Ferrous sulfate 325mg / Ascorbic acid 500mg modified-release tablets

Oral iron (Fe) supplementation is one of the mainstays of treatment for iron deficiency anemia (IDA). However, its therapeutic effects are limited when there is poor absorption from the gastrointestinal tract. Vitamin C is hypothesized to improve uptake when combined as an adjunct agent. We aimed to determine the difference in hematologic outcomes in patients with IDA receiving oral iron, with or without vitamin C. MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from database inception to July 2023 for studies investigating the use of oral iron supplements with vitamin C in patients with IDA. The primary outcome was the change in serum hemoglobin (Hb). Secondary outcomes include change in serum ferritin, reticulocyte percentage, and incidence of adverse events. A total of 2231 studies were retrieved; 10 randomized control trials (n = 1782), and 1 prospective cohort study (n = 148) comprising 1930 patients were included. Vitamin C supplementation was associated with a significant increase in serum Hb level (mean differences [MDs], 0.14 g/dL; 95% confidence interval [CI], 0.08-0.20; P P < .01; 9 studies, 1682 patients) in the iron plus vitamin C group compared with the iron-only group. The addition of vitamin C to iron supplementation was associated with a small and likely clinically insignificant increase in serum Hb. The results of this study do not support routine supplementation of oral iron therapy with vitamin C in the treatment of IDA.

Abstract licence: CC BY-NC-ND

BackgroundIron is an essential element for critical biological functions, with iron deficiency negatively affecting growth and brain development and iron excess associated with adverse effects. The goal of this review is to provide a comprehensive assessment of up-to-date evidence on iron absorption measured isotopically in children, preterm infants, and full-term infants, up to 24 months of age.MethodsSearch databases included Pubmed, Cochrane, Web of Science, and Scopus from a date range of 1 January 1953 to 22 July 2024. The included articles were experimental studies with iron absorption outcomes measured by isotopic techniques. The risk of bias was assessed using the Cochrane Risk of Bias Tool.ResultsA total of 1594 records were identified from databases, and 37 studies were included in the quality review with a total of 1531 participants. Article results were grouped by study commonality: absorption and red blood cell incorporation, type of milk feedings, additives to improve absorption, how and when to supplement with iron, and iron forms and complimentary foods.ConclusionsThe results from this review support the current recommendations of oral iron supplementation. Iron from breast milk has high bioavailability, and unmodified cow's milk reduces iron absorption. Supplemental iron is required at 4-6 months for healthy, full-term infants and sooner for preterm infants. Ascorbic acid increases iron absorption in full-term infants and children. Lactoferrin and prebiotics are promising candidates for enhancing iron absorption, but they require further investigation. Research evidence of iron absorption mechanisms and modulating factors in preterm infants is limited and should be a research priority.

Abstract licence: CC BY

Abstract Background: Anemia is a common cause of perinatal outcomes, including preterm delivery, neonatal neurodevelopmental problems, and indirect maternal death. As iron deficiency is the first acquired factor in the development of anemia, the appropriate nutrition of mothers and an accurate supplementation is recommended. Objectives: To determine the effects and gastrointestinal tolerance of one type of oral supplements with Ferrous sulfate glycine compared with Ferrous sulfate in anemic pregnant women. Methods: This study was performed on anemic pregnant women referring to the prenatal clinic in Imam Khomeini Hospital Complex, from 2019 to 2021. The women randomized into two groups of Ferro fort duodenal or Ferrous sulfate. In 16-20 and 24-28 weeks of gestation, data including of hemoglobin and ferritin changes as well as gastrointestinal tolerability were evaluated and analyzed by SPSS version 23. Results: From a total of 50 participants in every group, 16 and 33 women respectively completed the study with Ferrous sulfate and Ferro fort duodenal. After 8 weeks of starting the supplementation, decrease of hemoglobin and increase of ferritin were respectively observed in the groups of Ferrous sulfate and Ferro fort duodenal. Comparison between the two groups also showed a significant increase of hemoglobin in women consuming Ferro fort duodenal compared to Ferrous sulfate (P<0.001). Conclusion: Although improvement of hematology indices in Ferro fort duodenal group compared with Ferrous sulfate was shown, further clinical trials are needed to lead to confirmation or modification of our results.

Abstract licence: CC BY 4.0

BackgroundMethemoglobinemia (MetHb) is a rare and potentially life-threatening condition caused by oxidation of ferrous hemoglobin (Fe2+) to the ferric (Fe3+) state, making it incapable of binding oxygen and resulting in cyanosis and tissue ischemia.Case presentationThis case presentation describes a 1-year-old boy who developed sudden cyanosis and reduced consciousness disorder. An initial assessment showed decreased oxygen saturation (SpO2 85%) despite oxygen therapy, while point-of-care venous blood gas (VBG) analysis assessed high rates of MetHb (72.7%). Methylene blue and ascorbic acid were administered, resulting in in rapid clinical recovery and normalized VBG test results. The trigger for this condition was not identified, however the most likely cause of poisoning was attributed to food oxidants.ConclusionStarting from the description of a clinical case, this paper discusses the causes and mechanisms of possible poisoning and reviews recent guidelines for methemoglobinemia management.

Abstract licence: CC BY