ascorbic-acid and ferrous-fumarate

Iron (Fe) encapsulation has the potential to help overcome several major challenges in Fe fortification of foods. It may decrease unwanted sensory changes in fortified products and reduce interactions of Fe with food components that lower Fe bioavailability. However, the effect of encapsulation per se on Fe bioavailability is a concern. Rat studies comparing encapsulated ferrous sulfate, ferric ammonium citrate, and ferrous fumarate to non-encapsulated compounds indicate that a ratio of capsule:substrate of > or = 60:40 may decrease the relative bioavailability (RBV) of the Fe by approximately 20%. At a ratio of capsule:substrate of < or = 50:50, the RBV of encapsulated ferrous sulfate appears to be similar to ferrous sulfate. Even minor changes in capsule composition may influence Fe bioavailability. Encapsulated ferrous fumarate given with ascorbic acid as a complementary food supplement and encapsulated ferrous sulfate fortified into salt have been shown to be efficacious in anemic children. For salt fortification, further refinements in Fe capsule design are needed to increase resistance to moisture and abrasion, while maintaining bioavailability. Studies evaluating the potential efficacy of encapsulated Fe in staple cereals (wheat and maize flours) are needed. A potential barrier to use of encapsulated forms of Fe in staple food fortification is the relatively low melting point of the capsules, which may cause unwanted sensory changes during food preparation. Research and development efforts to improve the quality of coatings and their resistance to high temperatures are ongoing. Process costs for encapsulation can be high, and unless they can be reduced, may limit applications. Further research is needed to determine which encapsulation technologies are most effective in ensuring iron bioavailability from encapsulated compounds.

Topics: Animals; Ascorbic Acid; Biological Availability; Capsules; Cote d'Ivoire; Edible Grain; Ferric Compounds; Ferrous Compounds; Food, Fortified; Ghana; Humans; Iodine; Iron Compounds; Liposomes; Morocco; Quaternary Ammonium Compounds; Rats; Sodium Chloride, Dietary; Taste

Anaemia in young sub-Saharan African children may be due to the double burden of malaria and iron deficiency. Primary analysis of a double-blind, cluster randomized trial of iron containing micronutrient powder supplementation in Ghanaian children aged 6 to 35 months found no difference in malaria risk between intervention and placebo groups. Here, we performed a secondary analysis of the trial data to assess the impact of long-term prophylactic iron fortificant on the risk of iron deficiency and anaemia in trial subjects. This population-based randomized-cluster trial involved 1958 children aged between 6 to 35 months, identified at home and able to eat semi-solid foods. The intervention group (n = 967) received a daily dose containing 12.5 mg elemental iron (as ferrous fumarate), vitamin A (400 μg), ascorbic acid (30 mg) and zinc (5 mg). The placebo group (n = 991) received a similar micronutrient powder but without iron. Micronutrient powder was provided daily to both groups for 5 months. At baseline and endline, health assessment questionnaires were administered and blood samples collected for analysis. The two groups had similar baseline anthropometry, anaemia, iron status, demographic characteristics, and dietary intakes (p > 0.05). Of the 1904 (97.2%) children who remained at the end of the intervention, the intervention group had significantly higher haemoglobin (p = 0.0001) and serum ferritin (p = 0.0002) levels than the placebo group. Soluble transferrin receptor levels were more saturated among children from the iron group compared to non-iron group (p = 0.012). Anaemia status in the iron group improved compared to the placebo group (p = 0.03). Continued long-term routine use of micronutrient powder containing prophylactic iron reduced anaemia, iron deficiency and iron deficiency anaemia among pre-school children living in rural Ghana's malaria endemic area.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Child, Preschool; Dietary Supplements; Female; Ferrous Compounds; Ghana; Hemoglobins; Humans; Infant; Male; Placebo Effect; Trace Elements; Vitamin A; Vitamins; Zinc

