Iron Supplements May Help Fatigued Women
Women who experience unexplained fatigue, but who are not anemic may
benefit from iron supplementation.
However, the effect of any iron supplementation may be restricted to women
with low or borderline serum ferritin concentrations, reports Dr Bernard
Favrat and colleagues at the University of Lausanne, Switzerland. They
think their study is the first randomised clinical trial in women of
childbearing age to show that iron supplementation could have an effect on
fatigue in the absence of anaemia.
The clinicians point out that while the symptoms of fatigue are related to
iron deficiency anaemia, there is a lack of evidence for any association
between deficiency and tiredness in the absence of anaemia. Their
double-blind randomised placebo controlled trial was among 144 women aged
18 to 55, referred from 8 family practices. Seventy- five women were
assigned for 4 weeks to oral ferrous sulphate (80 mg/day of elemental iron
daily), and 69 women to placebo.
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Among the 136 women who completed the trial, most had a low serum ferritin
concentration, and it was less than 20 g/L in 69 (51%) of them. Mean age,
haemoglobin concentration, serum ferritin concentration, level of fatigue,
depression, and anxiety were similar in both groups at baseline, as well as
compliance in the trial.
The level of fatigue after one month decreased by - 1.82/6.37 points (29%)
in the iron group, compared with - 0.85/6.46 points (13%) in the placebo
group (difference 0.95 points).
Subgroups analysis showed that only women with ferritin concentrations of
less than 50 g/l improved with oral supplementation. 'This suggests that
iron deficiency could be present even with a 'normal' concentration of
serum ferritin, Dr Favrat and colleagues said.
"Indeed, the lower limit for serum ferritin concentration is controversial:
iron stores in the bone marrow may serve as a better indicator of iron
deficiency, they add. The lower reference limits for serum ferritin and
haemoglobin concentrations have been considered too low for women and it
has been suggested should be the same as for men."
BMJ 2003;326: 1124-1126.
British Medical Journal (BMJ)
By Harvey McConnell
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