Oral administration of lactoferrin increases hemoglobin and total serum iron in pregnant women. Lactoferrin Efficacy versus Ferrous Sulfate in Curing Iron Disorders in Pregnant and Non-Pregnant Women Lactoferrin versus ferrous sulphate for the treatment of iron deficiency anemia during pregnancy: a randomized clinical trial Efficacy and tolerability of oral bovine lactoferrin compared to ferrous sulfate in pregnant women with iron deficiency anemia: A prospective controlled randomized study Safety and efficacy of lactoferrin versus ferrous sulphate in curing iron deficiency and iron deficiency anaemia in hereditary thrombophilia pregnant women: an interventional study Efficacy of daily vs. weekly supplementation of iron in schoolchildren with low iron status. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. Iron Sucrose Versus Oral Iron Therapy in Pregnancy Anemia Intravenous iron sucrose complex in the treatment of iron deficiency anemia during pregnancy. A prospective randomized, controlled trial of intravenous versus oral iron for moderate iron deficiency anaemia of pregnancy. A comparison between intravenous iron polymaltose complex (Ferrum Hausmann®) and oral ferrous fumarate in the treatment of iron deficiency anaemia in pregnancy Efficacy and tolerability of low-dose iron supplements during pregnancy: a randomized controlled trial. Intravenous iron sucrose versus oral iron in treatment of iron deficiency anemia in pregnancy: a randomized clinical trial. Intravenous versus oral iron therapy for postpartum anaemia. Absorption of iron from sustained release and rapidly disintegrating tablets. Influence of daily numbers of administrations. Influence of lactoferrin in preventing preterm delivery: a pilot study. Large-dose intravenous ferric carboxymaltose injection for iron deficiency anemia in heavy uterine bleeding: a randomized, controlled trial. Hepcidin levels predict nonresponsiveness to oral iron therapy in patients with iron deficiency anemia Once Weekly Low-dose Iron Supplementation Effectively Improved Iron Status in Adolescent Girls Causal relationship of Helicobacter pylori with iron-deficiency anemia or failure of iron supplementation in children. Comparative efficacy and safety of intravenous ferric carboxymaltose in the treatment of postpartum iron deficiency anemia. Treatment of mild non-chemotherapy-induced iron deficiency anemia in cancer patients: comparison between oral ferrous bisglycinate chelate and ferrous sulfate.
Iron deficiency anemia ( IDA ) during pregnancy continues to be of world-wide concern . IDA is a risk factor for preterm delivery and subsequent low birth weight , and possibly for poor neonatal health . Iron supplementation in pregnancy is a widely recommended practice , yet intervention programs have met with many controversies . In our study , 300 women at different trimesters of pregnancy were enrolled in a trial of oral administration of ferrous sulfate ( 520 mg once a day ) or 30 % iron-saturated bovine lactoferrin ( bLf ) ( 100 mg twice a day ) . Pregnant women refusing treatment represented the control group . In this group hemoglobin and total serum iron values measured after 30 d without treatment decreased significantly , especially in women at 18 - 31 weeks of pregnancy . In contrast , after 30 d of oral administration of bLf , hemoglobin and total serum iron values increased and to a greater extent than those observed in women treated orally for 30 d with ferrous sulfate , independently of the trimester of pregnancy . Unlike ferrous sulfate , bLf did not result in any side effects . These findings lead us to hypothesize that lactoferrin could influence iron homeostasis directly or through other proteins involved in iron transport out of the intestinal cells into the blood Iron homeostasis in pregnancy compensates for increased iron requirements and in women of child-bearing age for iron loss in menses . Oral administration of ferrous sulfate , prescribed to cure iron deficiency ( ID ) and ID anemia ( IDA ) , often fails to increase hematological parameters and causes adverse effects . Recently , we demonstrated safety and efficacy of bovine lactoferrin ( bLf ) in pregnant women suffering from ID/IDA . Two clinical trials were conducted on pregnant and non-pregnant women of child-bearing age suffering from ID/IDA . In both trials , women received oral administration of bLf 100 mg/twice/day ( Arm A ) , or ferrous sulfate 520 mg/day ( Arm B ) . Hematological parameters , serum IL-6 and prohepcidin were assayed before and after therapy . Unlike ferrous sulfate , bLf  increased hematological parameters ( P<0.0001 ) . In pregnant women , bLf  decreased serum IL-6 ( P<0.0001 ) , and increased prohepcidin ( P=0.0007 ) . In non-pregnant women bLf did not change the low IL-6 levels while it increased prohepcidin ( P<0.0001 ) . Ferrous sulfate increased IL-6 ( P<0.0001 ) and decreased prohepcidin ( P=0.093 ) . bLf established iron homeostasis by modulating serum IL-6 and prohepcidin synthesis , whereas ferrous sulfate increased IL-6 and failed to increase hematological parameters and prohepcidin .  