Iron deficiency anemia has occurred more frequently in female than male regular blood donors. Iron supplement is necessary for maintaining the hemoglobin level. A combination with ascorbic acid increases the absorption of iron.. Compare the effect of ferrous fumarate 200 mg/day and the combination of ferrous fumarate 200 mg/day with ascorbic acid 100 mg/day and 500 mg/day on hemoglobin level and red blood cell indices in female regular blood donors.. Female regular blood donor volunteers were randomly divided into three equal groups to supplement with each regimen for one month. Hemoglobin (Hb), MCV, MCH, and MCHC before and after blood donation at 0.5, 1, 2, and 3 months, were compared.. Ninety-six volunteers were included and equally divided into three groups of 32 volunteers each. There were no significant differences between age, BMI, ABO blood group, Rh, Hb, MC, MCH, and MCHC before blood donation between each group (p > 0.05). The duration of recovery times of Hb to before blood donation levels in group I, II, and III being 2, 3, and 1 month, respectively were statistically significant difference (p < 0.001). The duration of recovery times of MCV, MCH, and MCHC to before blood donation levels in both group II and III were similar (0.5 months in every value), which was more rapid than in group I (> 3, 3, and 1 month, respectively) with statistically significant difference (p < 0.001). All three groups tolerated well. No participant withdrew from the present study because of side effects.. The present study shows that a combination of ferrous fumarate 200 mg and ascorbic acid 500 mg per day accelerates timing of hemoglobin and red blood cell indices in recovery to the level of before blood donation in female regular blood donors.

Topics: Adult; Ascorbic Acid; Blood Donors; Dietary Supplements; Female; Ferrous Compounds; Hemoglobins; Humans; Trace Elements

Ferrous fumarate is a common, inexpensive iron form increasingly used instead of ferrous sulfate as a food iron supplement. However, few data exist as to whether juices enhance iron absorption from ferrous fumarate.. We studied 21 children, ages 4.0 to 7.9 years using a randomized crossover design. Subjects consumed a small meal including a muffin containing 4 mg Fe as ferrous fumarate and either apple (no ascorbic acid) or orange juice (25 mg ascorbic acid). They were separately given a reference dose of Fe (ferrous sulfate) with ascorbic acid.. Iron absorption increased from 5.5% +/- 0.7% to 8.2% +/- 1.2%, P < 0.001 from the muffins given with orange juice compared with muffins given with apple juice. The absorption of ferrous fumarate given with orange juice and enhancement of absorption by the presence of juice were significantly positively related to height, weight, and age (P < 0.01 for each). Although iron absorption from ferrous fumarate given with apple juice was significantly inversely associated with the (log transformed) serum ferritin, the difference in absorption between juice types was not (P > 0.9).. These data demonstrate an overall benefit to iron absorption from ferrous fumarate provided with orange juice. The effect was age related such that in children older than 6 years of age, there was a nearly 2-fold increase in iron absorption from ferrous fumarate given with orange juice.

Topics: Ascorbic Acid; Beverages; Child; Child, Preschool; Citrus sinensis; Cross-Over Studies; Female; Ferritins; Ferrous Compounds; Fruit; Humans; Intestinal Absorption; Iron; Male; Malus; Plant Preparations

Non-water-soluble iron compounds have been reported to be less well absorbed than ferrous sulfate in young children, and concern has been raised about their usefulness as food fortificants.. The objective was to evaluate the usefulness of ferrous fumarate and ferric pyrophosphate, compared with ferrous sulfate, in maintaining hemoglobin concentrations >105 g/L in Bangladeshi children.. Two hundred thirty-five children aged 7-24 mo (hemoglobin >105 g/L) were randomly assigned in a double-blind study to receive an infant cereal fortified with ferrous fumarate, ferric pyrophosphate, or ferrous sulfate. One serving of cereal (9.3 mg Fe; molar ratio of ascorbic acid to iron of 3:1) was consumed per day, 6 d/wk, for 9 mo. Blood samples were drawn at 4.5 and 9 mo.. Raw data were reformatted, and a "time to event" was calculated that corresponded to reaching the following thresholds: hemoglobin <105 g/L, plasma ferritin <12 microg/L, or plasma C-reactive protein >10 mg/L at baseline, 4.5 mo, or 9 mo. Data were censored when children did not reach the threshold or were lost to follow-up. A Kaplan-Meier approach was used to compare the 3 groups. No statistically significant differences were observed for hemoglobin <105 g/L (P = 0.943), plasma ferritin <12 microg/L (P = 0.601), or plasma C-reactive protein >10 mg/L (P = 0.508).. Contrary to earlier concerns, these results do not indicate differences in usefulness between water-soluble and non-water-soluble iron compounds in maintaining hemoglobin concentrations and preventing iron deficiency. These data will be important in the development of food-fortification strategies to combat anemia and iron deficiency in highly vulnerable population groups.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Bangladesh; C-Reactive Protein; Child, Preschool; Diphosphates; Female; Ferritins; Ferrous Compounds; Food, Fortified; Hemoglobins; Humans; Infant; Iron; Iron, Dietary; Male; Trace Elements

