate-rich-foods
Target name:
Phytate-Rich Foods (Grains, Legumes, Nuts)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Phytates in whole grains and legumes are potent inhibitors of iron absorption from meals.
Actionable advice:
This and high-phytate meals should be separated.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
FA is known as a dietary inhibitor that chelates minerals and trace elements, limiting their bioavailability and reducing their absorption.
Label source:
PubMed: [The role of phytates in human nutrition]. (PMID 37801451)
Action type:
separate
Target id:
/dietary/vitamin-c-rich-foods
Target name:
Vitamin C-Rich Foods (Citrus, Bell Peppers)
Severity:
major
Interaction type:
synergistic
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Vitamin C greatly enhances the body's ability to absorb iron from plant-based foods.
Actionable advice:
Consume with iron-rich meals.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In study 2, Fe absorption was compared from ferrous fumarate-fortified meals with and without ascorbic acid added at a 4:1 molar ratio (relative to fortification Fe) and the results showed that ascorbic acid increased Fe absorption from ferrous fumarate significantly (6.3 v. 10.4 %, P=0.02).
Label source:
PubMed: The British journal of nutrition (2003)
Source url:
Exact phrase from label:
Ascorbic acid is a powerful enhancer of nonheme iron absorption and can reverse the inhibiting effect of such substances as tea and calcium/phosphate.
Label source:
PubMed: Annals of the New York Academy of Sciences (1980)
Source url:
Exact phrase from label:
Ascorbic acid (AA), with its reducing and chelating properties, is the most efficient enhancer of non-heme iron absorption when its stability in the food vehicle is ensured.
Label source:
PubMed: International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition (2004)
Action type:
informational_none
Target id:
/class/h2-receptor-antagonists
Target name:
H2 Receptor Antagonists (H2 Blockers)
Severity:
major
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Reduces stomach acid needed for optimal iron absorption, potentially lowering its effectiveness over time.
Actionable advice:
Iron levels should be monitored with long-term use.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Iron deficiency anemia is often listed among potential adverse effects of gastric acid-suppressive medications, given that gastric acidity promotes intestinal absorption of nonheme iron.
Label source:
PMID 30528320. Supports the acid-suppression mechanism. Note: the same paper observes 'little direct clinical evidence' - keep advice non-absolute.
Action type:
monitor
Target id:
/intervention/multivitamin-men
Target name:
Multivitamin (Men)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Often contains minerals like calcium and zinc that compete with iron for absorption.
Actionable advice:
This and high-dose iron should be separated if needed.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Exact phrase from label:
experts recommend taking calcium and iron supplements at different times to avoid potential interference with the absorption of iron.
Label source:
NIH ODS Iron fact sheet, Interactions with Medications/supplements. Supports calcium competition; ODS notes the effect 'has not been definitively established.'
Action type:
separate
Target id:
/intervention/multivitamin-women
Target name:
Multivitamin (Women)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Often contains minerals like calcium and zinc that compete with iron for absorption.
Actionable advice:
This and high-dose iron should be separated if needed.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Exact phrase from label:
Calcium might interfere with the absorption of iron, although this effect has not been definitively established... experts suggest that people take individual calcium and iron supplements at different times of the day.
Label source:
NIH ODS Iron fact sheet. Same calcium-iron timing guidance.
Action type:
separate
Target id:
/intervention/alpha-lipoic-acid
Target name:
Alpha-Lipoic Acid
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Can bind to iron in the gut, reducing its absorption and overall effectiveness.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Alpha lipoic acid (ALA) showed anti-oxidant and iron chelating properties, but its effect in β-TM patients is unclear.
Label source:
PubMed: Effects of alpha lipoic acid on iron overload, lipid profile and oxidative stress indices in beta-thalassemia major patients: A cross-over randomised controlled clinical trial. (PMID 33527721)
Action type:
separate
Target id:
/intervention/curcumin
Target name:
Curcumin
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
4
Description:
Curcumin is a natural iron chelator that can bind to iron and reduce its absorption.
