ferrous-fumarate and ferrous-bisglycinate

Iron deficiency in pregnancy is a major public health problem that causes maternal complications. The objective of this randomized, controlled trial was to examine the bioavailability, efficacy, and safety of oral ferrous bisglycinate plus folinic acid supplementation in pregnant women with iron deficiency. Subjects (12−16 weeks of gestation, n = 120) were randomly allocated to receive oral iron as ferrous bisglycinate (equiv. iron 24 mg) in supplement form with folinic acid and multivitamins (test group, n = 60) or as ferrous fumarate (equiv. iron 66 mg iron, control group, n = 60) after breakfast daily. Iron absorption was assessed by measuring fasted serum iron levels at 1 and 2 h immediately after supplementation. Hematological biomarkers and iron status were assessed before intervention, and at 3 and 6 months. Side effects were monitored throughout the intervention. A significant increase in serum iron was seen in both groups (p < 0.001) during the bioavailability assessment; however, the test group increases were comparatively higher than the control values at each timepoint (p < 0.001). Similarly, both test and control groups demonstrated a statistically significant increases in hemoglobin (Hb) (p < 0.001), erythrocytes (p < 0.001), reticulocytes (p < 0.001), mean corpuscular volume (MCV) (p < 0.001), mean corpuscular hemoglobin (MCH) (p < 0.001), mean corpuscular hemoglobin concentration (MCHC) (p < 0.001), % transferrin saturation (p < 0.001), and ferritin (p < 0.001) at 3 and 6 months after supplementation. However, in all cases, the test group increases were numerically larger than the control group increases at each timepoint. The test intervention was also associated with significantly fewer reports of nausea, abdominal pain, bloating, constipation, or metallic taste (p < 0.001). In conclusion, ferrous bisglycinate with folinic acid as a multivitamin nutraceutical format is comparable to standard ferrous fumarate for the clinical management of iron deficiency during pregnancy, with comparatively better absorption, tolerability, and efficacy and with a lower elemental iron dosage.

Topics: Anemia, Iron-Deficiency; Biomarkers; Female; Ferrous Compounds; Glycine; Humans; Iron Deficiencies; Leucovorin; Pregnancy; Pregnancy Complications

Food fortification is one approach for addressing anemia, but information on program effectiveness is limited.. We evaluated the impact of Costa Rica's fortification program on anemia in women aged 15-45 y and children aged 1-7 y.. Reduced iron, an ineffective fortificant, was replaced by ferrous fumarate in wheat flour in 2002, and ferrous bisglycinate was added to maize flour in 1999 and to liquid and powdered milk in 2001. We used a one-group pretest-posttest design and national survey data from 1996 (baseline; 910 women, 965 children) and 2008-2009 (endline; 863 women, 403 children) to assess changes in iron deficiency (children only) and anemia. Data were also available for sentinel sites (1 urban, 1 rural) for 1999-2000 (405 women, 404 children) and 2008-2009 (474 women, 195 children), including 24-h recall data in children. Monitoring of fortification levels was routine.. Foods were fortified as mandated. Fortification provided about one-half the estimated average requirement for iron in children, mostly and equally through wheat flour and milk. Anemia was reduced in children and women in national and sentinel site comparisons. At the national level, anemia declined in children from 19.3% (95% CI: 16.8%, 21.8%) to 4.0% (95% CI: 2.1%, 5.9%) and in women from 18.4% (95% CI: 15.8%, 20.9%) to 10.2% (95% CI: 8.2%, 12.2%). In children, iron deficiency declined from 26.9% (95% CI: 21.1%, 32.7%) to 6.8% (95% CI: 4.2%, 9.3%), and iron deficiency anemia, which was 6.2% (95% CI: 3.0%, 9.3%) at baseline, could no longer be detected at the endline.. A plausible impact pathway suggests that fortification improved iron status and reduced anemia. Although unlikely in the Costa Rican context, other explanations cannot be excluded in a pre/post comparison.

Topics: Adolescent; Adult; Anemia, Iron-Deficiency; Animals; Child; Child, Preschool; Costa Rica; Female; Ferrous Compounds; Food, Fortified; Glycine; Hemoglobins; Humans; Infant; Iron, Dietary; Male; Mandatory Programs; Middle Aged; Nutrition Policy; Nutrition Surveys; Prevalence; Program Evaluation; Sentinel Surveillance; Young Adult

Determination of the iron state in commercially manufactured iron containing vitamins and dietary supplements is important for evaluation of pharmaceuticals quality. Mössbauer (nuclear gamma-resonance) spectroscopy was used for analyzing the iron state in commercial pharmaceutical products containing ferrous fumarate (FeC(4)H(2)O(4)), ferrous sulfate (FeSO(4)), ferrous bisglycinate chelate (Ferrochel) and ferrous iron (hydrolyzed protein chelate). Mössbauer parameters and the iron states were determined for iron compounds in the studied pharmaceuticals. Various ferric and ferrous impurities were found in all of the commercial products. The quantities of ferric impurities exceeded the FDA limitation of 2% in products containing ferrous fumarate. The quantities of ferric impurities exceeded 58% and 30% in products containing ferrous bisglycinate chelate and ferrous iron (hydrolyzed protein chelate), respectively. The presence of ferrous and ferric impurities was not related to the ageing of the vitamins and dietary supplements. Two pharmaceutical products contained major iron compounds, the Mössbauer parameters of which did not correspond to the ferrous fumarate or ferrous bisglycinate chelate claimed by the manufacturer.

Topics: Dietary Supplements; Drug Contamination; Ferrous Compounds; Glycine; Iron; Spectroscopy, Mossbauer; Vitamins