A REVIEW ON ORAL IRON SUPPLEMENTS AND IRON ABSORPTION PATHWAYS – SCIENTIFIC RATIONALE AND CLINICAL RELEVANCE

Downloads

Download the Article:

Authors

  • Udaya Kumar N Asso. Professor, Dept of Pharmaceutical Analysis & Chemistry, MB School of Pharmaceutical Sciences (Earst while Sree Vidyanikethan College of Pharmacy) Mohan Babu University, Sree Sainath Nagar, Rangampeta, Tirupati – 517102 Andhra Pradesh
  • Masuma S Pharm.D, Dept of Pharmaceutical Analysis & Chemistry, MB School of Pharmaceutical Sciences (Earst while Sree Vidyanikethan College of Pharmacy), Mohan Babu University, Sree Sainath Nagar, Rangampeta, Tirupati – 517102 Andhra Pradesh
  • Roopesh L Pharm.D, Dept of Pharmaceutical Analysis & Chemistry, MB School of Pharmaceutical Sciences (Earst while Sree Vidyanikethan College of Pharmacy), Mohan Babu University, Sree Sainath Nagar, Rangampeta, Tirupati – 517102 Andhra Pradesh
  • Gowtham C Pharm.D, Dept of Pharmaceutical Analysis & Chemistry, MB School of Pharmaceutical Sciences (Earst while Sree Vidyanikethan College of Pharmacy), Mohan Babu University, Sree Sainath Nagar, Rangampeta, Tirupati – 517102 Andhra Pradesh
  • Himani K Pharm.D, Dept of Pharmaceutical Analysis & Chemistry, MB School of Pharmaceutical Sciences (Earst while Sree Vidyanikethan College of Pharmacy), Mohan Babu University, Sree Sainath Nagar, Rangampeta, Tirupati – 517102 Andhra Pradesh
https://doi.org/10.55559/jjbrpac.v1i5.205

Keywords:

Iron, Ferrous salts, Ferric, Liposomal iron, Heme iron, Anemia, Hemoglobin

Abstract

Iron supplements are mainstay for prevention and management of anemia. Women, pregnant or not, in particular are vulnerable, and need regular clinical monitoring and care. A knowledge of different pathways of iron absorption and their regulation, helps in understanding the scientific rationale behind formulation, dosing, and response of different iron supplements. The amount of elemental iron, the absorption of the selected iron supplement, and the hemoglobin rise needed, are the parameters that help calculate the dosing amount and frequency. Conventional iron supplements like ferrous sulphate may be lower on cost with acceptable efficacy and therefore suitable for initiating therapy especially in low socio-economic strata, but gastrointestinal adverse effects are common, that may compromise response and compliance. Advanced formulations like liposomal iron have shown higher bioavailability and tolerability among iron supplements, maintaining at least comparable efficacy to conventional ferrous supplements, and therefore can be the treatment of choice to initiate therapy in those where cost is not a factor, or as a switch when tolerability, compliance, or rise in hemoglobin and ferritin with conventional iron supplements is not satisfactory. For heme iron, comparative clinical studies are yet to show clinical benefits over conventional ferrous supplements, however it can still serve as another option available when gastro-intestinal side effects like constipation, limit the effectiveness of conventional iron supplements.

References

Moustarah F, Daley SF. Dietary Iron. [Updated 2022 Oct 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK540969/

Worldwide prevalence of anaemia 1993-2005. WHO Global Database on Anaemia. [Updated 2020 Dec 9]. In: WHO [Internet]. Geneva, World Health Organization, 2008. Available from: https://www.who.int/publications/i/item/‌‌9789241596657

Sharif N, Das B, Alam A. Prevalence of anemia among reproductive women in different social group in India: Cross-sectional study using nationally representative data. PLoS One, 2023; 2, 18(2): e0281015.

Sharp P, Srai SK. Molecular mechanisms involved in intestinal iron absorption. World J Gastroenterol, 2007; 21, 13(35): 4716-24.