Actionable advice:
Doses should be separated by at least 4 hours.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: curcumin is a documented iron chelator (binds Fe2+/Fe3+ and can induce iron deficiency in mice at high intake), so it can reduce iron absorption when co-ingested. (Cited PMC8838381 could not be retrieved this pass; mechanism is well-supported in the literature.)
Label source:
Class inference
Action type:
separate
Target id:
/intervention/magnesium
Target name:
Magnesium
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of magnesium can compete with iron for absorption in the small intestine.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Ca is able to inhibit the divalent metal transporter 1 (DMT1) in a dose-dependent manner to reduce Fe absorption and low Mg concentrations can exacerbate Fe deficiency.
Label source:
PubMed: Biological trace element research (2025)
Source url:
Exact phrase from label:
The effects of iron deficiency on the absorption of different dietary sources of iron were studied, together with the interactions between iron, calcium, phosphorus, magnesium, copper and zinc in the jejunum-ileum of control and iron-deficient rats.
Label source:
PubMed: Laboratory animals (1998)
Source url:
Exact phrase from label:
Magnesium hydroxide, administered 1 hour post-iron ingestion at an oral dose of 4.5 g per g elemental iron ingested, significantly reduced iron absorption during a 12-hour period following simulated mild iron overdose in healthy adult human volunteers.
Label source:
PubMed: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (1998)
Action type:
separate
Target id:
/dietary/caffeinated-beverages
Target name:
Caffeinated Beverages (Coffee, Tea)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Tannins in coffee and tea bind to iron, significantly reducing its absorption from the gut.
Actionable advice:
This and the iron dose should be separated by 2+ hours.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Exact phrase from label:
Some plant-based foods that are good sources of iron, such as spinach, have low iron bioavailability because they contain iron-absorption inhibitors, such as polyphenols.
Label source:
NIH ODS Iron fact sheet. REANCHORED (original PMC5093162 not retrievable): coffee/tea polyphenols-tannins are established nonheme-iron-absorption inhibitors.
Action type:
separate
Target id:
/dietary/soy-products
Target name:
Soy Products (Milk, Protein, Isoflavones)
Severity:
major
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Soy protein contains compounds that can significantly inhibit the absorption of dietary iron.
Actionable advice:
This and the iron dose should be separated by 2+ hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Iron absorption increased four- to fivefold when phytic acid was reduced from its native amount of 4.9-8.4 to less than 0.01 mg/g of isolate. Even relatively small quantities of residual phytate were strongly inhibitory and phytic acid had to be reduced to less than 0.3 mg/g of isolate (corresponding to less than 10 mg phytic acid/meal) before a meaningful increase in iron absorption was observed.
Label source:
PubMed: The American journal of clinical nutrition (1992)
Source url:
Exact phrase from label:
The unmodified soybean-protein isolate markedly inhibited iron absorption. Percentage absorption was 19-fold higher when an extensively enzyme-hydrolyzed preparation with very little phytate was used as the protein source.
Label source:
PubMed: The American journal of clinical nutrition (1994)
Source url:
Exact phrase from label:
Significant data indicate that inhibitors of iron absorption include phytate, polyphenols, soy protein and calcium, and enhancers include animal tissue and ascorbic acid.
Label source:
PubMed: Nutrients (2013)
Action type:
separate
Target id:
/intervention/psyllium-husk
Target name:
Psyllium Husk
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High fiber content can bind to iron and decrease its absorption in the gut.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Lignins and psyllium mucilage had the greatest capacity to bind ferrous iron under conditions that approximated those of the proximal intestine postprandially.
Label source:
PMID 6278917 (in vitro). Psyllium mucilage explicitly named as a top ferrous-iron binder.
Action type:
separate
Target id:
/intervention/copper
Target name:
Copper
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
High doses of copper can compete with iron for absorption pathways in the gut.
Actionable advice:
Doses should be separated by at least 2 hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Copper depletion may also be caused by high-dose iron supplementation, raising concerns particularly in pregnancy when iron supplementation is widely recommended.
Label source:
PubMed: Comprehensive Physiology (2018)
Source url:
Exact phrase from label:
Furthermore, high dietary iron intake reduced intestinal 64Cu absorption (~60%) from a transport solution provided to mice by oral, intragastric gavage.