bLf is a more effective and safer alternative than ferrous sulfate for treating ID and IDA Abstract Objective : This study was conducted to evaluate the efficacy and safety of lactoferrin in comparison to ferrous sulphate for the treatment of iron deficiency anemia ( IDA ) during pregnancy . Material s and methods : This prospect i ve , r and omized , parallel-group , single-center study was conducted in the Department of Obstetrics and Gynecology at Menoufia University Hospital , Egypt and included a total of 200 pregnant women in the second trimester with IDA who were enrolled and r and omly assigned either to receive 150 mg of dried ferrous sulphate capsules or lactoferrin 250 mg capsules once daily for eight consecutive weeks . The primary efficacy parameter was the amount of increase in hemoglobin concentration by 4 and 8 weeks , the adverse effects related to iron therapy and the patient compliance to the treatment . Results : Total increase in Hb after 2 months with lactoferrin was higher ( 2.26 ± 0.51 g/dL ) compared to ferrous sulfate ( 1.11 ± 0.22 g/dL ) ( p < 0.001 ) . Gastrointestinal adverse events occurred more frequently with ferrous sulphate than the lactoferrin group ( p < 0.001 ) . The number of women requesting change the drug was higher in the ferrous sulphate group ( p < 0.001 ) . Conclusion : Lactoferrin was more effective than ferrous sulfate over a two-month period in pregnant women with IDA , with fewer gastrointestinal adverse events and better treatment acceptability Objective . To compare the effects of bovine lactoferrin with ferrous sulfate on iron nutritional status and to evaluate their tolerability in 100 pregnant women with iron deficiency anemia . Design . Prospect i ve , r and omized , controlled , double blind trial . Setting . Obstetrics clinic of a University Department of Obstetrics and Gynecology . Population . One‐hundred pregnant , healthy women to be treated either with one capsule of 100 mg bovine lactoferrin twice a day ( Group A ; n = 49 ) and 520 mg ferrous sulfate once a day ( Group B ; n = 48 ) . Methods . After 30 days , we evaluated hemoglobin ( Hb ) , serum ferritin , serum iron and total iron‐ binding capacity ( TIBC ) values . All women were asked to keep a diary of five potential gastrointestinal side effects ( abdominal pain , nausea , vomiting , diarrhea and constipation ) . For each symptom , patients had to rate its severity according to a scale ranging from 0 ( absent ) to 3 ( severe ) . Main outcome measures . Hb level before and after treatment . Secondary outcomes were serum ferritin , serum iron and TIBC levels and the difference in symptom scores between groups . Results . In Groups A and B , Hb , serum ferritin and iron were significantly increased while TIBC was significantly reduced in comparison with basal values . No significant differences were observed between Groups A and B. The median scores of abdominal pain and constipation were significantly higher in patients treated with ferrous sulfate in comparison with those treated with bovine lactoferrin . Conclusions . The results show that bovine lactoferrin has the same efficacy as ferrous sulfate in restoring iron deposits with significantly fewer gastrointestinal side effects Objective Evaluate the safety and efficacy of bovine lactoferrin ( bLf ) versus the ferrous sulphate st and ard intervention in curing iron deficiency ( ID ) and ID anaemia ( IDA ) in pregnant women affected by hereditary thrombophilia ( HT ) . Design Interventional study . Setting Secondary -level hospital for complicated pregnancies in Rome , Italy . Population 295 HT pregnant women ( ≥18 years ) suffering from ID/IDA . Methods Women were enrolled in Arm A or B in accordance with their personal choice . In Arm A , 156 women received oral administration of 100 mg of bLf twice a day ; in Arm B , 139 women received 520 mg of ferrous sulphate once a day . Therapies lasted until delivery . Main outcome measures Red blood cells , haemoglobin , total serum iron , serum ferritin ( haematological parameters ) were assayed before and every 30 days during therapy until delivery . Serum IL-6 , key factor in inflammatory and iron homeostasis disorders , was detected at enrolment and after therapy at delivery . Possible maternal , foetal , and neonatal adverse effects were assessed . Results Haematological parameters were significantly higher in Arm A than in Arm B pregnant women ( P ≤ 0.0001 ) . Serum IL-6 significantly decreased in bLf-treated women and increased in ferrous sulphate-treated women . BLf did not exert any adverse effect . Adverse effects in 16.5 % of ferrous sulphate-treated women were recorded . Arm A women experienced no miscarriage compared to five miscarriages in Arm B women . Conclusions Differently from ferrous sulphate , bLf is safe and effective in curing ID/IDA associated with a consistent decrease of serum IL-6 . The absence of miscarriage  among bLf-treated women provided