Nutrient-nutrient interactions are an important consideration for any multiple-micronutrient formulation, including Sprinkles, a home-fortification strategy to control anemia. The objectives of this randomized controlled trial were as follows: 1) to compare the absorption of zinc at 2 doses given as Sprinkles; and 2) to examine the effect of zinc and ascorbic acid (AA) on iron absorption from Sprinkles. Seventy-five children aged 12-24 mo were randomly assigned to the following groups: 1) 5 mg of labeled zinc (67Zn) with 50 mg AA (LoZn group); b) 10 mg of labeled zinc (67Zn) with 50 mg AA (HiZn group); or 3) 5 mg zinc with no AA (control). All groups contained 30 mg of labeled iron (57Fe). Intravenous infusions labeled with 70Zn (LoZn and HiZn groups) and 58Fe (control) were administered. Blood was drawn at baseline, 48 h and 14 d later. The percentage of zinc absorbed did not differ between LoZn (geometric mean = 6.4%; min-max: 1.7-14.6) and HiZn (geometric mean = 7.5%; min-max: 3.3-18.0) groups. However, total zinc absorbed was significantly different between the LoZn (geometric mean = 0.31 mg; min-max: 0.08-0.73) and HiZn (geometric mean = 0.82 mg; min-max: 0.33-1.82) groups (P = 0.0004). Geometric mean percentage iron absorption values did not differ between the LoZn (5.9%; min-max: 0.8-21) and HiZn (4.4%; min-max: 0.6-12.3) groups and between the LoZn and control groups (5.0%; min-max: 1.4-24). We conclude that zinc in the form of Sprinkles has a low bioavailability, yet provides adequate amounts of absorbed zinc in young children, and that there is no effect of zinc or AA on iron absorption from the given formulations of Sprinkles.

Topics: Absorption; Ascorbic Acid; Biological Availability; Diet; Drug Compounding; Ferrous Compounds; Ghana; Gluconates; Hemoglobins; Humans; Infant; Infant Nutritional Physiological Phenomena; Iron Isotopes; Iron, Dietary; Zinc; Zinc Isotopes

Fe absorption is affected by many dietary factors. The objective of the present study was to measure the effects of high v. low content of vitamin C, meat and phytic acid in whole diets with Fe-fortified bread on the efficacy of Fe absorption. Thirty-two healthy women with low Fe stores were randomised to three groups, each of which was given two of six test diets containing either low/high amounts of vitamin C, meat or phytic acid, respectively, in a cross-over design. Each diet was served throughout a 5 d period. Fe-fortified rye bread, extrinsically labelled with (59)Fe, was given with all main meals. Fe absorption was determined from whole-body counter measurements of (59)Fe retention. The fractional non-haem Fe absorption (corrected to a 40 % standard absorption by measurements from the reference dose) was 1.9 % v. 3.4 % (P=0.04) for the low/high vitamin C diets, 3.0 % v. 3.5 % (P=0.58) on the low/high meat diets and 4.9 % v. 3.8 % (P=0.24) on the low/high phytic acid diet, respectively. The total Fe absorbed (geometric mean with standard error) varied from 0.43 (se 0.11) mg from the diet with lowest bioavailability to 1.09 (se 0.18) mg from the diet with highest bioavailability (P<0.001). The present whole-diet study indicates that diet composition is a strong predictor of Fe absorption. In the diet with a low content of enhancers and a high content of inhibitors, vitamin C improved non-haem Fe absorption. The total Fe absorption varied 2.5-fold after small alterations of the content of enhancers and inhibitors in the diet.

