Iron (Ferrous Bisglycinate)

CONTEXT: Iron deficiency and anemia have serious consequences, especially for children and pregnant women. Iron salts are commonly provided as oral supplements to prevent and treat iron deficiency, despite poor bioavailability and frequently reported adverse side effects. Ferrous bisglycinate is a novel amino acid iron chelate that is thought to be more bioavailable and associated with fewer gastrointestinal (GI) adverse events as compared with iron salts. OBJECTIVE: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the effects of ferrous bisglycinate supplementation compared with other iron supplements on hemoglobin and ferritin concentrations and GI adverse events. DATA SOURCES: A systematic search of electronic databases and grey literature was performed up to July 17, 2020, yielding 17 RCTs that reported hemoglobin or ferritin concentrations following at least 4 weeks' supplementation of ferrous bisglycinate compared with other iron supplements in any dose or frequency. DATA EXTRACTION: Random-effects meta-analyses were conducted among trials of pregnant women (n = 9) and children (n = 4); pooled estimates were expressed as standardized mean differences (SMDs). Incidence rate ratios (IRRs) were estimated for GI adverse events, using Poisson generalized linear mixed-effects models. The remaining trials in other populations (n = 4; men and nonpregnant women) were qualitatively evaluated. DATA ANALYSIS: Compared with other iron supplements, supplementation with ferrous bisglycinate for 4-20 weeks resulted in higher hemoglobin concentrations in pregnant women (SMD, 0.54 g/dL; 95% confidence interval [CI], 0.15-0.94; P < 0.01) and fewer reported GI adverse events (IRR, 0.36; 95%CI, 0.17-0.76; P < 0.01). We observed a non-significant trend for higher ferritin concentrations in pregnant women supplemented with ferrous bisglycinate. No significant differences in hemoglobin or ferritin concentrations were detected among children. CONCLUSION: Ferrous bisglycinate shows some benefit over other iron supplements in increasing hemoglobin concentration and reducing GI adverse events among pregnant women. More trials are

BACKGROUND: Iron deficiency in women of reproductive age can have severe adverse perinatal consequences. Although iron supplementation can be effective at treating iron deficiency, excess unabsorbed iron in the gut may also promote colonization by enteropathogens such as Group B Streptococcus (GBS), increasing the potential risk of maternal and neonatal infection. OBJECTIVES: We examined whether 12 wk of supplementation with 18 mg elemental iron as ferrous bisglycinate, 60 mg as ferrous sulfate, or a placebo differentially influences GBS colonization in Cambodian women of reproductive age. METHODS: This study is a secondary analysis of a randomized controlled trial conducted in 25 villages in 3 districts of Kampong Thom province, Cambodia, including 144 nonpregnant women (18‒45 y) who received 18 mg of elemental iron as ferrous bisglycinate, 60 mg ferrous sulfate, or placebo for 12 wk. GBS colonization was assessed by real-time quantitative polymerase chain reaction targeting the cfb gene (which encodes the Christie-Atkins-Munch-Peterson [CAMP] factor, an indicator of GBS colonization) from stool collected at baseline and 12 wk. Cycle threshold values were compared within and across groups using Kruskal-Wallis and Wilcoxon signed-rank tests. RESULTS: No changes in cfb expression were detected between baseline and endline within any treatment arm, nor were there differences across groups at 12 wk. However, regional differences in cfb expression were detected, with participants from the Srayov district exhibiting lower baseline and endline expression, than those from Prey Kuy and Tboung Krapeu. CONCLUSIONS: Oral iron supplementation for 12 wk did not increase cfb expression in this population of predominantly iron-replete Cambodian women, compared with placebo. However, the observed geographic variation in cfb expression across districts suggests that environmental or behavioral factors may contribute to GBS colonization risk. These findings highlight the need to further investigate region-specific risk factors and provide a foundation for future research into GBS screening in Cambodia. This trial was registered at clinicaltrials.gov as NCT04017598.

BACKGROUND: Regular blood donation is associated with an increased risk of iron deficiency and anaemia. Oral iron supplementation is known to shorten post-donation iron recovery time and could serve as an alternative to extended donation intervals. We aimed to evaluate the effect of different iron supplementation protocols on ferritin and haemoglobin levels, gastrointestinal side-effects, iron deficiency-related symptoms, and donor return compared with placebo supplementation. METHODS: In this double-blind, randomised, placebo-controlled trial conducted at seven of Sanquin's blood donation centres in The Netherlands, donors aged 18-80 years with ferritin levels equal to or less than 30 μg/L were randomly allocated to one of six study groups, using block randomisation in equal numbers by sex and age. Donors were instructed to adhere to a ferrous bisglycinate supplementation protocol for 56 days, taking capsules containing 0 mg (placebo), 30 mg, or 60 mg of elemental iron, either daily or on alternate days. The primary outcomes were presence of iron deficiency (<15 μg/L), low ferritin (15-30 μg/L), and low haemoglobin (≤135 g/L for male donors and ≤125 g/L for female donors) at 56 days' follow-up. Analyses were conducted using an intention-to-treat approach. This trial is registered in the Dutch trial registry (NL7328.018.20) and is complete. FINDINGS: Between Aug 1, 2021, and Jan 15, 2023, 830 donors (464 [56%] female donors and 366 [44%] male donors; 789 [95%] of Dutch origin and 26 [3%] of non-Dutch origin) had low ferritin and were included in the trial. At 56 days, 55 (51%) of 108 participants in the placebo daily group, 58 (49%) of 119 participants in the placebo alternate day group, 11 (10%) of 107 participants in the 30 mg daily group, eight (7%) of 112 participants in the 30 mg alternate day group, one (1%) of 114 participants in the 60 mg daily group, and four (4%) of 110 participants in the 60 mg alternate day group presented with iron deficiency. Compared with daily placebo, all iron supplementation groups exhibited similar significantly lower odds of iron deficiency at 56 days, with odds ratios (ORs) of 0·62 (95% CI 0·56-0·68) for 30 mg daily, 0·63 (0