West AR, Oates PS. Mechanisms of heme iron absorption: current questions and controversies. World J Gastroenterol, 2008; 14, 14(26): 4101-10.

Mackenzie, K, Foot N, Anand S, Dalton HE, Chaudhary N, Collins BM et al. Regulation of the divalent metal ion transporter via membrane budding. Cell Discov, 2016; 2: 16011.

Garrick MD, Singleton ST, Vargas F, Kuo HC, Zhao L, Knöpfel M, Davidson T, Costa M, Paradkar P, Roth JA, Garrick LM. DMT1: which metals does it transport? Biol Res, 2006; 39(1): 79-85.

Conrad ME, Umbreit JN. Pathways of iron absorption. Blood Cells Mol Dis, 2002; 29: 336–355.

Umbreit JN, Conrad ME, Hainsworth LN, Simovich M. The ferrireductase paraferritin contains divalent metal transporter as well as mobilferrin. Am J Physiol Gastrointest Liver Physiol, 2002; 282: G534–G539.

Yeh KY, Yeh M, Mims L, Glass J. Iron feeding induces ferroportin 1 and hephaestin migration and interaction in rat duodenal epithelium. Am J Physiol Gastrointest Liver Physiol, 2009; 296(1): G55-65.

Sangkhae V, Nemeth E. Regulation of the Iron Homeostatic Hormone Hepcidin. Adv Nutr, 2017; 17, 8(1): 126-136.

Rishi G, Wallace DF, Subramaniam VN. Hepcidin: regulation of the master iron regulator. Biosci Rep, 2015; 31, 35(3): e00192.

Le Blanc S, Garrick MD, Arredondo M. Heme carrier protein 1 transports heme and is involved in heme-Fe metabolism. Am J Physiol Cell Physiol, 2012; 15, 302(12): C1780-5.

Gkouvatsos K, Papanikolaou G, Pantopoulos K. Regulation of iron transport and the role of transferrin. Biochim Biophys Acta, 2012; 1820(3): 188-202.

Mattu M, Fasano M, Spallarossa A, Bolognesi M, Ascenzi P. Hemopexin: The primary specific carrier of plasma heme. Biochemistry and Molecular Biology Education, 2002; 30(5): 332-335.

Stoffel NU, von Siebenthal HK, Moretti D, Zimmermann MB. Oral iron supplementation in iron-deficient women: How much and how often? Molecular Aspects of Medicine, 2020; 75: 100865.

Ward RJ, Crichton RR. Iron: Properties and Determination. Editor(s): Benjamin Caballero, Paul M. Finglas, Fidel Toldrá, Encyclopedia of Food and Health, Academic Press, 2016; 468-475.

Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med, 2008; 121(11): 943-8.

Lee H, Poon MC, Allan GM. Iron dosing frequency. Can Fam Physician, 2021; 67(6): 436.

Malhotra N, Kriplani A, Pal B, Bhat V, Swami O. Ferrous Ascorbate: Current Clinical Place of Therapy in the Management of Iron Deficiency Anemia. Journal of South Asian Federation of Obstetrics and Gynaecology, 2021; 10.5005/jp-journals-10006-1896.

Chavan S, Rana P, Tripathi R, Tekur U. Comparison of efficacy & safety of iron polymaltose complex & ferrous ascorbate with ferrous sulphate in pregnant women with iron-deficiency anaemia. Indian J Med Res, 2021; 154(1): 78-84.

Angadi E, Karandikar Y, Talathi M, Wagh G, Pandit V. Pharmacoeconomic Evaluation of Ferrous Ascorbate, Ferrous Fumarate and Iron Polymaltose Complex in 14 To 24.

Weeks of Gestation. International Journal of Health Sciences & Research, 2015; 5(11): 339-344.

Singhal SR, Kadian V, Singh S, Ghalaut VS. Comparison of Various Oral Iron Salts in the Treatment of Iron Deficiency Anemia. Indian Journal of Obstetrics and Gynaecology Research, 2015; 2(3): 155-158.

Santiago P. Ferrous versus ferric oral iron formulations for the treatment of iron deficiency: a clinical overview. Scientific World Journal, 2012; 2012: 846824.