Topics: Absorption; Adult; Ascorbic Acid; Bread; Cross-Over Studies; Diet; Energy Intake; Female; Ferrous Compounds; Food, Fortified; Heme; Humans; Iron; Meat; Phytic Acid; Secale

Despite efforts to improve iron supplements for iron deficiency anemia, there is no consensus on products that balance efficacy, safety and tolerability, and cost. Ferrous products are effective, but they are associated with more gastrointestinal side effects than ferric products. Ferric products tend to have lower absorption. We present results from a 12-week study that randomized 72 people with uncomplicated iron deficiency anemia to receive a ferrous iron supplement (Ferall, a combination of ferrous fumarate with ascorbic acid, folic acid, and cyanocobalamin) or a ferric iron polysaccharide complex (Niferex, ferro-glycine sulfate) plus ascorbic acid. The ferrous product was significantly more effective, the primary and secondary endpoints including changes in levels of hemoglobin and serum ferritin. There was a slightly higher frequency of gastrointestinal side effects in patients taking the ferrous product, but both supplements were well tolerated. No participant withdrew from the study because of side effects. We concluded that the ferrous product is safe and effective for use in uncomplicated iron deficiency anemia. The lack of direct comparison between single-agent ferrous fumarate and the combination ferrous product limited interpretation of results in terms of possible effects due to other components, such as ascorbic acid.

Topics: Administration, Oral; Adult; Anemia, Iron-Deficiency; Ascorbic Acid; Female; Ferritins; Ferrous Compounds; Folic Acid; Hemoglobins; Humans; Intestinal Absorption; Iron; Iron, Dietary; Male; Middle Aged; Polysaccharides; Taiwan; Treatment Outcome

To compare the effectiveness of microencapsulated iron(II) fumarate sprinkles (with and without vitamin A), iron(II) sulfate drops, and placebo sprinkles in preventing recurrence of anaemia and to determine the long-term haematological outcomes in children at high risk of recurrence of anaemia 12 months after the end of supplementation.. A prospective, randomized, placebo-controlled design was used to study 437 Ghanaian children aged 8-20 months who were not anaemic (haemoglobin > or = 100 g/l). Four groups were given microencapsulated iron(II) fumarate sprinkles, microencapsulated iron(II) fumarate sprinkles with vitamin A, iron(II) sulfate drops or placebo sprinkles daily for six months. Primary outcome measures were change in haemoglobin and anaemic status at baseline and study end. Non-anaemic children at the end of the supplementation period were reassessed 12 months after supplementation ended.. Overall, 324 children completed the supplementation period. Among the four groups, no significant changes were seen in mean haemoglobin, ferritin or serum retinol values from baseline to the end of the supplementation period. During the trial, 82.4% (267/324) of children maintained their non-anaemic status. Sprinkles were well accepted without complications. At 12 months post-supplementation, 77.1% (162/210) of children with no intervention remained non-anaemic. This proportion was similar for children among the four groups.. In most children previously treated for anaemia, further supplementation was not needed to maintain their non-anaemic status. These results may have important implications for community intervention programmes in which initial high-dose treatment is needed because of a high prevalence of anaemia.

Topics: Administration, Oral; Anemia, Iron-Deficiency; Ascorbic Acid; Child, Preschool; Dietary Supplements; Ferrous Compounds; Ghana; Humans; Infant; Placebos; Prospective Studies; Risk Factors; Secondary Prevention

Ascorbic acid and Na2EDTA enhance Fe absorption from the water-soluble Fe compound FeSO4 but their effect on poorly water-soluble Fe compounds such as ferrous fumarate is less well established. In the present study, the effects of ascorbic acid and Na2EDTA on Fe absorption from ferrous fumarate were evaluated in adult women (ten women/study) from the erythrocyte incorporation of Fe stable isotopes ((57)Fe or (58)Fe) 14 d after administration. Two separate studies were made with test meals of Fe-fortified infant cereal (5 mg Fe/meal). Data were evaluated by paired t tests and the results are presented as geometric means. In study 1a, the comparison between Fe absorption from ferrous fumarate- and FeSO4-fortified cereal showed that adult women absorb Fe as well from ferrous fumarate as from FeSO4 (3.0 and 3.1 % respectively, P=0.85). After addition of Na2EDTA (Na2EDTA:fortification Fe molar ratio of 1:1), Fe absorption from FeSO4 was significantly higher than from ferrous fumarate (5.3 v. 3.3 % respectively, P<0.01; study 1b). In study 2, Fe absorption was compared from ferrous fumarate-fortified meals with and without ascorbic acid added at a 4:1 molar ratio (relative to fortification Fe) and the results showed that ascorbic acid increased Fe absorption from ferrous fumarate significantly (6.3 v. 10.4 %, P=0.02). The results of the present studies show that Fe absorption from ferrous fumarate is enhanced by ascorbic acid but not by Na2EDTA, thus emphasising that not all findings from Fe absorption studies made with FeSO4 can be extrapolated to Fe compounds with different solubility properties.

