A comparison of the bioavailability of ferrous fumarate and ferrous sulfate in non-anemic Mexican women and children consuming a sweetened maize and milk drink

Harrington, Mary; Hotz, Christine; Zeder, Christophe; Polvo, G O; Villalpando, Salvador; Zimmermann, Michael; Walczyk, Thomas; Rivera‐Dommarco, Juan; Hurrell, Richard F.

doi:10.1038/ejcn.2010.185

Cited by 35 publications

(30 citation statements)

References 23 publications

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“…Previous studies have shown mixed results when comparing absorption of these two iron salts, with some reporting ferrous sulfate is better absorbed [12,31], while others report that the two are equally absorbed [32][33][34][35][36]. Results might differ due to differences in study population, the iron status of participants, the fortification levels or the nature of test meals provided by these studies.…”

Section: Discussionmentioning

confidence: 73%

Effect of Helicobacter pylori Infection on Iron Absorption in Asymptomatic Adults Consuming Wheat Flour Fortified with Iron and Zinc

Romaña

Pizarro

Diazgranados

et al. 2011

Biol Trace Elem Res

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Helicobacter pylori infection could impair iron absorption from fortified products. The objective of the study was to determine the effect of H. pylori infection on iron absorption from asymptomatic adults consuming wheat flour fortified with iron and zinc. The (13)C urea breath test was used to assess H. pylori infection. Twenty-four H. pylori-positive and 26 H. pylori-negative volunteers completed the study. On day 1, the subjects were randomized to receive for breakfast bread fortified with either ferrous sulfate and zinc sulfate or ferrous fumarate and zinc oxide. Bread fortified with ferrous sulfate was labeled with (59)Fe as sulfate, and bread fortified with ferrous fumarate was labeled with (55)Fe as fumarate. On day 3, they received the other type of bread, with the respective tracers. On days 18-23, a proton pump inhibitor was administered to all subjects. On day 24, all subjects received bread fortified with ferrous fumarate and zinc oxide labeled with (55)Fe as fumarate. H. pylori prevalence was 77.6%. The geometric mean (±1 SD) of iron absorption was significantly higher for ferrous sulfate than fumarate (6.9 ± 2.9% vs. 0.5 ± 3.5%, p < 0.001). The H. pylori-negative subjects absorbed significantly more iron from bread fortified with either ferrous sulfate (10.5 ± 3.1% vs. 4.4 ± 2.2%, p < 0.001) or ferrous fumarate (0.6 ± 3.9% vs. 0.4 ± 3.1%, p < 0.001). Iron absorption was not significantly different between groups after administration of a proton pump inhibitor (0.3 ± 3.3% vs. 0.3 ± 2.7%, p = 0.11). H. pylori infection has a negative effect on iron absorption in asymptomatic adults consuming iron- and zinc-fortified wheat flour.

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Section: Discussionmentioning

confidence: 73%

Effect of Helicobacter pylori Infection on Iron Absorption in Asymptomatic Adults Consuming Wheat Flour Fortified with Iron and Zinc

Romaña

Pizarro

Diazgranados

et al. 2011

Biol Trace Elem Res

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“…Due to lower solubility, ferric iron is less bioavailable than ferrous iron [64]. Ferrous fumarate, ferrous sulphate, and ferrous gluconate are the major types of ferrous iron supplements, with comparable bioavailability [65–67]. The estimated absorption rate of the ferrous salts was found to be 10–15%, without significant differences among the three major formulations, in a small RCT [68].…”

Section: Oral Iron Supplementationmentioning

confidence: 99%

Iron Therapy in Patients with Heart Failure and Iron Deficiency: Review of Iron Preparations for Practitioners

Drozd

Jankowska

Banasiak³

et al. 2016

Am J Cardiovasc Drugs

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In patients with heart failure (HF), iron deficiency (ID) correlates with decreased exercise capacity and poor health-related quality of life, and predicts worse outcomes. Both absolute (depleted iron stores) and functional (where iron is unavailable for dedicated tissues) ID can be easily evaluated in patients with HF using standard laboratory tests (assessment of serum ferritin and transferrin saturation). Intravenous iron therapy in iron-deficient patients with HF and reduced ejection fraction has been shown to alleviate HF symptoms and improve exercise capacity and quality of life. In this paper, we provide information on how to diagnose ID in HF. Further we discuss pros and cons of different iron preparations and discuss the results of major trials implementing iron supplementation in HF patients, in order to provide practical guidance for clinicians on how to manage ID in patients with HF.

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“…[22] In two studies comparing the absorption of ferrous sulfate and ferrous fumarate from fortified milk-based drinks, one study found that ferrous sulfate was better absorbed than ferrous fumarate,[23] while absorption of ferrous sulfate and ferrous fumarate did not differ significantly in the second study. [24] Given the significant effects that the type of salt may have on in vitro dissolution, ferrous sulfate-containing supplements such as Folifer® may therefore be a better choice for iron/folic acid supplementation in individuals at risk of iron/folate deficiencies, such as pregnant and lactating women.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Dissolution Profile of Two Commercially Available Iron Preparations

2012

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Background: Current scientific evidence indicates that anemia in pregnancy, regardless of severity, is associated with an increased risk of maternal and fetal mortality. There is little published information about the bioavailability and bioequivalence of formulations containing both iron and folic acid. However, in vitro dissolution studies can provide important information on the likely relative bioavailability of various formulations. Aim: The objective of our study was to compare the in vitro dissolution of two similar commercially available formulations of iron- and folic acid-containing supplements, Folifer® (Bialport — Produtos Farmacêuticos, S.A., Portugal) and Ferroliver® (SM Pharma c.a., Venezuela), in order to determine the in vitro availability of their iron content. Folifer® and Ferroliver® were chosen because they contained similar amounts of elemental iron.Methods: The amount of iron released from each tablet was evaluated over a 4-hour period in three dissolution media replicating gastric or intestinal juices with pH values ranging from 1.5 to 6.9. The samples were then titrated with a solution of cerium ammonium sulfate in order to calculate the amount of iron released in each specific pH condition. The percentage of dissolved iron was calculated as a cumulative frequency, using the percentage of dissolved iron at all timepoints. The dissolution similarity between the two commercially available formulations was evaluated using the f2 statistic formula.Results: During a 4-hour dissolution test, Folifer® released 59.4mg of iron compared with 48.5mg released by Ferroliver®. The value obtained for the similarity factor, an indicator of likely bioequivalence, was 41. Conclusion: These data suggest that Folifer® releases more iron than Ferroliver®, and that the two formulations are not equivalent in vitro. The superior dissolution of ferrous sulfate with Folifer® compared with ferrous fumarate in Ferroliver® might be responsible for the observed difference.

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A comparison of the bioavailability of ferrous fumarate and ferrous sulfate in non-anemic Mexican women and children consuming a sweetened maize and milk drink

Cited by 35 publications

References 23 publications

Effect of Helicobacter pylori Infection on Iron Absorption in Asymptomatic Adults Consuming Wheat Flour Fortified with Iron and Zinc

Effect of Helicobacter pylori Infection on Iron Absorption in Asymptomatic Adults Consuming Wheat Flour Fortified with Iron and Zinc

Iron Therapy in Patients with Heart Failure and Iron Deficiency: Review of Iron Preparations for Practitioners

In Vitro Dissolution Profile of Two Commercially Available Iron Preparations

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