Iron, A & Zinc

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Eur J Clin Nutr 1999 Feb;53(2):102-6

Treatment for iron deficiency anemia with a combined supplementation of iron, vitamin A and zinc in women of Dinajpur, Bangladesh.

Kolsteren P, Rahman SR, Hilderbrand K, Diniz A Institute of Tropical Medicine, Antwerp, Belgium.

OBJECTIVE: The study was set up to determine to what extent the addition of a supplement of vitamin A alone or in combination with zinc would improve standard iron treatment and correction of iron deficiency anemia. DESIGN: 216 non-pregnant anemic women of 15-45 years of age with hemoglobin levels < or = 100 g/l were randomly assigned to three treatment groups. One group (A) received iron alone, a second group (B) received iron and vitamin A, and a third group (C) received iron, vitamin A and zinc. Every woman was given one iron capsule per day for 60 days as FeSO4 containing 60 mg of elemental iron. In addition, groups B and C received 200,000 i.u. of vitamin A, given as a supervised dose, on the first day of the treatment after collection of the blood sample. Group C received one zinc tablet per day for 60 days as zinc gluconate containing 15 mg of elemental zinc. SETTING: The north-western part of Bangladesh in the urban slums of Dinajpur district between February and August 1995. SUBJECTS: To select women with a hemoglobin level of < or = 100 g/l, all the women of four randomly selected municipal slums of the district in the targeted age group (328) were invited to take part in the study. Blood samples were analyzed for hemoglobin, serum iron, total iron binding capacity (TIBC), ferritin, retinol and zinc. RESULTS: Out of the 328 women screened, 254 (77.5%) had a hemoglobin level < or = 100 g/l and 322 (98%) < or = 120 g/l. The three treatment schedules significantly increased hemoglobin levels and improved iron parameters, except for serum iron in the group who received iron alone. The group who received iron, vitamin A and zinc responded best with an increase in hemoglobin of 17.9 g/l as compared to the group receiving iron alone (13.4 g/l). Iron and vitamin A treatment gave an intermediate response of 15.9 g/l. However, these differences are only statistically significant only for the group who received iron, vitamin A and zinc and only for the increase in hemoglobin, P = 0.03. CONCLUSION: The results are suggestive that the addition of vitamin A and zinc to the treatment for anemia can increase hemoglobin levels more than with iron alone.

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