Topics: Adult; Ascorbic Acid; Edetic Acid; Female; Ferrous Compounds; Food Additives; Food, Fortified; Humans; Intestinal Absorption; Iron Isotopes; Iron, Dietary

Standard therapy for anemia in infants is ferrous sulfate drops administered 3 times/d. Adherence to treatment, however, is often poor. One likely reason for poor adherence is the unpleasant side effects associated with drops.. The objective was to evaluate the use of a new form of iron and a delivery system to treat anemia in infants that is likely to produce better adherence to treatment.. Using a prospective, randomized, controlled design, we studied 557 anemic children aged 6-18 mo (hemoglobin: 70-99 g/L) in rural Ghana. One group received a daily sachet of microencapsulated ferrous fumarate (80 mg elemental Fe) in powder form plus ascorbic acid to be sprinkled onto any complementary food eaten (sprinkles group); a control group received ferrous sulfate drops 3 times/d for 2 mo (total dose: 40 mg elemental Fe). Hemoglobin and serum ferritin concentrations were measured at baseline and at the end of treatment.. Successful treatment of anemia (hemoglobin > 100 g/L) occurred in 58% of the sprinkles group and in 56% of the drops group, with minimal side effects in both groups. Geometric mean ferritin concentrations increased significantly in each group from baseline to the end of treatment (P < 0.001).. Use of ferrous sulfate drops or a single daily dose of microencapsulated ferrous fumarate sprinkles plus ascorbic acid resulted in a similar rate of successful treatment of anemia without side effects. To our knowledge, this is the first demonstration of the use of microencapsulated iron sprinkles to treat anemia. Improved ease of use may favor the use of sprinkles to deliver iron.

Topics: Anemia, Iron-Deficiency; Ascorbic Acid; Drug Administration Schedule; Drug Compounding; Drug Therapy, Combination; Female; Ferritins; Ferrous Compounds; Ghana; Hemoglobins; Humans; Infant; Infant Food; Male; Patient Compliance; Prospective Studies; Rural Population; Weaning

Impaired uteroplacental perfusion has been shown to play a role in the pathogenesis of some complicated pregnancies with placenta insufficiency. Apart from this, lower oestrogen, magnesium and zinc are found in many of these conditions in the third trimester with placenta insufficiency. In this study, we examined the effect of a 4 mg intravenous dexamethasone injection on estriol, since maternal cortisol or synthetic corticosteroids cross the placental barrier and inhibit the release of dehydroepiandrostesone sulfate in the fetal adrenals. Dexamathasone was found to suppress estriol levels in all groups but a significant difference in suppression was found between the Chemiron--a new combination hematinic--and the control single iron therapy groups. Our preliminary results showed that Chemiron has a protective effect on the development of placenta insufficiency during the third trimester of pregnancy.

Topics: Adult; Anemia; Ascorbic Acid; Dexamethasone; Drug Combinations; Estriol; Female; Ferrous Compounds; Folic Acid; Hematinics; Humans; Magnesium Sulfate; Placental Insufficiency; Pregnancy; Pregnancy Tests; Pregnancy Trimester, Third; Vitamin B 12; Zinc Sulfate

An evaluation was made into the usefulness of ferrous fumarate as an iron fortificant for an experimental chocolate drink powder targetted to children and adolescents. Organoleptically ferrous furmarate was acceptable when the chocolate drink powder was reconstituted in milk or water that was heated to less than 80 degrees. Unacceptable colour changes occurred, however, when boiling milk or water were used. In human Fe absorption studies when the Fe compounds were added to the chocolate drink immediately before consumption, ferrous fumarate was 3.31% absorbed compared with 2.82% for ferrous sulphate and 2.11% for ferric pyrophosphate. When the Fe compounds were processed during the manufacture of the chocolate drink powder, the absorption of ferrous furmarate was 5.27%, ferrous sulphate 2.62% and ferric pyrophosphate 0.55%. Ascorbic acid had little or no effect on the absorption of ferrous furmarate. It is concluded that food processing can influence the relative absorption of fortification Fe and that, if not reconstituted with boiling milk or water, ferrous fumarate could be a useful compound for the fortification of chocolate drink powders.

