A considerable percentage of people, most especially women, are anemic or borderline anemic. There are different forms of anemia, with the most common being caused by an iron deficiency. A vitamin B12 deficiency causes another less common form of anemia. Recently I was looking into various iron supplements and I noticed one of the most popular brands on Amazon.com is Feosol. I had to dig around on the  Internet in order to find the ingredient list of this product as it was not listed on Amazon.com nor on the web site devoted to Feosol. Just the fact the ingredients were obscured from easy viewing had me suspicious. The following article is a modified version of a long review of Feosol which I posted on Amazon.com.

The Feosol Review

Like many of my Amazon product “reviews” this is a long one. In fact it’s one of my longest to date. For this reason I include a brief review at the top for those people who don’t wish to read all the information I share further down. If you don’t like long and informative reviews, or simply don’t have the time to read so much, please read the In Brief section at the top and perhaps skip down to the bottom if you wish to see other iron products I have provided links to.

In Brief

My research on Amazon and elsewhere online indicates many people are satisfied with this product (Feosol). My concern, however, is with its overall formulation and the potential effects that may have on a person’s health in the long term. In my professional opinion (as a traditional naturopath and someone who for seven years formulated and developed natural health products and supplements), Feosol contains multiple inactive ingredients which I think are highly questionable at best. For anyone following a holistic approach to his or her own health I would not recommend mid to long-term use of this product unless there was simply no other iron supplement that proved effective for them. Since the active form of iron in Feosol is the commonly available ferrous sulphate, I see no reason to use this product at all. There are plenty of excellent ferrous sulphate supplements available on Amazon, most of which are without the strange list of ingredients in Feosol.

The ingredients that concern me the most are Crospovidone, FD&C Blue No. 1, FD&C Yellow No. 6, and Polyethylene Glycol. All of these have zero health benefits, do nothing to assist the uptake of iron in the body, and all are potentially detrimental to our health. In my view, there is no health-affirming reason to include these inactive ingredients in a “health product” or dietary supplment. Personally I take supplements to aid my health, if deemed necessary, and therefore give great consideration to exactly which products I use. I think there are cleaner and better quality iron products available with ferrous sulphate in them (the form of iron Feosol products us with). There are also other forms of iron that research indicates are just as good or potentially better than ferrous sulphate.

In more detail – The Full and Long Review

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Pills, pills, pills

I was searching on Amazon for a high quality, effect, and natural iron supplement. Feosol had excellent reviews and a high rating so I looked further into it. Before ordering I wanted to know exactly what was in it. I could find no mention of the ingredient list on the Feosol website dedicated to this product. After searching the Internet I eventually found the ingredient list. When I saw the ingredients I got the immediate impression this product was more than likely made by a pharmaceutical company rather than a quality supplement company. I am not suggesting there is anything “wrong” with vitamins made by pharmaceutical companies per se, although many years of working with and researching high quality supplements has taught me what the typical signs are of products made by pharmaceutical companies — most specifically that they invariably include ingredients I’ll almost never see in high quality nutritional products. Basically I find pharmaceutical companies typically made supplements of low to average quality, in much the same way that most supermarket brand food manufactures make low to average quality food products.

For example, I have NEVER ever seen synthetic coloring agents in ANY nutritional product I have considered using or recommending. The quality nutritional brands just simply don’t use them. The company that makes Feosol is Meda Pharmaceuticals.

Here is the full (as far as I know) list of Feosol ingredients:

– Feosol Ingredients –

Dried Ferrous Sulfate [(200 mg; 65 mg Elemental Iron), Equivalent to (325 mg) Ferrous Sulfate per Tablet], Lactose, Sorbitol, Crospovidone, Magnesium Stearate, Carnauba Wax. Contains 2% or Less of FD&C Blue No. 1, FD&C Yellow No. 6, Hypromellose, Polydextrose, Polyethylene Glycol, Titanium Dioxide, Triacetin.

Crospoidone: The first ingredient that stood out for me was Crospoidone. Here is a description I found after researching what it is (from Wikipedia):

Insoluble polyvinylpyrrolidone has its name Crospovidone in the pharmaceutical industry and PVPP (abbreviation of polyvinylpolypyrrolidone) in the beverages industry. It is crosslinked polyvinylpyrrolidone, white or yellowish to white free flowing powder practically without odor, which is insoluble in water, alkali, acid and usual solvents. It has good swelling characteristics in water without forming a gel.

Crospovidone has been used in the manufacture of different pharmaceutical products. Because of its swelling property, it is used as a disintegrant in tablets, granules and gelatin.

