Hi Sharmin,
The problem with metals and Exjade is that Exjade reacts with the metals, reducing its effectiveness. In effect, the Exjade has already chelated metal from the container or spoon, or reacts with aluminum in the digestive tract, thereby weakening the dose of Exjade to the patient. If you mix it with metal, you are actually introducing chelated metals into your system, which your body then has to excrete.
Nausea is the most common side effect with Exjade and it is something that patients learn to live with if it persists. Ambareen is one who did switch to taking it at night and was able to reduce the nausea that way.