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Oral iron supplementation is often the first\u2010line treatment for the acute and chronic management of iron deficiency due to its ease and accessibility. However, there is no consensus on the optimal formulation or dosing strategy, or which patients should be preferentially treated with intravenous iron. Management of iron deficiency is complicated by the hepcidin\u2010ferroportin iron regulatory pathway, which has evolved to prevent iron overload and thereby creates an inherent limit on gastrointestinal iron uptake and efficacy of oral iron. Unabsorbed iron propagates many of the side effects that complicate oral iron use including dyspepsia and constipation, all of which can thus be exacerbated by excessive oral iron doses. Daily low dose and every other day dosing protocols have attempted to bypass this physiologic bottleneck to allow for effective absorption and limit side effects; however, this approach has still resulted in low fractional iron absorption. In the following manuscript, we review the pathophysiology of iron absorption and current evidence for various preparations of oral iron. Lastly, we highlight opportunities for further study to advance the care of individuals affected by iron deficiency.<\/jats:p>","DOI":"10.1111\/ejh.13892","type":"journal-article","created":{"date-parts":[[2022,11,7]],"date-time":"2022-11-07T02:48:55Z","timestamp":1667789335000},"page":"123-130","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["The role of oral iron in the treatment of adults with iron deficiency"],"prefix":"10.1111","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1934-1935","authenticated-orcid":false,"given":"Jamie O.","family":"Lo","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley E.","family":"Benson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Oregon Health &amp; Science 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