an unexpected benefit . Trial registration : Clinical Trials.gov Identifier NCT01221844 Iron deficiency anemia ( IDA ) is still a major nutritional and public health problem in developing countries . The prevalence among young children and pregnant women is particularly high . Daily oral supplementation with medicinal iron is considered an effective strategy for reducing the incidence of IDA but non-compliance is a major problem with this strategy . We undertook this study to compare the results of once-weekly vs. daily oral iron supplementation in schoolchildren . Sixty children ranging between 5 and 10 years with iron deficiency anemia were selected from a school in Karachi , Pakistan and were divided into two equal groups , i.e. , daily and weekly supplementation groups . Hemoglobin ( Hb ) , hematocrit ( Hct ) , serum iron , total iron binding capacity ( TIBC ) , and serum ferritin were determined before the start of the study . Ferrous sulfate ( 200 mg ) was given daily to the daily supplementation group and once-weekly to the weekly supplementation group for 2 months . When post-supplementation values of the above-mentioned parameters were determined , a significant improvement was observed in all parameters in both groups . It is concluded that once-weekly iron supplementation is as effective as daily supplementation for the treatment of iron deficiency anemia . Moreover , weekly iron supplementation is cost effective and has no or fewer side-effects Abstract Objective : To compare the effects of oral ferrous bisglycinate 25 mg iron/day vs. ferrous sulfate 50 mg iron/day in the prevention of iron deficiency ( ID ) and iron deficiency anemia ( IDA ) in pregnant women . Design : R and omized , double-blind , intention-to-treat study . Setting : Antenatal care clinic . Sample : 80 healthy ethnic Danish pregnant women . Methods : Women were allocated to ferrous bisglycinate 25 mg elemental iron ( Aminojern ® ) ( n=40 ) or ferrous sulfate 50 mg elemental iron ( n=40 ) from 15 to 19 weeks of gestation to delivery . Hematological status ( hemoglobin , red blood cell indices ) and iron status ( plasma iron , plasma transferrin , plasma transferrin saturation , plasma ferritin ) were measured at 15–19 weeks ( baseline ) , 27–28 weeks and 36–37 weeks of gestation . Main outcome measures : Occurrence of ID ( ferritin < 15 μg/L ) and IDA ( ferritin < 12 μg/L and hemoglobin < 110 g/L ) . Results : At inclusion , there were no significant differences between the bisglycinate and sulfate group concerning hematological status and iron status . The frequencies of ID and IDA were low and not significantly different in the two iron groups . The frequency of gastrointestinal complaints was lower in the bisglycinate than in the sulfate group ( P=0.001 ) . Newborns weight was slightly higher in the bisglycinate vs. the sulfate group ( 3601±517 g vs. 3395±426 g , P=0.09 ) . Conclusions : In the prevention of ID and IDA , ferrous bisglycinate was not inferior to ferrous sulfate . Ferrous bisglycinate in a low dose of 25 mg iron/day appears to be adequate to prevent IDA in more than 95 % of Danish women during pregnancy and postpartum BACKGROUND The efficacy of iron polymaltose complex ( IPC ) in the treatment of iron deficiency anemia ( IDA ) during pregnancy has not been well established , and the evidence is inconclusive . AIMS The aim of the study was to compare efficacy , safety , compliance , and cost-effectiveness of IPC with ferrous sulphate ( FS ) in pregnant patients . SETTING S AND DESIGN S The r and omized , double-blind , parallel-group study was conducted in the Department of Pharmacology in collaboration with the Department of Obstetrics and Gynaecology Postgraduate Institute of Medical Education and Research , Ch and igarh , India . METHODS One hundred pregnant women aged 20 - 40 years at 14 to 27 weeks ' gestation , with hemoglobin ( Hb ) < 9 g/dL , and serum ferritin < 12 mcg/L , were classified into 2 groups . One group received IPC ( 100 mg elemental iron ) , and the other group received FS ( 120 mg elemental iron ) daily for 8 weeks . At Week 0 and Week 8 , Hb , packed cell volume ( PCV ) , mean corpuscular volume ( MCV ) , mean corpuscular hemoglobin ( MCH ) , mean corpuscular hemoglobin concentration ( MCHC ) , serum iron , and serum ferritin were measured . Compliance with study medication was determined by pill counting at each visit . Cost minimization analysis was done to compare the costs of the 2 treatments . STATISTICAL ANALYSIS Data are expressed as mean -/+ SD . Paired and unpaired ' t ' test were used to analyze differences within groups and between groups . Chi-square ( x2 ) test was used to analyze primary efficacy parameters and adverse drug reactions ( ADR ) . RESULTS Statistically significant increases in Hb , PCV , MCV , MCH , MCHC , serum iron , and serum ferritin levels were seen at the end of 8 weeks of treatment in both groups . The overall adverse effects were more common in the FS group compared with the IPC group [ 41 ( 78 % ) vs 15 ( 31 % ) , P < .001 ] . The compliance rate was significantly ( P < .05 ) higher for the IPC ( 91 % ) group than for the FS ( 87 % ) group . The average total cost ( direct + indirect ) of treatment of anemia was comparable between the 2 groups . CONCLUSION The results of the present study suggest that IPC can be considered as a useful alternative formulation for the treatment of IDA during pregnancy for those patients who can not tolerate other iron preparations ( ferrous form ) ; this is an important finding , as compliance is a significant concern during pregnancy Background : Iron deficiency anemia ( IDA ) is the most common medical problem in pregnancy .  