My iron levels have dropped to 9 and now i am on iron supplements. every time i take the supplements i feel week, nausea and drained out. is it ok to take iron supplements with acv on an empty stomach?

I'm sorry I don't know what ACV is. However, if you have too many side effects with oral iron, it can be given intravenously. It may be expensive, but your doctor may justify IV iron if you cannot take iron orally due to too many side effects. If you are taking oral iron, it is best to take it with orange juice, or vitamin C, not with milk or tea.

There are many types of oral iron supplements. Ferrous sulfate is the less tolerable one and Ferrous fumarate is easily tolerable. The newest one, Auryxia (ferric citrate) is also well tolerated. There is no interaction between Apple Cider Vinegar and Iron pill. However, both can irritate your stomach especially if you do not dilute ACV solution.

If taking ferrous sultate, switch to ferrous gluconate. Can take with food initially. When tolorated change to 30 minutes before meals, then work-up to three times daily. If still a "no-go" see a hematologist for the other options, iron by shot or intravenously. And find out where the blood loss comes from. The low iron saturation suggests you are bleeding from some place.