Intrinsic Factor (IF) was so named because of its essential role in helping vitamin B12 perform in its role to produce red blood cells. The amount of iron in these preparations bound to heme is generally less than 1/2 milligram. Liver extract contain ferritin as well as some heme iron. Other pharmacies add things like “intrinsic factor” or liver extract. Because the manufacturers know this, they generally make them with very low iron concentrations. These present some danger however because if the whole bottle is consumed by a child, a very real risk of overdose exists. This is done so that people won’t have to worry about whether the pills dissolve in their stomachs – it’s already in solution. The tonics are made as solutions that keep the iron soluble. There are a few specialty pharmacies around the country that make special iron tonics or capsules. As such the person will derive no benefit from the iron supplement. If a person is taking antacids or H2 blockers such as cimetidine (Tagamet), their stomach will be “achlorhydric” – no acid in the stomach and the iron salt will not dissolve. Once ingested, it is imperative that the stomach contains acid to dissolve the iron salt. The manufacture of these products gives an important clue as to how they work in the body. The slurry is then dehydrated and the remaining dry matter is the iron salt. As this happens the iron is no longer soluble so it binds to the counter-ion and drops out of solution. Once dissolved, the counter ion is added and the pH is slowly adjusted back to neutrality. Typically, the way these compounds are made is that pure iron, usually as iron filings which are dissolved in sulfuric or hydrochloric acid. Fumarate and Gluconate are carbon containing carboxylic acids. Popular and common counter ions are sulfate, gluconate and fumarate. That is, a positively charged iron and its counter ion (negatively charged counterpart). Until 1999, in the United States, the vast majority of iron supplements were made with ferrous iron salts.
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