Parenteral iron is a useful treatment , although iron dextran use decreased due to anaphylaxis . Iron sucrose is a newer agent that has overcome the shortcomings of iron dextran . Objective : The aim of this study was to compare the efficacy and tolerance of intravenous iron sucrose ( IVIS ) therapy with oral iron ( OI ) therapy in pregnant women with IDA and to study the factors influencing treatment . Material s and Methods : This prospect i ve , r and omized clinical trial included pregnant women between 14 and 36 weeks with established IDA who were treated with IVIS or OI ( ferrous fumarate ) .  All patients were monitored for laboratory response and adverse effects . Independent sample -t test , Chi square test and ANOVA were used for statistical analysis . P < 0.05 was considered significant . Results : Although hemoglobin increased in both the groups , increase in the reticulocyte count and percentage increase in hemoglobin was significantly higher in the IVIS group than in the OI group ( 23.62 % vs. 14.11 % ) . Serum ferritin was significantly higher in the IVIS group than in the OI group ( P = 0.000 ) . The IVIS group had no major side-effects . Compliance was good with OI , although 23 % had gastrointestinal side-effects . Patient weight , gestation at diagnosis , initial hemoglobin and ferritin levels did not influence the response to treatment . Conclusion : IVIS is safe and effective in the treatment of IDA during pregnancy . Iron stores increased better with IVIS compared with OI OBJECTIVE To evaluate the safety and efficacy of intravenous iron sucrose complex ( ISC ) as compared with oral ferrous sulfate in the treatment of iron deficiency anemia during pregnancy . STUDY DESIGN prospect i ve , open , controlled study in which pregnant women with iron deficiency anemia were sequentially selected from the antenatal clinic and assigned either to ISC ( study group ) or to ferrous sulfate ( control group ) . METHODS Each study patient was given the total calculated amount of ICS ( Hb deficit ( g/l ) x body weight ( kg ) x 0.3 ) in divided doses ( 200 mg ( elemental iron ) in 100 ml normal saline intravenously over 1 h daily ) followed by 10 mg/kg to replenish iron stores . Each patient of the control group was given ferrous sulfate 300 mg ( 60 mg elemental iron ) orally three times a day . All patients were monitored for adverse effects , clinical and laboratory response . RESULTS There were 52 patients and 59 controls . ISC group achieved a significantly higher Hb level ( 128.5 + /- 6.6 g/l vs. 111.4 + /- 12.4 g/l in the control group P < or = 0.001 ) in a shorter period ( 6.9 + /- 1.8 weeks vs. 14.9 + /- 3.1 weeks in the control group , P < or = 0.001 ) . ISC complex group showed no major side effects while 4 ( 6 % ) of the control group could not tolerate ferrous sulfate , 18 ( 30 % ) complained of disturbing gastrointestinal symptoms and 18 ( 30 % ) had poor compliance . CONCLUSION We conclude that ISC is safe and effective in the treatment of iron deficiency anemia during pregnancy BACKGROUND Iron deficiency anaemia is the most common deficiency disorder in the world , affecting more than one billion people , with pregnant women at particular risk . OBJECTIVES AND DESIGN We conducted a single site , prospect i ve , nonblinded r and omized-controlled trial to compare the efficacy , safety , tolerability and compliance of st and ard oral daily iron versus intravenous iron . SUBJECTS We prospect ively screened 2654 pregnant women between March 2007 and January 2009 with a full blood count and iron studies , of which 461 ( 18 % ) had moderate IDA . Two hundred women matched for haemoglobin concentration and serum ferritin level were recruited . INTERVENTIONS Patients were r and omized to daily oral ferrous sulphate 250 mg ( elemental iron 80 mg ) with or without a single intravenous iron polymaltose infusion . RESULTS Prior to delivery , the intravenous plus oral iron arm was superior to the oral iron only arm as measured by the increase in haemoglobin level ( mean of 19.5 g/L vs. 12 g/L ; P < 0.001 ) ; the increase in mean serum ferritin level ( 222 microg/L vs. 18 ug/L ; P < 0.001 ) ; and the percentage of mothers with ferritin levels below 30 microg/L ( 4.5 % vs. 79 % ; P < 0.001 ) . A single dose of intravenous iron polymaltose was well tolerated without significant side effects . CONCLUSIONS