Here is some additional information from Wikipedia on possible issues with this ingredient:

However, there have been documented cases of allergic reactions to PVP/povidone, particularly regarding subcutaneous (applied under the skin) use and situations where the PVP has come in contact with autologous serum (internal blood fluids) and mucous membranes. For example, a boy having an anaphylactic response after application of PVP-Iodine for treatment of impetigo was found to be allergic to the PVP component of the solution.[14] A woman, who had previously experienced urticaria (hives) from various hair products, later found to contain PVP, had an anaphylactic response after povidone-iodine solution was applied internally. She was found to be allergic to PVP.[15] In another case, a man experiencing anaphylaxis after taking acetaminophen tablets orally was found to be allergic to PVP.[16]

Povidone is commonly used in conjunction with other chemicals. Some of these, such as iodine, are blamed for allergic responses, although testing results in some patients show no signs of allergy to the suspect chemicalAllergies attributed to these other chemicals may possibly be caused by the PVP instead.[17][18]

Synthetic colorants: The next ingredients that grabbed my attention are the two colorants in Feosol, FD&C Blue No. 1 and FD&C Yellow No. 6. This is the first time I have seen synthetic colors in a nutritional product I am considering buying. As an advocate of holistic health I see no justifiable reason to include these colorants in a product such as this. It’s purely for cosmetic purposes, which seems pointless when the product will been seen for only a few seconds under most circumstances. It suggests to me that the company making this product is likely more concerned about increasing sales through consumer appeal than they are about real health.

Rainbow of chemicals

Rainbow of chemicals (Photo credit: Wikipedia)

FD&C Blue No. 1 is a synthetic dye produced using aromatic hydrocarbons from petroleum. It is banned in Austria, Belgium, Denmark, France, Germany, Greece, Italy, Norway, Spain, Sweden and Switzerland. I am not sure of what their exact reasoning was but I consider it cause for concern in the health conscious individual.

~ FD&C Yellow No. 6 (aka Sunset Yellow or Yellow 6): 

Sunset Yellow, also known as E110, Orange Yellow S and Yellow 6, is a synthetic coal tar and azo dye and is used in fermented foods that must be heat-treated. It can be found in foods such as packet soups, breadcrumbs, ice cream, canned fish, lemon curd, hot chocolate mix, some jams and jellies and many medications.

In some individuals, consumption of Sunset Yellow synthetic dye can lead to the development of hives, hyperactivity, nausea, abdominal pain, nasal congestion and rhinitis.

Some studies have shown a link between the consumption of Sunset Yellow dye and chromosomal damage and an increase incidence of tumors in laboratory animals. However, the World Health Organization’s review of Sunset Yellow found no evidence of increased tumour incidence in both short term and long term studies conducted on rats, guinea pigs, hamsters and dogs. As such they established the acceptable daily intake (ADI) at 2.5 milligrams/kilogram bodyweight per day. World Health Organization. (- from Wikipedia)

Granted, the amount of colorant in this product is not likely to cause the average person significant issues, I personally choose to avoid it if I can.

Polyethylene Glycol (PEG): This is commonly used as a thickening agent, although that’s in gels and liquids (such as body care products). It is also known to increase the permeability of skin and mucous membranes, which means it makes it increases the absorption of whatever else is with it. PEG is most likely in this product as a component of the coating or film on the tablet, and/or as a binding agent (a tableting aid). That’s an informed guess. One possible side-effect of this may be increased absorption of the above-mentioned colorants (this, however, would need to be verified). One factor that contributes to these colorants being considered “generally safe” or “relatively non-toxic” is that they are not well absorbed. The Blue color in this product is consider to have about a 5% absorption, except in cases where a person has increased gut permeability (such as those with leaky gut, Crohns disease, etc.). PEG is know to increase skin and mucous membrane permeability.

It should also be noted that depending on the method of manufacturing PEG may be contaminated with measurable amounts of ethylene oxide and 1,4-dioxane. My research on the Dow Chemical web site and in their product literature, indicates that all PEG 8000 (the form typically used in tablets) has ethylene oxide and 1,4-dioxane in it. Small amounts, but it’s there none-the-less. Why eat such rubbish when it can safely be avoided.

The International Agency for Research on Cancer classifies ethylene oxide as a known human carcinogen and 1,4-dioxane as a possible human carcinogen. Ethylene oxide can also harm the nervous system and the California Environmental Protection Agency has classified it as a developmental toxicant based on evidence that it may interfere with human development. As the manufacturers of Feosol do not disclose information about the quality of their ingredients, there is no easy way to know whether the PEG they use is contaminated. If it comes from Dow Chemicals then it likely is (although within Government allowed levels). This is just one of the reasons why lack of full product ingredient disclosure from this company concerns me.