Schmidt C, Allen S, Kopyt N, Pergola P. Iron Replacement Therapy with Oral Ferric Maltol: Review of the Evidence and Expert Opinion. J Clin Med, 2021; 28, 10(19): 4448.

Malhotra J, Garg R, Malhotra N, Agrawal P. Oral Liposomal Iron: A Treatment Proposal for Anemia. World J Anemia, 2017; 1(4): 1-6.

Baomiao D, Xiangzhou Y, Li L, Hualin Y. Evaluation of iron transport from ferrous glycinate liposomes using Caco-2 cell model. Afr Health Sci, 2017; 17(3): 933-941.

Piskin E, Cianciosi D, Gulec S, Tomas M, Capanoglu E. Iron Absorption: Factors, Limitations, and Improvement Methods. ACS Omega, 2022; 7, 24: 20441–20456.

Pleşea-Condratovici A, Pleşea-Condratovici C, Rosoga N, Nedelcu N. Efficacy and tolerability of a novel food supplement (Turbofer®) containing microencapsulated iron in liposomal form, in female iron deficiency anaemia. Progr Nutr, 2015; 17(3): 214-9.

Parisi F., Fusè, F., Brunetti, M., Mazzocco, M., Berti, C. and Cetin, I. Effects of Different Regimens of Iron Supplementation on Iron Status and Pregnancy Outcomes in a Cohort of Healthy Pregnant Women: A Randomized Control Trial. The Journal of Maternal-Fetal & Neonatal Medicine, 2017; 30: 1787-1792.

Guilio G, Fabio D, Giuseppe B, Bruno C. Liposomal Iron has an Anti-Inflammatory Effect and Is Better than Iron Sulfate in Correction of Anemia of Chronic Inflammatory Disease of Young Women. Poster P067 haematologica |, 2013; 98(s3). Presented at 18th Congress of the European Hematology Association. Available on https://www.artoi.it/wp- content/uploads/2013/11/Abstract_Giordano_Giulio2.pdf

Indriolo A, Ravelli P. Comparison between liposomial iron and ferrous sulfate in patients with iron deficiency anemia and inflammatory bowel disease. A pilot-controlled study. Papa Giovanni XXIII Hospital, Gastroenterology and Digestive Endoscopy Unit, Bergamo, Italy Background. Clinical Therapy and Observation, 2014; S289: P530.

Gómez-Ramírez S, Brilli E, Tarantino G, Muñoz M. Sucrosomial® Iron: A New Generation Iron for Improving Oral Supplementation. Pharmaceuticals (Basel), 2018; 4, 11(4): 97.

Narayanan V, Bhargava A. Real-World Efficacy and Tolerability of Heme Iron Polypeptide in Non-Pregnant and Pregnant Women with Iron Deficiency Anemia. International Journal of Medical Research and Health Sciences, 2018; 7(6): 50-56.

Narayanan V, Bhargava A. In Clinic Effectiveness of Heme Iron Polypeptide in Women with Iron Deficiency Anemia Nonresponsive or Noncompliant to Conventional Iron Supplements. Journal of Gynecology and Women’s Health, 2018; 11(5): JGWH.MS.ID.555822.

Moe S, Grill AK, Allan GM. Newer iron supplements for anemia. Can Fam Physician, 2019; 65(8): 556.

Published on: 13-12-2024

Also Available On

Note: Third-party indexing sometime takes time. Please wait one week or two for indexing. Validate this article's Schema Markup on Schema.org

How to Cite

Kumar, U., Masuma, S., Roopesh, L., Gowtham, C., & Himani, K. (2024). A REVIEW ON ORAL IRON SUPPLEMENTS AND IRON ABSORPTION PATHWAYS – SCIENTIFIC RATIONALE AND CLINICAL RELEVANCE. Jabirian Journal of Biointerface Research in Pharmaceutics and Applied Chemistry, 1(5), 11–15. https://doi.org/10.55559/jjbrpac.v1i5.205

Issue

Section

Research Article
2584-2536