Our data indicate that intravenous iron polymaltose is safe and leads to improved efficacy and iron stores compared to oral iron alone in pregnancy-related IDA Abstract : Anaemia is the most common medical disorder in pregnancy with iron deficiency anaemia accounting for the majority of cases . Over 90 % of the iron deficiency anaemia is due to red cell iron deficiency associated with depleted iron stores and deficient intake . The two main modalities of treating iron deficiency anaemia are oral or parenteral iron . Ferrous Hausmann ® ( iron dextrin ) is the latest iron preparation which can be used for intravenous parenteral administration as a total dose infusion . This study compares the efficacy of Ferrum Hausmann ® with oral ferrous fumarate therapy in the treatment of iron deficiency anaemia in pregnancy . Our study shows that treatment with intravenous Ferrum Hausmann ® ( iron dextrin ) result ed in a significantly better level and rate of increase of haemoglobin ( p<0.001 ) . Serum ferritin , which is the best indicator of iron stores , was significantly higher ( p<0.001 ) in the intravenous group . Other indices of iron status such as serum iron , serum transferrin and zinc protoporphyrin also showed a significant improvement in the intravenous group compared to those given oral iron . The results suggest that intravenous iron as a total dose infusion is able to replenish iron stores more efficiently , completely and at a faster rate than oral iron therapy , thus providing the fuel for stimulation of full erythopoiesis compared to oral iron . There were also no reports of any adverse reactions with intravenous iron dextrin , whereas there were a considerable proportion of women on oral iron therapy who reported side effects . In conclusion , intravenous iron therapy with Ferrous Hausmann ® ( iron dextrin ) is a suitable , effective and safe alternative to oral iron therapy in the treatment of iron deficiency anaemia in pregnancy BACKGROUND Iron deficiency anemia ( IDA ) is common in pregnant women , but previous trials aim ed at preventing IDA used high-dose iron supplements that are known to cause gastrointestinal side effects . OBJECTIVE The objective was to assess the effect on  maternal IDA and iron deficiency ( ID , without anemia ) of supplementing pregnant women with a low dosage ( 20 mg/d ) of iron . Effects on iron status were assessed at the time of delivery and at 6 mo postpartum . Gastrointestinal side effects were assessed at 24 and 36 wk of gestation . DESIGN This was a r and omized , double-blind , placebo-controlled trial of a 20-mg daily iron supplement ( ferrous sulfate ) given from 20 wk of gestation until delivery . RESULTS A total of 430 women were enrolled , and 386 ( 89.7 % ) completed the follow-up to 6 mo postpartum . At delivery , fewer women from the iron-supplemented group than from the placebo group had IDA [ 6/198 , or 3 % , compared with 20/185 , or 11 % ; relative risk ( RR ) : 0.28 ; 95 % CI : 0.12 , 0.68 ; P < 0.005 ] , and fewer women from the iron-supplemented group had ID ( 65/186 , or 35 % , compared with 102/176 , or 58 % ; RR : 0.60 ; 95 % CI : 0.48 , 0.76 ; P < 0.001 ) . There was no significant difference in gastrointestinal side effects between groups . At 6 mo postpartum , fewer women from the iron-supplemented group had ID ( 31/190 , or 16 % , compared with 51/177 , or 29 % ; RR : 0.57 ; 95 % CI : 0.38 , 0.84 ; P < 0.005 ) . The rate of IDA between the groups did not differ significantly at 6 mo postpartum . CONCLUSION Supplementing the diet of women with 20 mg Fe/d from week 20 of pregnancy until delivery is an effective strategy for preventing IDA and ID without side effects AIM Iron deficiency is a leading cause of anemia in pregnancy . The present study aim ed to compare the efficacy of oral and intravenous iron therapy in improving iron deficiency anemia in pregnancy and restoring iron stores , compare the obstetric outcome in the two groups and evaluate the safety of intravenous iron sucrose . MATERIAL AND METHODS This was a prospect i ve study , where 100 anemic antenatal women with hemoglobin 7 - 9 g/dL , mean corpuscular volume < 85 fL and serum ferritin < 15 ng/mL , were r and omized into two groups . In group A ( n=50 ) , the women received 200 mg tablets of ferrous sulphate , each containing 60 mg elemental iron , three times a day for 4 weeks . In group B ( n=50 ) , iron sucrose was given in divided doses of 200 mg each on alternate days by slow intravenous infusion . Primary outcome measure was treatment efficacy , assessed by measurement of hemoglobin , red blood cell indices and reticulocytes on days 7 , 14 , 21 , and 30 and at delivery , and of ferritin on day 30 and at delivery . Any side-effects of treatment and the neonatal outcome were studied as secondary outcome measures . RESULTS There was a statistically significant difference in increase of hemoglobin levels ( 3.1g/dL in group A vs 5.1 g/dL in group B ; P=0.002 ) and ferritin levels between the two groups on day 30 ( P=0.005 ) . The adverse effects from iron treatment were mild but more prominent in group A. Neonatal outcome was comparable in the two groups . CONCLUSION Intravenous administration of iron sucrose is a safe treatment for correction of anemia in pregnancy , without serious side-effects OBJECTIVE Postpartum iron deficiency anaemia ( IDA ) is common in women . Most women are treated with either oral iron supplementation or blood transfusion . Hence , the aim of our study was to compare the effect of treatment with either oral ferrous sulphate or intravenous ferrous sucrose on postpartum IDA . DESIGN A single centre , prospect i ve r and omised controlled trial . SETTING Women 's Centre , John Radcliffe Hospital , Oxford , UK . POPULATION Forty-four women with haemoglobin ( Hb ) of < 9 g/dl and ferritin of < 15 microgram/l at 24 - 48 hours postdelivery . METHODS Women were r and omised to receive either oral ferrous sulphate 200 mg twice daily for 6 weeks ( group O ) or intravenous ferrous sucrose 200 mg ( Venofer ; Vifor International Ltd , St Gallen , Switzerl and ) , two doses given on days 2 and 4 following recruitment ( group I ) . RESULTS were analysed by the Students t-test , chi-square test and analysis of variance . MAIN OUTCOME MEASURES Hb , haematocrit , red cell indices , ferritin and serum iron levels were measured on days 0 , 5 , 14 and 40 . Results By day 5 , the Hb level in women treated with intravenous iron had risen from 7.3 + /- 0.9 to 9.9 + /- 0.7 g/dl , while there was no change in those treated with oral iron . Women treated with intravenous iron had significantly higher Hb levels on days 5 and 14 ( P < 0.01 ) than those treated with oral iron ; although by day 40 , there was no significant difference between the two groups . Throughout the study , ferritin levels rose rapidly in those treated with intravenous iron and remained significantly higher than in those treated with oral iron ( P < 0.01 ) . CONCLUSIONS Intravenous iron sucrose increases the Hb level more rapidly than oral ferrous sulphate in women with postpartum IDA . It also appears to replenish iron stores more rapidly . However , this study was not large enough to address the safety of this strategy . The absorption of iron from a sustained release preparation given in a dose of 100 mg ferrous iron twice daily ( at breakfast and at dinner or bedtime ) has been compared to the absorption from a rapidly disintegrating ferrous sulphate tablet given in a dose of 50 mg iron 4 times daily ( at breakfast , lunch , dinner and bedtime ) . The studies were performed in 34 subjects—20 blood donors and 14 patients with iron deficiency anemia . In blood donors the same amount of iron was absorbed from the two types of medication . In patients with iron deficiency anemia significantly more iron was absorbed from the sustained release preparation . There was no indication that the time of intake of the second daily dose of the sustained release preparation had any significant influence on the absorption Lactoferrin ( Lf ) is an approximately 80-kDa iron-binding glycoprotein , belonging to the transferrin family , with well-known bacteriostatic and bactericidal properties . It is produced and stored in specific ( secondary ) neutrophil granules and released during neutrophil activation and degranulation . Nowadays , Lf has a well-known therapeutic indication for combating iron deficiency anemia ( IDA ) in pregnant women . Studies suggest that Lf plays an important role against cervicovaginal infections by decreasing cytokines levels , such as interleukin (IL)-6 , in cervicovaginal fluid . The aim of this preliminary trial was to evaluate the effectiveness of Lf in preventing preterm delivery caused by cervical infections and ripening . From November 2009 to August 2010 , 21 pregnant women ( 26 - 32 weeks pregnant ) , aged between 22 and 36 years , suffering from IDA , at risk of preterm delivery , were prospect ively enrolled in the study . One group ( N=14 ) received 100 mg of recombinant human lactoferrin ( bLf ) [ corrected ] ( lattoferrina ; AG-pharma ) twice a day before meals , for one month . The other group ( N=7 ) received 520 mg of ferrous sulfate ( Ferro-Grad ; Abbott Laboratories , USA ) once a day . The patients underwent  transvaginal ultrasound  to evaluate cervical length and funneling , and vaginal swabs were used to detect infections and cervicovaginal fluid sample collection to determine IL-6 levels . The results showed a correlation between the oral administration of 200 mg of bLf [ corrected ] with both the normalization of vaginal flora ( vaginal infection disappearance ) and the decrease in IL-6 cervicovaginal fluid levels in women at risk of preterm delivery BACKGROUND The objective was to evaluate efficacy and safety of rapid , large-dose intravenous ( IV ) administration of ferric carboxymaltose compared to oral iron in correcting iron deficiency anemia due to heavy uterine bleeding . STUDY DESIGN AND METHODS In a r and omized , controlled trial , 477 women with anemia , iron