Aside from the possible contaminants, PEG compounds themselves show some evidence of genotoxicity and if used on broken skin can cause irritation and systemic toxicity. I would not recommend ingestion of PEG by people with an impaired gut lining, and that may include more people than many of us realise.

I think it is also important to point out that PEG can be purchased with Butylated Hydroxytoluene (BHT) in it. Meda Pharmaceuticals does not disclose whether the PEG they use has BHT in it. Look up Butylated Hydroxytoluene online and on Wikipedia to learn more. In all fairness, Meda Pharmaceuticals will need to be contacted to find out if their PEG contains BHT and also what levels of ethylene oxide and 1,4-dioxane the PEG contains. I have emailed them and await their reply (as of Oct 4, 2012).

None of these additives are substances I would choose to put in my body, if I can avoid it. As for the colorants, I always avoid those in foods, so would not want them in a vitamin supplement (something I am taking to improve my health). [amazon_link id=”1573244031″ target=”_blank” ]An A-Z Guide to Food Additives: Never Eat What You Can’t Pronounce[/amazon_link] lists FD&C Blue No. 1 as a potential cause of neuro-toxicity.

My conclusions?

I do not actually draw any specific conclusions about the possible detrimental effects of mid- to long-term ingestion of these ingredients. Each person is different, and we each tolerate artificial chemical additives in different ways and to different degrees. The main issue that comes up for me is that the inclusion of these ingredients is for me an indication that the company making this product has a general disregard for or lack of awareness of holistic and preventative health. Having formulated and manufactured nutritional and health products myself for 7 years I am confident the “cause for concern” ingredients I have listed about could have been avoided in this product formulation.

For these reasons I continued my Iron supplement search, looking for alternatives.

Some of the potentially better alternatives

According to the Linus Pauling Institute, ferrous fumerate provides the highest amount of elemental iron, 33 percent, making it the most bioavailable type of iron supplement. Ferrous sulfate comes in second place, providing 22 percent elemental iron. I would say a product with either form of iron is bioavailable enough to justify using it. Ferrous sulfate is the more common iron supplement.

These days there are other forms available such as iron bis-glycinate chelate (used in Ferrochel® based products), ferric pyrophosphate (found in SunActive® iron supplements), various ferrous sulfate amino acid chelates (as found in Trans/Mins 2 Iron 27+, for instance), and various iron salts such as ferrous gluconate and ferrous fumarate. All of these forms are considered to have benefits over and above elemental iron (except perhaps Ferronyl, which is said to be a more concentrated and bioavailable form of elemental iron).

For the health conscious (those people who pay particular attention to what they put into their body, and recognise that these things are cumulative in their effect) I would personally not recommend this product. [amazon_link id=”B003AYEHMK” target=”_blank” ]Starwest Botanicals Organic Spirulina Powder[/amazon_link] or [amazon_link id=”B0039ITKR4″ target=”_blank” ]Nutrex Hawaii Hawaiian Spirulina Pacifica Powder[/amazon_link] may be a better source of food-sourced iron for long-term use.  It is my understanding not everyone absorbs iron so well from non-meat/animal sources, so if you choose to use an iron rich product like Spirulina, I think it is important to have your iron levels checked again after a few months of using it daily.

As you may have figured out, there is nothing particularly unique or special about Feosol in terms of the form of iron in it (ferrous sulphate is a very common form used in supplements). So why take would one want to ingest ferrous sulphate with all these additives when it can be just as easily and cheaply obtained without them?

For people not so concerned about what they eat

For those folk not so concerned about ingesting these types of synthetic, petroleum (and other) derived ingredients I’d say that this iron supplement is one of the more highly recommended ones I could find, and will likely be just fine for you. The price is also very reasonable. Although I suspect the only reason it is so popular is because it is the one doctors tend to recommend. Why’s that? Because it is marketed to doctors by the pharmaceutical industry. I highly doubt there is any other reason.