Topics: Adolescent; Ascorbic Acid; Beverages; Biological Availability; Cacao; Child; Diphosphates; Ferrous Compounds; Food Handling; Food, Fortified; Humans; Intestinal Absorption; Iron; Iron Radioisotopes

Topics: Adult; Alopecia; Amines; Analgesics; Anemia, Iron-Deficiency; Ascorbic Acid; Cyclohexanecarboxylic Acids; Diagnosis, Differential; Drug Combinations; Female; Ferrous Compounds; Gabapentin; gamma-Aminobutyric Acid; Humans; Menorrhagia; Thyroid Diseases; Thyroid Function Tests

Restless legs syndrome is a common condition that results in difficulties falling and staying asleep and perception of poor sleep quality. We report a case of a 73-year-old woman with uncontrolled restless legs syndrome who spent most of the night standing and walking. As a result of her nighttime behaviors, she fell several times and sustained, on several separate occasions, fractures of both forearms, ribs, and nose. Iron replacement therapy and changing of her dopamine-agonist medications resulted in almost complete relief of symptoms. Physicians should be aware of the potential for injury in patients with uncontrolled RLS.

Topics: Accidental Falls; Aged; Ascorbic Acid; Continuous Positive Airway Pressure; Drug Therapy, Combination; Female; Ferrous Compounds; Fractures, Bone; Humans; Multiple Trauma; Restless Legs Syndrome; Trace Elements; Treatment Outcome

Factors affecting absorption of physiological doses of vitamin C in man have not been widely studied, partly because few suitable tools exist to distinguish recently absorbed vitamin C from endogenous vitamin. Stable isotope-labelled vitamin C provides such a tool. Fifteen healthy non-smoking subjects aged 26-59 years were studied. Each received 30 mg l-[1-(13)C]ascorbic acid orally on two occasions, 3-4 weeks apart. The ascorbate was given alone or with Fe (100 mg as ferrous fumarate) or with red grape juice, which is rich in polyphenols. Blood was collected at frequent intervals for 1 h, and then each hour for a further 3 h. Total concentration of vitamin C was measured fluorometrically and its (13)C-isotope enrichment was measured by GC-MS after conversion to volatile trimethylsilyl esters. Peak plasma enrichment occurred within 25-50 min. No kinetic variables were significantly altered by the iron fumarate supplement. Grape juice attenuated vitamin C absorption, reaching significance at the 20 min time point. There were weak correlations between isotope enrichment and body weight or endogenous ascorbate concentration. The increment in total plasma ascorbate was smaller if calculated from isotope enrichment than from vitamin C concentration increase. The dilution pool was much larger than the plasma ascorbate pool. Further studies are needed to resolve these paradoxes. Stable isotope-labelled ascorbate is potentially useful for measurement of vitamin C absorption by human subjects.

Topics: Absorption; Administration, Oral; Adult; Ascorbic Acid; Body Weight; Carbon Dioxide; Carbon Isotopes; Citrus paradisi; Dietary Supplements; Female; Ferrous Compounds; Humans; Male; Middle Aged

A 61-day short-term prospective study comparing the efficacy of Chemiron capsules (Ferrous Fumarate 300 mg, Folic Acid 5 mg, Vitamin B12 10 ug, Vitamin C 25 mg, Magnesium sulphate, 0.3 mg and Zinc Sulphate 0.3 mg) with conventional ferrous gluconate and folic acid administration has shown that both haematinic regimens improve haematological indices in normal pregnant women. A significant rise in haemoglobin was seen in the Chemiron group on days 5 and 19 whereas a significant increase in packed cell volume was observed on days 5, 19 and 61. There were no significant differences between the mean value of platelets during the therapy period in either group. A significant rise in the mean reticulocyte values could be demonstrated in the Chemiron group throughout the study period. This study further shows that Chemiron has a better haematological effect than Ferrous Gluconate at the dosage used.

Topics: Adolescent; Adult; Ascorbic Acid; Drug Combinations; Female; Ferrous Compounds; Folic Acid; Hematocrit; Hemoglobins; Humans; Iron; Magnesium Sulfate; Nigeria; Platelet Count; Pregnancy; Prospective Studies; Reticulocyte Count; Vitamin B 12; Zinc Sulfate

Topics: Ascorbic Acid; Diet; Diet Therapy; Ferrous Compounds; Folic Acid; Humans; Tissue Extracts; Vitamin B 12

Topics: Anemia; Anemia, Hypochromic; Ascorbic Acid; Ferrous Compounds; Fumarates; Hematologic Diseases; Humans; Iron