deficiency , and heavy uterine bleeding were assigned to receive either IV ferric carboxymaltose ( < or=1000 mg over 15 min , repeated weekly to achieve a total calculated replacement dose ) or 325 mg of ferrous sulfate ( 65 mg elemental iron ) prescribed orally thrice daily for 6 weeks . RESULTS Compared to those assigned to ferrous sulfate , more patients assigned to ferric carboxymaltose responded with a hemoglobin ( Hb ) increase of 2.0 g/dL or more ( 82 % vs. 62 % , 95 % confidence interval for treatment difference 12.2 - 28.3 , p < 0.001 ) , more achieved a 3.0 g/dL or more increase ( 53 % vs. 36 % , p < 0.001 ) , and more achieved correction ( Hb > or= 12 g/dL ) of anemia ( 73 % vs. 50 % , p < 0.001 ) . Patients treated with ferric carboxymaltose compared to those prescribed ferrous sulfate reported greater gains in vitality and physical function and experienced greater improvement in symptoms of fatigue ( p < 0.05 ) . There were no serious adverse drug events . CONCLUSIONS In patients with iron deficiency anemia due to heavy uterine bleeding , rapid IV administration of large doses of a new iron agent , ferric carboxymaltose , is more effective than oral iron therapy in correcting anemia , replenishing iron stores , and improving quality of life Levels of hepcidin , a major regulator of iron homeostasis , may identify patients with iron deficiency anemia ( IDA ) who will not respond to oral iron therapy . In this study , IDA patients underwent a 14‐day trial ( run‐in ) course of ferrous sulfate therapy . Nonresponders ( Hgb increase < 1 g/dL with 67 % compliance rate ) were r and omized to IV ferric carboxymaltose ( FCM ; two injections of 750 mg ) or further oral iron for 14 days . Screening hepcidin levels were 38.4 versus 11.3 ng/mL , P = 0.0002 in nonresponders versus responders to a trial of oral iron . Hepcidin of > 20 ng/mL , showed sensitivity of 41.3 % , specificity of 84.4 % , and positive predictive value of 81.6 % for predicting nonresponsiveness to oral iron . PPVs for ferritin > 30 ng/mL or transferrin saturation (TSAT)>15 % were 59.2 and 55 % , respectively . Negative predictive values for hepcidin , ferritin , and TSAT were 46.3 , 22.7 , and 19.7 , respectively . FCM versus oral iron showed Hgb increases of ≥1 gm/dL in 65.3 % versus 20.8 % ( P < 0.0001 ) and Hgb increases of 1.7 ± 1.3 versus 0.6 ± 0.9 g/dL ( P = 0.0025 ) , respectively . We conclude that hepcidin predicts nonresponsiveness to oral iron in patients with IDA and is superior to TSAT or ferritin for this purpose . Nonresponse  to oral iron therapy does not rule out IDA , since two‐thirds of patients subsequently responded to intravenous iron . Am . J. Hematol . 88:97–101 , 2013 . © 2012 Wiley Periodicals , Iron supplementation has been suggested as a strategy for prevention and treatment of iron deficiency ( ID ) and iron deficiency anemia ( IDA ) in many countries , but non-compliance of daily regimens and common dosage remain as major challenges . The aim of this study was to investigate the effects of low dose once weekly iron supplementation in adolescent girls . The study was design ed as a community-based , r and omized , supplementation trial . The initial sample consisted of 200 female high school students , aged 14–16 years old , of whom 193 students concluded the study . They were r and omly selected and assigned into either iron-supplemented group ( ISG ) or iron-unsupplemented group ( IUG ) . The ISG received 150 mg ferrous sulfate once weekly for 16 weeks , whereas the IUG received nothing .  Weight , height , and hematological parameters were measured and compared between the two groups before and after the intervention . There was no significant difference between the initial measures of the two groups before the intervention . After 16 weeks of intervention , mean of hemoglobin and serum ferritin improved significantly in ISG compared to IUG . At the beginning of the study , percent of anemia , IDA , and ID in ISG were 12.5 % , 8.3 % , and 30.2 % , whereas these figures for IUG in this period of study were 14.4 , 10.3 , and 38.2 , respectively , which were not significantly different between the two groups . However , percentages of the above items at the end of study in ISG were 2.1 % , 0 % , and 21.9 % , respectively . In contrast to IUG , all cases of IDA were abolished in the ISG . Our study showed that once weekly supplementation of 150 mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescents and effectively treated IDA . There is no need for higher dosage of iron for supplementation that may cause adverse effects and bear higher costs BACKGROUND & AIMS We investigated Helicobacter pylori ( H pylori)-infection as a cause of iron deficiency ( ID ) and iron-deficiency anemia ( IDA ) or treatment failure of iron supplementation . METHODS We r and omized 200 Hp-infected children ( positive urea breath test ) 2 - 5 years of age with IDA ( hemoglobin level < 110 g/L ; serum ferritin level < 12 microg/L ; and soluble transferrin receptor > 8.3 mg/L ) or ID ( serum ferritin level < 12 microg/L or soluble transferrin receptor level > 8.3 mg/L ) to 1 of 4 regimens : 2-week anti-Hp therapy ( amoxicillin , clarithromycin , and omeprazole ) plus 90-day oral ferrous sulfate ( anti-Hp plus iron ) , 2-week anti-Hp therapy alone , 90-day oral iron alone , or placebo .  