Vitamin C Has No Role In Improving Hb In Patients With Iron-
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It remains uncertain whether vitamin C routinely used with oral iron supplements is essential for patients with iron deficiency anemia (IDA).

The objective of this study was to compare the equivalence and assess the safety of oral iron supplements plus vitamin C or oral iron supplements alone in patients with IDA.

This single-center, open-label, equivalence randomized clinical trial included adult patients with newly diagnosed IDA were enrolled. Participants were randomly assigned (1:1) to the oral iron supplements plus vitamin C group or the oral iron supplements–only group. Patients were randomized to receive a 100-mg oral iron tablet plus 200 mg of vitamin C or a 100-mg iron tablet alone every 8 hours daily for 3 months.

The primary outcome was the change in hemoglobin level from baseline to 2 weeks of treatment, and an equivalence margin of 1 g/dL in hemoglobin was chosen for the demonstration of comparable efficacy. Secondary outcomes included the change in the reticulocyte percentage after 2 weeks of treatment, the increase in hemoglobin level after 4 weeks of treatment, the increase in serum ferritin level after 8 weeks of treatment, and adverse events.

Results:
-- Among the 440 randomized patients, from baseline to the 2-week follow-up, the mean (SD) change in hemoglobin level was 2.00 (1.08) g/dL in the oral iron supplements plus vitamin C group and 1.84 (0.97) g/dL in the oral iron supplements–only group.

-- The mean change in serum ferritin level from baseline to 8-week follow-up was 35.75 ng/mL in the vitamin C plus iron group and 34.48 ng/mL in the iron-only group.

-- There were no significant differences between the 2 groups regarding the rates of adverse events. No patient withdrew because of adverse events.

Conclusively, among patients with IDA, oral iron supplements alone were equivalent to oral iron supplements plus vitamin C in improving hemoglobin recovery and iron absorption. These findings suggest that on-demand vitamin C supplements are not essential to take along with oral iron supplements for patients with IDA.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772395
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