Oral iron supplementation leads to oxidative imbalance in anemic women: a prospective study.
OBJECTIVE
This study was aimed to assess the desirable and undesirable effects of iron (100 mg/day as ferrous sulphate) and folic acid (500 μg/day) supplementation in iron deficient anemic women.


METHODS
Iron and folic acid supplementations were given to 117 anemic women (mild = 55, moderate = 40, and severe = 22) and 60 age matched placebo treated (100 mg cane sugar) non-anemic controls for 100 days. Blood index values, oxidative stress parameters, antioxidant enzymes and vitamins were estimated as per standard protocols.


RESULTS
Haemoglobin (Hb) levels along with antioxidant enzymes, namely catalase, superoxide dismutase (SOD), glutathione reductase (GSH-Rd), reduced glutathione (GSH) and total antioxidant capacity (TAC) were found significantly increased (P < 0.01) in anemic women after treatment. However, the glutathione peroxidase (GSH-Px) and antioxidant vitamins A, C and E were found significantly decreased (P < 0.01) in all treated groups. Lipid peroxide levels (LPO), protein carbonyl (PC), conjugated dienes (CD), lipid hydroperoxide (LOOH) and oxidized glutathione (GSSG) levels were found significantly increased (P < 0.01) after oral iron supplementation groups. Moreover, undesirable side effects of iron supplementation were observed maximally in mild as compared with moderate and severe anemic groups, whereas nausea, vomiting, systemic reactions were negligible in all treated subjects.


CONCLUSIONS
Study found recommended dose of iron effective for improving Hb, but at the cost of increased oxidative stress (mild > moderate > severe). It is suggested that blind iron supplementation should be avoided and shall be provided on need basis.
Tiwari
Amit Kumar Mani
AK
Medical Elementology & Free Radical Biology Lab, Department of Biochemistry, C.S.M. Medical University, Lucknow-226003, India.
Mahdi
Abbas Ali
AA
Chandyan
Sudarshna
S
Zahra
Fatima
F
Godbole
Madan Mohan
MM
Jaiswar
Shyam Pyari
SP
Srivastava
Vinod Kumar
VK
Negi
Mahendra Pal Singh
MP
D000284:Administration, Oral; D000328:Adult; D000704:Analysis of Variance; D018798:Anemia, Iron-Deficiency / Q000628:therapy*; D000975:Antioxidants / Q000032:analysis; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D005978:Glutathione / Q000097:blood; D006397:Hematinics / Q000008:administration & dosage*; D006801:Humans; D019266:Iron, Dietary / Q000008:administration & dosage*; D018384:Oxidative Stress; D011446:Prospective Studies; D013482:Superoxide Dismutase / Q000097:blood; D055815:Young Adult
D000975:Antioxidants; D006397:Hematinics; D019266:Iron, Dietary; D005492:Folic Acid; D013482:Superoxide Dismutase; D005978:Glutathione