Vitamin C has no role in improving Hb in patients with iron-deficiency anemia: JAMA
China: Addition of vitamin C supplements to iron supplementation does nothing to improve hemoglobin recovery and iron absorption in patients with iron-deficiency anemia (IDA), suggests a recent study in the journal JAMA Network Open.
Vitamin C has been routinely used with oral iron supplements for IDA patients but it remains uncertain whether vitamin C is essential or not. Nianyi Li, Department of Hematology, Huashan Hospital, Fudan University, Shanghai, China, and colleagues compared the equivalence and assessed the safety of oral iron supplements plus vitamin C or oral iron supplements alone in patients with IDA.
The study enrolled about 440 adult patients with newly diagnosed IDA -- hemoglobin level less than 13 g/dL for men, less than 12 g/dL for women. They were randomly assigned to receive 100-mg oral iron supplements with or without 200-mg vitamin C supplements every 8 hours.
Key findings of the study include:
- From baseline to the 2-week follow-up, the mean (SD) change in hemoglobin level was 2.00 g/dL in the oral iron supplements plus vitamin C group and 1.84 g/dL in the oral iron supplements–only group thus meeting the criteria for equivalence.
- The mean (SD) change in serum ferritin level from baseline to 8-week follow-up was 35.75 ng/mL in the vitamin C plus iron group and 34.48 ng/mL in the iron-only group.
- There were no significant differences between the 2 groups regarding the rates of adverse events (20.9% vs 20.5%).
- No patient withdrew because of adverse events.
"Among patients with IDA, oral iron supplements alone were equivalent to oral iron supplements plus vitamin C in improving hemoglobin recovery and iron absorption," wrote the authors.
"These findings suggest that on-demand vitamin C supplements are not essential to take along with oral iron supplements for patients with IDA," they concluded.
"The Efficacy and Safety of Vitamin C for Iron Supplementation in Adult Patients With Iron Deficiency Anemia: A Randomized Clinical Trial," is published in the journal JAMA Network Open.