fumarates and ferrous-sulfate

Anaemia is a condition where the number of red blood cells (and consequently their oxygen-carrying capacity) is insufficient to meet the body's physiologic needs. Fortification of wheat flour is deemed a useful strategy to reduce anaemia in populations.. To determine the benefits and harms of wheat flour fortification with iron alone or with other vitamins and minerals on anaemia, iron status and health-related outcomes in populations over two years of age.. We searched CENTRAL, MEDLINE, Embase, CINAHL, and other databases up to 4 September 2019.. We included cluster- or individually randomised controlled trials (RCT) carried out among the general population from any country aged two years and above. The interventions were fortification of wheat flour with iron alone or in combination with other micronutrients. Trials comparing any type of food item prepared from flour fortified with iron of any variety of wheat were included.. Two review authors independently screened the search results and assessed the eligibility of studies for inclusion, extracted data from included studies and assessed risk of bias. We followed Cochrane methods in this review.. Our search identified 3048 records, after removing duplicates. We included nine trials, involving 3166 participants, carried out in Bangladesh, Brazil, India, Kuwait, Phillipines, Sri Lanka and South Africa. The duration of interventions varied from 3 to 24 months. One study was carried out among adult women and one trial among both children and nonpregnant women. Most of the included trials were assessed as low or unclear risk of bias for key elements of selection, performance or reporting bias. Three trials used 41 mg to 60 mg iron/kg flour, two trials used less than 40 mg iron/kg and three trials used more than 60 mg iron/kg flour. One trial employed various iron levels based on type of iron used: 80 mg/kg for electrolytic and reduced iron and 40 mg/kg for ferrous fumarate. All included studies contributed data for the meta-analyses. Seven studies compared wheat flour fortified with iron alone versus unfortified wheat flour, three studies compared wheat flour fortified with iron in combination with other micronutrients versus unfortified wheat flour and two studies compared wheat flour fortified with iron in combination with other micronutrients versus fortified wheat flour with the same micronutrients (but not iron). No studies included a 'no intervention' comparison arm. None of the included trials reported any other adverse side effects (including constipation, nausea, vomiting, heartburn or diarrhoea). Wheat flour fortified with iron alone versus unfortified wheat flour (no micronutrients added) Wheat flour fortification with iron alone may have little or no effect on anaemia (risk ratio (RR) 0.81, 95% confidence interval (CI) 0.61 to 1.07; 5 studies; 2200 participants; low-certainty evidence). It probably makes little or no difference on iron deficiency (RR 0.43, 95% CI 0.17 to 1.07; 3 studies; 633 participants; moderate-certainty evidence) and we are uncertain about whether wheat flour fortified with iron increases haemoglobin concentrations by an average 3.30 (g/L) (95% CI 0.86 to 5.74; 7 studies; 2355 participants; very low-certainty evidence). No trials reported data on adverse effects in children, except for risk of infection or inflammation at the individual level. The intervention probably makes little or no difference to risk of Infection or inflammation at individual level as measured by C-reactive protein (CRP) (moderate-certainty evidence). Wheat flour fortified with iron in combination with other micronutrients versus unfortified wheat. Eating food items containing wheat flour fortified with iron alone may have little or no effect on anaemia and probably makes little or no difference in iron deficiency. We are uncertain on whether the intervention with wheat flour fortified with iron increases haemoglobin concentrations improve blood haemoglobin concentrations. Consuming food items prepared from wheat flour fortified with iron, in combination with other micronutrients, has little or no effect on anaemia, makes little or no difference to iron deficiency and may or may not improve haemoglobin concentrations. In comparison to fortified flour with micronutrients but no iron, wheat flour fortified with iron with other micronutrients, the effects on anaemia and iron deficiency are uncertain as certainty of the evidence has been assessed as very low. The intervention may make little or no difference to the average haemoglobin concentrations in the population. None of the included trials reported any other adverse side effects. The effects of this intervention on other health outcomes are unclear.