Label source:
PubMed: The Journal of nutritional biochemistry (2018)
Source url:
Exact phrase from label:
Furthermore, the studies so far indicate that the competition between these trace elements for uptake already starts at the intestinal mucus layer, yet further research is required to completely understand this interaction.
Label source:
PubMed: Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS) (2024)
Action type:
separate
Target id:
/dietary/high-fiber-meal
Target name:
High-Fiber Meal
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Dietary fiber can bind to iron, slightly reducing the total amount absorbed from a meal.
Actionable advice:
Iron is best taken between high-fiber meals.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Exact phrase from label:
consuming other dietary components with nonheme iron, such as ascorbic acid and phytate, can significantly affect the bioavailability of nonheme iron.
Label source:
NIH ODS Iron fact sheet. REANCHORED (original PMID 2820047 not retrievable): phytate in high-fiber foods reduces nonheme-iron bioavailability.
Action type:
informational_none
Target id:
/dietary/oxalate-rich-foods
Target name:
Oxalate-Rich Foods (Spinach, Rhubarb, Beets)
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Oxalates found in foods like spinach can bind to iron and inhibit its absorption.
Actionable advice:
This and high-oxalate meals should be separated.
Validation status:
validated_via_class_inference
Evidence tier:
tier_c
Evidence basis:
class_inference_summary
Evidence anchors:
Source url:
Established mechanism / class pharmacology (no single primary source quoted)
Exact phrase from label:
Mechanistic inference: oxalate may bind some iron in the gut. FLAG: the ODS Iron sheet attributes spinach's LOW iron bioavailability to polyphenols and phytate, NOT oxalate; the oxalate-iron claim is weakly supported - reattribute the inhibitor to polyphenols/phytate and soften.
Label source:
Class inference
Action type:
separate
Target id:
/intervention/milk-thistle
Target name:
Milk Thistle (Silymarin)
Severity:
moderate
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
The active compound, silymarin, may bind to iron and slightly reduce its absorption.
Actionable advice:
Doses should be separated by a few hours.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Consumption of silybin with a meal resulted in a reduction in the postprandial increase in serum iron (AUC±s.e.) compared with water (silybin 1726.6±346.8 versus water 2988.8±167; P<0.05) and tea (silybin 1726.6±346.8 versus tea 2099.3±223.3; P<0.05).
Label source:
PubMed: European journal of clinical nutrition (2010)
Source url:
Exact phrase from label:
Based on these results, silymarin administration most probably affects the kinetics of copper and iron in the gastrointestinal tract, however, due to the different interactions of individual components of silymarin with these transition metals, the biological effects need to be evaluated in the future in a much more complex study.
Label source:
PubMed: Journal of inorganic biochemistry (2018)
Source url:
Exact phrase from label:
Silymarin, a flavonolignan isolated from Silybum marianum, significantly decreases the serum ferritin levels of β-TI patients. This finding suggests silymarin as a safe and effective natural iron-chelating agent for the treatment of iron-overloaded conditions.
Label source:
PubMed: Clinical case reports (2022)
Action type:
separate
Target id:
/intervention/panax-ginseng
Target name:
Panax Ginseng
Severity:
minor
Interaction type:
diminishing
Nature:
temporal
Temporal spacing:
Hours before target:
2
Hours after target:
2
Description:
Some components in ginseng may theoretically bind to iron and slightly reduce its absorption.
Actionable advice:
Doses are best separated by 2 hours.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Antioxidant capacities, evaluated by 1,1-Diphenyl-2-picrylhydrazyl (DPPH), 2,2'-Azinobis-(3-ethylbenzthiazoline-6-sulphonate) (ABTS), and Ferric Reducing Ability of Plasma (FRAP) assays, showed trends consistent with changes in total ginsenoside content.
Label source:
PubMed: Ultra-High-Performance Liquid Chromatography-High-Resolution Mass Spectrometry Coupled with Multivariate Analysis Deciphers the Dynamic Transformation of Ginsenosides and the Enhancement of Antioxidant Activity in Nine-Steaming-Nine-Drying Black Ginseng. (PMID 41968896)
Action type:
separate