Are we giving too much iron? Low-dose iron therapy is effective in octogenarians

Rimon, Ephraim; Kagansky, Nadya; Kagansky, Michael; Mechnick, Lora; Mashiah, Tony; Namir, Michael; Levy, Shmuel

doi:10.1016/j.amjmed.2005.01.065

Cited by 194 publications

(145 citation statements)

References 19 publications

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“…The ferrous state of iron accelerates lipid oxidation by breaking down hydrogen and lipid peroxides to reactive free radicals via the Fenton reaction. The presence of excessive free ferrous ion in the intestine results in abdominal discomfort due to nausea, vomiting, altered bowel motility and black stools (Rimon et al, 2005). This is due to the reaction of Fe 2+ with H 2 O 2 and O 2¯…”

Section: Antioxidant and Free Radical Scavenging Assaymentioning

confidence: 99%

Polarity of extracts and fractions of four Combretum (Combretaceae) species used to treat infections and gastrointestinal disorders in southern African traditional medicine has a major effect on different relevant in vitro activities

Ahmed

McGaw

Elgorashi

et al. 2014

Journal of Ethnopharmacology

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Graphical abstractPhenolic-enriched extracts of four Combretum species namely Combretum bracteosum, Combretum padoides, Combretum vendae and Combretum woodii used in South African traditional medicine to treat various ranges diseases were evaluated against some diarrhoeal aetiologies. All the crude extracts and their fractions of varied polarities had good antimicrobial (non-polar fractions) or good antioxidant (polar fractions) activity. The crude extract of all the plant species were cytotoxic to Vero cell lines but did not lead to COX enzyme inhibition. Phenolic-enriched extractsFour Combretum species traditionally used for treating infectious and gastrointestinal complications in southern Africa In vitro assays: antioxidant, anti-inflammation, antimicrobial, cytotoxicity AbstractEthnopharmacological importance: Infections and gastrointestinal (GIT) disorders such as diarrhoea causes many problems in human health and animal production. Many Combretum species are used in traditional medicine to treat various diseases by rural people in Africa and Asia. Much of the work done to date on some species to validate their ethnopharmacological use was on the non-polar or intermediate polarity components. Many species are yet to be studied against relevant disease parameters using more polar extracts. Aims:The polar components were extracted and fractionated by solvent-solvent fractionation to yield fractions of different polarities. The activity of these fractions on different parameters that could be involved in infectious and gastrointestinal track (GIT) disorders was investigated. The cytotoxic activities of the extracts were also determined to evaluate the potential of these extracts to combat diarrhoea in production animals. Materials and Methods:Phenolic-enriched leaf extracts of Combretum bracteosum (Cob), Combretum padoides (Cop), Combretum vendae (Cov) and Combretum woodii (Cow) were obtained by extracting with a mixture of 70% acetone acidified with 1% HCl and n-hexane. The extract was sequentially treated by solvent-solvent fractionation with dichloromethane, ethyl acetate, and butanol to yield fractions with a large variation in polarity. The phenolic constituents of the extracts and fractions were determined using standard procedures. The antioxidant activities were determined using various standard methods. The minimum inhibitory concentrations (MICs) of the crude extracts and fractions against four bacterial and three fungal strains were assessed with a microplate serial dilution method.Cyclooxygenase (COX) and lipoxygenase (LOX) enzyme inhibitory assays and cytotoxicity studies against Vero cells were also carried out.Result: Some of the fractions had much higher antioxidant activity than the positive controls. The average EC 50 values of the extracts for the DPPH and ABTS antioxidant assays were 0.21-12 µg/ml (Cop), 0.25-16 µg/ml (Cov), 0.33-9.41 µg/ml (Cow) and 4.97-85 µg/ml (Cob) respectively while the mean EC 50 values for the positive controls ascorbic acid and trolox were 1.28-1.51 and 1.02-1.19 ...