Topics: Adolescent; Adult; Anemia; Child; Child, Preschool; Edetic Acid; Female; Ferric Compounds; Ferrous Compounds; Flour; Food, Fortified; Fumarates; Hemoglobin A; Humans; Infant; Iron; Iron Deficiencies; Male; Micronutrients; Middle Aged; Randomized Controlled Trials as Topic; Triticum; Young Adult

The primary cause of anemia in dialysis patients is inadequate production of erythropoietin (EPO) by the dysfunctional kidneys. The EPO circulates in plasma and acts on erythroid progenitor cells in the bone marrow to produce red blood cells (RBCs). At the same time, chronic inflammatory diseases reduce the release of iron from storage sites, resulting in low transferrin saturation (Fe+ sat%). Anemia can cause fatigue and heart problems. Two main blood tests measure anemia: hemoglobin (Hb) measures the oxygen-carrying protein in RBCs, and Fe+ sat% measures Fe+ status in the bloodstream. The goal of anemia management is to maintain Hb levels at 11 - 12 g/dL and Fe+ sat% above 20%.

Topics: Adolescent; Adult; Anemia; Ferrous Compounds; Fumarates; Hemoglobins; Humans; Middle Aged; Peritoneal Dialysis; Transferrin; Young Adult

The effect of a pH change from 2 to 6 was tested on the solubility of ferrous sulfate, ferrous fumarate, iron bis-glycine chelate (Ferrochel) and sodium-iron ethylenediaminetetraacetic acid (NaFeEDTA). It was found that at pH 2 ferrous sulfate, Ferrochel and NaFeEDTA were completely soluble and only 75% of iron from ferrous fumarate was soluble. When pH was raised to 6, iron from amino acid chelate and NaFeEDTA remained completely soluble while solubility from ferrous sulfate and ferrous fumarate decreased 64 and 74%, respectively compared to the amount of iron initially soluble at pH 2. These results suggest that iron solubility from iron bis-glycine chelate and NaFeEDTA is not affected by pH changes within the ranges tested, probably because iron remained associated to the respective compounds.

Topics: Edetic Acid; Ferric Compounds; Ferrous Compounds; Food, Fortified; Fumarates; Glycine; Hydrogen-Ion Concentration; Iron Chelating Agents; Iron Compounds; Solubility

To understand the direct involvement of hydroxyl radical (.OH) in the modification of functional reactivity in isolated rabbit lingual artery ring preparations, this study was undertaken to examine the effect of .OH generated from dihydroxy fumarate (DHF) plus Fe(3+)-ADP or from H2O2 plus FeSO4. When vasodilators (acetylcholine and nitroglycerin) were given after the .OH-generating system was removed from the organ chamber, the earlier .OH exposure produced an attenuation of the ring relaxation induced by acetylcholine but not that by nitroglycerin. Moreover, the earlier .OH exposure attenuated caffeine-induced contraction and depressed the phasic response, but potently enhanced the tonic response of norepinephrine-induced contraction. Both the enhanced tonic response of KCl-induced contraction produced by earlier .OH exposure and norepinephrine-induced contraction was inhibited by nisoldipine. These results are consistent with the view that .OH radicals can potentiate the voltage-dependent influx of Ca. It is also postulated that .OH may damage sarcoplasmic reticulum (SR) function in the smooth muscle cells, thus reducing Ca release from the SR (this may be reflected by the attenuation of the phasic response), and may selectively attenuate endothelium-dependent relaxation as opposed to endothelium-independent relaxation.

Topics: Animals; Arteries; Caffeine; Endothelium, Vascular; Ferric Compounds; Ferrous Compounds; Fumarates; Hydrogen Peroxide; Hydroxyl Radical; In Vitro Techniques; Male; Muscle Contraction; Muscle Relaxation; Muscle, Smooth, Vascular; Nisoldipine; Norepinephrine; Rabbits; Sarcoplasmic Reticulum; Tongue; Vasodilator Agents

Ferrous fumarate (Fersamal) and ferrous carbonate (Ferrodic) may produce false-positive results with the orthotolidine tablet tests (Occultest and Hematest) if administered to patients being investigated for alimentary bleeding. Misleading results are also likely if the benzidine test is employed as a filter-paper procedure. Ferrous sulphate, gluconate, succinate, iron and ammonium citrate, and other preparations of iron have no influence on the modern tablet tests for occult alimentary bleeding.

Topics: Blood Chemical Analysis; Clinical Laboratory Techniques; Ferrous Compounds; Fumarates; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Iron; Occult Blood; Pharmacology