Fig 3. Effect of daily ferrous sulfate supplementation on the incidence of gastrointestinal side-effects and hemoglobin repletion in intravenous iron-controlled RCTs. Fig 4. Forest plot for the effect of daily ferrous sulfate supplementation on the incidence of gastrointestinal side-effects in pregnant women.
Individual gastrointestinal symptoms reported Thirty three of the 43 studies reported incidences of individual gastrointestinal symptoms Table 3. Fig 5.
Meta-regression analysis of the association between daily iron dose and the odds ratio of gastrointestinal side-effects. Discussion WHO considers IDA as one of the most expensive diseases in the world due to lost productivity and the sheer numbers of the population affected ca.
Conclusions In summary, our analyses show that: i ferrous sulfate causes significant gastrointestinal side-effects in adults in all the population groups investigated, with the caveat of potential biases associated with study blinding that are inherent to interventions with oral iron, as discussed above; ii the OR of side-effects in IBD is higher than in non-IBD and non-pregnant participants but overall numbers were small and significance not established; iii the pregnancy subgroup analysis revealed considerable heterogeneity; iv there is no evidence for dose effect; v there is no evidence that modified-release ferrous sulfate causes less side-effects than conventional gastric release ferrous sulfate.
DOCX Click here for additional data file. S1 File Figure A , Funnel plots of effect of daily ferrous sulfate supplementation on the incidence of gastrointestinal side-effects against standard error. PDF Click here for additional data file. Data Availability All relevant data are within the paper and its Supporting Information files.
References 1. WHO Global database on anaemia. Arch Dis Child 93 : Public Health Nutr 4 : — Br J Haematol : — Abdullah K, Kendzerska T, Shah P, Uleryk E, Parkin PC Efficacy of oral iron therapy in improving the developmental outcome of pre-school children with non-anaemic iron deficiency: a systematic review.
Public Health Nutr: 1— Gut 53 : — Inflamm Bowel Dis 13 : — Cook JD Diagnosis and management of iron-deficiency anaemia. Best Pract Res Clin Haematol 18 : — NHS GP prescribing data. Curr Med Res Opin 29 : — A double-blind study of different iron compounds in tablet form. Acta Med Scand Suppl : 3— PLoS One 7 : e Gut 60 : — Am J Clin Nutr 92 : — Cell Rep 2 : — Clinical Therapeutics 13 : — Journal of Obstetrics and Gynaecology 29 : — Acta medica Scandinavica Supplementum : 3— Br J Clin Res 4 : — Saha L, Pandhi P, Gopalan S, Malhotra S, Saha PK Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women.
Cad Saude Publica 25 : — Zaim M, Piselli L, Fioravant iP, Kanony-Truc C Efficacy and tolerability of a prolonged release ferrous sulphate formulation in iron deficiency anaemia: a non-inferiority controlled trial. Eur J Nutr 51 : — Scandinavian Journal of Gastroenterology 44 : — Scand J Gastroenterol 44 : — Santiago P Ferrous versus ferric oral iron formulations for the treatment of iron deficiency: a clinical overview.
Scientific World Journal : Z Gastroenterol 49 : — Nat Rev Gastroenterol Hepatol 7 : — Iranian Journal of Medical Sciences 33 : — Controlled Clinical Trials 7 : — BMJ : d BMJ : — Int J Epidemiol 31 : — Surgical infections 10 : 9— BMC Gastroenterol 14 : A double-blind, randomised, controlled trial of ferrous sulphate versus placebo.
J Bone Joint Surg Br 86 : 31— WHO The global burden of disease: update. Geneva: WHO; 1— p. Saha L, Pandhi P, Gopalan S, Malhotra S, Saha P Comparison of efficacy, tolerability, and cost of iron polymaltose complex with ferrous sulphate in the treatment of iron deficiency anemia in pregnant women. Carrier J, Aghdassi E, Cullen J, Allard JP Iron supplementation increases disease activity and vitamin E ameliorates the effect in rats with dextran sulfate sodium-induced colitis.
J Nutr : — Am J Clin Nutr 69 : — A prospective, community Cohort study. Am J Gastroenterol 98 : — Am J Manag Care 17 : e— Heading RC Prevalence of upper gastrointestinal symptoms in the general population: a systematic review. Scand J Gastroenterol Suppl : 3—8.
J Gastrointestin Liver Dis 18 : — Low-dose iron therapy is effective in octogenarians. Am J Med : — Pa Nurse 53 : 16— Liguori L Iron protein succinylate in the treatment of iron deficiency: controlled, double-blind, multicenter clinical trial on over 1, patients. Are any oral iron formulations better tolerated than ferrous sulfate? American Journal of Obstetrics and Gynecology : — Clin Nephrol 7 : 55— BMC Med 10 : 8 Vaucher P, Druais PL, Waldvogel S, Favrat B Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial.
CMAJ : — This can take up to 6 months. You can buy iron supplements without a prescription. Your doctor will give you directions on how much to take and for how long. Your doctor will also tell you whether you need any testing for iron levels. You may have other side effects or reactions not listed here.
Check the information that comes with your medicine. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems.
It's also a good idea to know your test results and keep a list of the medicines you take. Author: Healthwise Staff. Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional.
Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. It looks like your browser does not have JavaScript enabled. When the body does not get enough iron, it cannot produce enough red blood cells to keep itself healthy. This is called iron-deficiency anemia. Lack of iron can cause tiredness, shortness of breath, and decreased physical performance.
It also can increase the chance of a liver transplant patient getting infections. Ferrous sulfate uses include treating or preventing low levels of iron in the blood; it treats or prevents iron-deficiency anemia. Foods rich in iron include lean red meat, beans, nuts, asparagus, oatmeal, and dried peaches. Vitamin C can increase the absorption of iron, which can be found in citrus fruits and fresh vegetables.
Ferrous sulfate might be prescribed if your child is not able to maintain a healthy level of iron through diet alone after a liver transplant. Ferrous sulfate medication is taken by mouth. It is available in liquid form, as caplets, and as and mg tablets. Ferrous sulfate should be taken on an empty stomach and with water or fruit juice.
If your child misses a dose of ferrous sulfate, take it as soon as you or your child remembers. Do not double the dose to catch up. Keep tablets in a cool place. Bathroom medicine cabinets may be too warm and humid, which may cause the pills to fall apart. Keep iron supplements out of the reach of children. If your child swallows an iron pill, contact a poison control center right away.
Brittenham GM. Disorders of iron homeostasis: iron deficiency and overload. Hematology: Basic Principles and Practice. Philadelphia, PA: Elsevier; chap Silbermins D, Metjian A. In: Harward MP, ed. Medical Secrets. Updated by: David C.
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