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Section: Antioxidant and Free Radical Scavenging Assaymentioning

confidence: 99%

Polarity of extracts and fractions of four Combretum (Combretaceae) species used to treat infections and gastrointestinal disorders in southern African traditional medicine has a major effect on different relevant in vitro activities

Ahmed

McGaw

Elgorashi

et al. 2014

Journal of Ethnopharmacology

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“…Fractional absorption can vary substantially between different compounds, but what is clear is that most AEs are related to the unabsorbed fraction. A small study in elderly (> 80 years) with IDA conducted more than 10 years ago, showed that two low-dose schedules (15 or 50 mg/day of elemental iron in form of liquid ferrous gluconate) were equally effective as high "traditional" dose (150 mg/day of elemental iron in form of ferrous calcium citrate tablets) [90]. Low-doses also resulted in significantly lower AEs [90].…”

Section: New Preparationsmentioning

confidence: 99%

“…A small study in elderly (> 80 years) with IDA conducted more than 10 years ago, showed that two low-dose schedules (15 or 50 mg/day of elemental iron in form of liquid ferrous gluconate) were equally effective as high "traditional" dose (150 mg/day of elemental iron in form of ferrous calcium citrate tablets) [90]. Low-doses also resulted in significantly lower AEs [90]. Overall, the new studies cited above, including those on alternate day regimen, suggest that it is time to reconsider our traditional way of giving oral iron.…”

Section: New Preparationsmentioning

confidence: 99%

Modern iron replacement therapy: clinical and pathophysiological insights

et al. 2017

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Iron deficiency, with or without anemia, is extremely frequent worldwide, representing a major public health problem. Iron replacement therapy dates back to the seventeenth century, and has progressed relatively slowly until recently. Both oral and intravenous traditional iron formulations are known to be far from ideal, mainly because of tolerability and safety issues, respectively. At the beginning of this century, the discovery of hepcidin/ferroportin axis has represented a turning point in the knowledge of the pathophysiology of iron metabolism disorders, ushering a new era. In the meantime, advances in the pharmaceutical technologies are producing newer iron formulations aimed at minimizing the problems inherent with traditional approaches. The pharmacokinetic of oral and parenteral iron is substantially different, and diversities have become even clearer in light of the hepcidin master role in regulating systemic iron homeostasis. Here we review how iron therapy is changing because of such important advances in both pathophysiology and pharmacology.

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“…3,5,7,13 Sabe-se que, quando se administram doses diárias menores que 60 mg de ferro elementar, a frequência e intensidade dos EA observados são similares entre sal ferroso e placebo. Desta forma, vários estudos clínicos utilizaram o sulfato ferroso em diferentes esquemas posológicos, como: 25 mg de ferro elementar uma vez por semana; 13 60 mg de ferro elementar uma vez por dia, duas vezes por semana ou uma vez por dia, diariamente; 15 60 mg de ferro elementar uma vez por semana ou uma vez por dia, diariamente; 16 e demonstraram claramente que a adesão ao tratamento é melhor quando se utilizam doses menores em intervalos maiores; entretanto, o sucesso terapêutico não é o esperado, ou o tempo necessário para se atingir o resultado esperado é bem mais demorado (semanas ou meses).…”

Section: Como Minimizar Os Eventos Adversos Dos Sais Ferrosos?unclassified

Tratamento da anemia ferropriva com ferro por via oral

Cançado¹,

Lobo²,

Friedrich³

2010

Rev. Bras. Hematol. Hemoter.

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IntroduçãoO tratamento da anemia ferropriva foi introduzido por Blaud, em 1832, com um composto cujo principal constituinte era o carbonato férrico. A "pílula de Blaud" permaneceu como pilar do tratamento da deficiência de ferro por mais de cem anos, até o aparecimento de novos compostos com ferro. 1O tratamento da anemia ferropriva consiste da orientação nutricional (tema específico abordado em outro artigo deste fascículo), administração por via oral ou parenteral de compostos com ferro e, eventualmente, transfusão de hemácias.A identificação e correção, quando possível, da causa -ou causas -que levaram à anemia, associadas à reposição do ferro, na dose correta e por tempo adequado, resultam, na maioria das vezes, na sua correção e, consequentemente, confirmam o diagnóstico.Tratar a anemia ferropriva sem identificar sua causa pode significar a perda da oportunidade de se diagnosticar

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Are we giving too much iron? Low-dose iron therapy is effective in octogenarians

Cited by 194 publications

References 19 publications

Polarity of extracts and fractions of four Combretum (Combretaceae) species used to treat infections and gastrointestinal disorders in southern African traditional medicine has a major effect on different relevant in vitro activities

Polarity of extracts and fractions of four Combretum (Combretaceae) species used to treat infections and gastrointestinal disorders in southern African traditional medicine has a major effect on different relevant in vitro activities

Modern iron replacement therapy: clinical and pathophysiological insights

Tratamento da anemia ferropriva com ferro por via oral

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