Some other iron products on Amazon

Here are some other iron supplements on Amazon with relatively high ratings (I don’t necessarily endorse any of these products. I provide this list as a starting point in finding health Feosol Iron Supplement alternatives):

  • [amazon_link id=”B000QGKHQA” target=”_blank” ]Nature Made Iron 65mg, Equivalent to 325 mg Ferrous Sulfate – 300 Tablets[/amazon_link]. It is also a good price, and it has a few less funky looking ingredients, although still has more than is to my liking. For instance, it also has Polyethylene Glycol (PEG) in it, most likely as the tablet coating.
  • [amazon_link id=”B0013OUHUA” target=”_blank” ]Enzymatic Therapy Ultimate Iron, 90 Softgels[/amazon_link] – I’ve always held this company’s products in high regard. Their iron product gets excellent ratings on Amazon, and it also contains important co-factors such as vitamin-C (shown to help the body absorb iron). It also has B12 in it which, although it’s not the form of B12 I prefer, is also often found lacking in many people with anemia (depending on the form of anemia).
  • [amazon_link id=”B000WQDD2O” target=”_blank” ]Now Foods Iron 18mg Ferrochel, Veg-capsules, 120-Count[/amazon_link][amazon_link id=”B000WQDD2O” target=”_blank” ]Now Foods Iron 18mg Ferrochel, Veg-capsules, 120-Count[/amazon_link] – Ferrochel is iron bis-glycinate (search for ‘iron bisglycinate’ to find the other brands on Amazon with this form of iron). It is reported to be well tolerated with relatively high bioavailability.
  • [amazon_link id=”B000SVT5H0″ target=”_blank” ] Douglas Labs – Ferronyl Tablets 90 Tab[/amazon_link] – has no ratings on Amazon as of yet. It is currently the only one on Amazon with the Ferronyl form of iron. Google search ‘Ferronyl’ to learn more about this form.
  • SunActive® iron – there are currently a few products with this on Amazon. Search for ‘sunactive iron’ to see them. Most don’t have ratings or reviews at this time. Natural Factor’s does though…
  • [amazon_link id=”B001ECXJ1K” target=”_blank” ] Natural Factors Easy Iron Chewables 20mg Tablets, 60-Count[/amazon_link] – Uses SunActive FE ferric pyrophosphate as the active ingredient. (Inactive Ingredients: Dextrose, fructose, xylitol, natural tropical flavor, citric acid, magnesium silicate, stearic acid, silica, natural peach flavor. Contains soy.
  • [amazon_link id=”B00280M13O” target=”_blank” ] Garden of Life Vitamin Code, Raw Iron, 30 Capsules[/amazon_link] – For a very different approach to iron supplementation. These two utilise whole-foods and iron co-factors. These are the most “natural” iron supplements I found on Amazon, and they both have positive reviews. For some people they may seem a little pricey though. I am familiar with both brands and have no trouble recommending them
  • [amazon_link id=”B0015R2MFI” target=”_blank” ] New Chapter Every Woman’s Iron Support 60 tablets[/amazon_link]
  • [amazon_link id=”B00280M13O” target=”_blank” ] Garden of Life Vitamin Code, Raw Iron, 30 Capsules[/amazon_link]

You may also find [amazon_link id=”B004IJYAOQ” target=”_blank” ]Bifera Iron Supplement[/amazon_link] on Amazon. Some time after late 2010 it was rebranded as ‘Feosol with Bifera’. Bifera was made by Alaven Pharmaceuticals, which was acquired by Meda Pharmaceuticals in October 2010. Like Felsol it also contains useless chemical colorants, and what I consider to be an excessive number of synthetic inactive ingredients.

A few general suggestions

From a holistic health perspective anemia is best addressed from two angles. One is to increase iron intake (through food and supplementation, if necessary) and iron absorption, and the other is to limit iron losses. For instance, the tannins in black tea are known to significantly inhibit the uptake of iron from our digestive system. Coffee has a similar, although lesser, effect. Taking your iron supplement (or eating foods you would naturally derive iron from) within a few hours of drinking coffee and tea may be unwise for those lacking in iron.

I wish you all the best of health…

Jonathan

P.S. You may be wondering why I have taken the time to write such an extensive review on this iron product. The simple answer is that I don’t appreciate it when I see food, health, and body “care” products loaded with unnecessary and potentially harmful ingredients. What I appreciate even less is when Doctors recommend products that contain these unnecessary ingredients and don’t suggest alternatives that are potentially more supportive to a person’s overall well-being. Experience and research tells me that the primary reason doctors recommend products like Feosol (as opposed to other brands) is that it is made by a pharmaceutical company and pharmaceutical companies heavily market their brands to medical profession (through advertising in medical journals, at medical conferences, etc.).

“Number one doctor recommended iron supplement” PLUS “list of unnecessary potentially harmful ingredients” = me feeling motivated to share what I can about the bigger picture on the product in question and other product options.

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