Sixty noninfected children with IDA received iron treatment as negative control . RESULTS Hp-infected children receiving iron had significantly less frequent treatment failure compared with those with no iron in correcting IDA ( 11 % [ 95 % confidence interval ( CI ) , 2%-20 % ] for anti-Hp plus iron , 0 % for iron alone vs 33 % [ 95 % CI , 26%-46 % ] for anti-Hp and 45 % [ 95 % CI , 31%-59 % ] for placebo ; chi(2 ) = 127 ; P < .0001 ) , ID ( 19 % [ 95 % CI , 8%-30 % ] for anti-Hp plus iron , 7 % [ 95 % CI , 0%-14 % ] for iron alone vs 65 % [ 95 % CI , 52%-78 % ] for anti-Hp alone , and 78 % [ 95 % CI , 66%-90 % ] for placebo ; chi(2 ) = 124 ; P < .0001 ) , or anemia ( 34 % [ 95 % CI , 20%-40 % ] for anti-Hp plus iron , 27 % [ 95 % CI , 14%-40 % ] for iron alone vs 65 % [ 95 % CI , 52%-78 % ] for anti-Hp alone and 78 % [ 95 % CI , 66%-90 % ] for placebo ; chi(2 ) = 46 ; P < .0001 ) . Cure rates of IDA , ID , or anemia with iron were comparable with that of the negative control group . Improvements in iron status also were significantly greater in groups with iron . CONCLUSIONS H pylori is neither a cause of IDA/ID nor a reason for treatment failure of iron supplementation in young Bangladeshi children OBJECTIVES To compare the safety and efficacy of iron carboxymaltose with ferrous sulfate to treat iron deficiency anemia in the post partum . METHODS Patients were r and omized ( 2:1 ratio ) to receive iron carboxymaltose  ( up to 3 weekly doses of 1000 mg maximum , applied in 15 min ; n=227 ) or ferrous sulfate ( 100 mg twice daily , 12 weeks ; n=117 ) . Changes in hemoglobin and iron stores up to week 12 were analyzed . RESULTS Iron carboxymaltose was as effective as oral iron sulfate in changing hemoglobin , despite the much shorter treatment period ( 2 weeks vs 12 weeks ) . Ferritin levels were significantly higher . Except for injection site burning , iron carboxymaltose was better tolerated than ferrous sulfate , mainly concerning gastrointestinal side effects . There were no safety concerns identified in breast-fed infants . CONCLUSION Parenteral iron carboxymaltose is a safe and effective treatment option for postpartum anemia , with advantages of a shorter treatment period , better compliance , rapid normalization of iron storages , and lower incidence of gastrointestinal side effects In cancer patients mild-moderate non-chemotherapy-induced iron deficiency anemia ( IDA ) is usually treated with oral iron salts , mostly ferrous sulfate . In this study , we compare efficacy and toxicity of oral ferrous bisglycinate chelate and ferrous sulfate in cancer patients with mild IDA . Twenty-four patients operated on for solid tumors ( 10 breast , 12 colorectal , 2 gastric ) , aged 61±10 years ( range 45 - 75 ) , with non-chemotherapy-induced hemoglobin ( Hb ) values between 10 and 12 g/dL and ferritin lower than 30 ng/mL were r and omized to receive oral ferrous bisglycinate chelate , 28 mg per day for 20 days , and then 14 mg per day for 40 days ( 12 patients ) ( A group ) or oral ferrous sulphate , 105 mg per day for 60 days ( 12 patients ) ( B group ) . Values of hemoglobin and ferritin obtained at diagnosis , 1 and 2 months from the beginning of treatment were compared . Adverse events ( AEs ) related to the two treatments were recorded . In the 12 patients treated with ferrous bisglycinate chelate  , basal hemoglobin and ferritin values ( mean±SD ) were 11.6±0.8 g/dL and 16.1±8.0 ng/mL. After 2 months of treatment , they were 13.0±1.4 g/dL and 33.8±22.0 ng/mL , respectively ( P=0.0003 and P=0.020 ) . In the group treated with ferrous sulphate , hemoglobin and ferritin mean values were 11.3±0.6 g/dL and 19.0±6.4 ng/mL basally , and 12.7±0.70 g/dL and 40.8±28.1 ng/mL ( P<0.0001 and P=0.017 ) after 2 months of treatment . AEs occurred in six cases . In all these six cases , two ( 17 % ) treated with ferrous bisglycinate chelate and four ( 33 % ) with ferrous sulphate , toxicity was grade 1 . In conclusion , these data suggest that ferrous bisglycinate chelate has similar efficacy and likely lower GI toxicity than ferrous sulphate given at the conventional dose of 105 mg per day for the same time
Significantly less gastrointestinal side effects were reported with lactoferrin treatment .
No significant differences existed with regard to other outcomes .
In conclusion , for pregnant women with IDA , daily oral bovine lactoferrin is just as good as ferrous sulfate in improving hematological parameters with fewer gastrointestinal side effects .
This systematic review and meta- analysis aim ed to evaluate the efficacy of daily oral bovine lactoferrin versus daily oral ferrous iron preparations for treatment of iron deficiency anemia ( IDA ) during pregnancy .