July 25, 2012

Anemia Diagnosis Not Necessary to Recommend Iron for Fatigued Women

Can taking iron help menstruating women who feel tired but whose hemoglobin levels are in normal range?

A new study answers that question, finding that iron supplementation reduced fatigue by almost 50% in women up to 50 years old who are low in iron but not clinically anemic. The Swiss study was published recently in the Canadian Medical Association Journal.

"We found that iron supplementation for 12 weeks decreased fatigue by almost 50% from baseline, a significant difference of 19% compared with placebo, in menstruating iron-deficient nonanemic women with unexplained fatigue and ferritin levels below 50 ug/L," writes coauthor Dr. Bernard Favrat of the Department of Ambulatory Care and Community Medicine, University of Lausanne, Switzerland.

For the study, researchers recruited 198 menstruating women between the ages of 18 and 50 years from the practices of 44 primary care physicians in France in 2006. The women, who complained of fatigue and who had a ferritin level of less than 50 µg/L and hemoglobin greater than 12.0 g/dL, were randomly assigned to two groups in the double-blind trial. One received 80 mg of prolonged-release ferrous sulfate orally each day for 12 weeks; a placebo was administered to the other. Biological markers were measured at 6 and 12 weeks.

The study found that the mean score on the Current and Past Psychological scale for fatigue decreased by 47.7% in the iron group and by 28.8% in the placebo group (–18.9%, 95%CI –34.5 to –3.2; P = 0.02). No significant effects were noted on quality of life (P = 0.2), depression (P = 0.97), or anxiety (P = 0.5), however.

Compared to the group receiving a placebo, women receiving iron supplementation increased their hemoglobin (0.32 g/dL; P = 0.002) and ferritin (11.4 µg/L; P < 0.001) and decreased soluble transferrin receptor (–0.54 mg/L; P < 0.001) at 12 weeks.

“Iron supplementation should be considered for women with unexplained fatigue who have ferritin levels below 50 µg/L,” the authors conclude, recommending blood draws after 6 weeks of treatment.

U.S. Pharmacist Social Connect