Background: Many pregnant women are reluctant to follow the recommendation concerning oral iron prophylaxis due to concerns about gastrointestinal (GI) side effects. Objective: To assess the frequency of GI complaints during low-dose oral iron prophylaxis and compare three iron formulas in equipotent doses: ferrous fumarate versus ferrous bisglycinate versus ferrous sulphate, in healthy women with an uncomplicated single pregnancy. Methods: Results from two randomized, double-blind studies are reported: the Gentofte study comprising 404 women allocated into four groups taking 20, 40, 60, and 80 mg of elemental iron as ferrous fumarate/day and the Naestved study comprising 78 women allocated into two groups: 25 mg of elemental iron as ferrous bisglycinate/day and 50 mg of elemental iron as ferrous sulphate/day between meals from 15 to 19 weeks of gestation to delivery. GI complaints (nausea, vomiting, epigastric pain/pyrosis, belching, meteorism, borborygmi, intestinal colic, flatulence, loose stools, constipation, and use of laxatives), as well as black stools, were recorded by interview at the time of inclusion and at regular intervals during gestation. Results: At inclusion, the frequency of total combined GI complaints in all women (n = 482) was 21%. The Gentofte study showed that in the groups taking 20-60 mg iron/day as fumarate, there was no association between the iron dose and the frequency of GI side effects. An iron dose of 80 mg as fumarate was associated with significantly higher frequencies of constipation and the use of laxatives. Comparing the three equipotent doses of iron formulas, which can prevent iron deficiency, ferrous bisglycinate 25 mg iron had the most favourable GI side effect profile, while ferrous fumarate 40 mg iron and ferrous sulphate 50 mg iron had higher but similar GI side effect profiles. The frequency of black stools increased with the iron dose. Ferrous bisglycinate 25 mg iron had a lower frequency of black stools (8%) than ferrous fumarate 40 mg iron (22%) and ferrous sulphate 50 mg iron (31%). Conclusion: Low-dose iron supplementation appears to have no clinically significant GI side effects, as none of the included women p

BACKGROUND: Global guidelines recommend untargeted iron supplementation for women in regions of anemia prevalence ≥40%, such as Cambodia. However, the potential harms of untargeted iron on the gut have not been rigorously studied in women and likely vary depending on iron dose and form. OBJECTIVES: We investigated if a lower dose of a highly bioavailable iron amino acid chelate was as effective as the standard dose of iron salts in increasing ferritin concentrations and whether any differences were observed in gut inflammation or enteropathogen detection. METHODS: A double-blind, randomized placebo-controlled noninferiority trial was conducted in Cambodia. Nonpregnant women (n = 480, 18-45 y) were randomly assigned to 60-mg ferrous sulfate, 18-mg ferrous bisglycinate, or placebo for 12 wk. Nonfasting blood and stool specimens were collected at baseline and 12 wk. Ferritin and fecal calprotectin were measured with an ELISA. A molecular assay was used to detect 11 enteropathogens in a random subset of n = 100 women. Generalized linear mixed-effects models were used to estimate the adjusted mean difference in ferritin concentrations at 12 wk (primary outcome), as compared with our 'a priori' noninferiority margin of 20 μg/L. RESULTS: Baseline anemia and iron deficiency prevalence was low (17% and 6%, respectively). The adjusted mean difference in ferritin concentrations between the iron groups was 14.6 (95% confidence interval [CI]: 7.6, 21.6) μg/L. Mean ferritin concentration at 12 wk was higher in the ferrous sulfate (99 [95% CI: 95, 103] μg/L, P < 0.001) than in ferrous bisglycinate (84 [95% CI: 80, 88] μg/L) and placebo groups (78 [95% CI: 74, 82] μg/L). No differences in fecal calprotectin concentrations or enteropathogen detection were observed across groups at 12 wk. CONCLUSIONS: Ferrous bisglycinate (18-mg) was not as effective as ferrous sulfate (60-mg) in increasing ferritin concentrations and did not differentially influence biomarkers of gut health in this predominantly iron-replete population of Cambodian women. This trial was registered at clinicaltrials.gov registry as NCT04017598.

The World Health Organization recommends untargeted iron supplementation for women of reproductive age (WRA) in countries where anemia prevalence is greater than 40%, such as Cambodia. Iron supplements, however, often have poor bioavailability, so the majority remains unabsorbed in the colon. The gut houses many iron-dependent bacterial enteropathogens; thus, providing iron to individuals may be more harmful than helpful. We examined the effects of two oral iron supplements with differing bioavailability on the gut microbiomes in Cambodian WRA. This study is a secondary analysis of a double-blind, randomized controlled trial of oral iron supplementation in Cambodian WRA. For 12 weeks, participants received ferrous sulfate, ferrous bisglycinate, or placebo. Participants provided stool samples at baseline and 12 weeks. A subset of stool samples (n = 172), representing the three groups, were randomly selected for gut microbial analysis by 16S rRNA gene sequencing and targeted real-time PCR (qPCR). At baseline, 1% of women had iron-deficiency anemia. The most abundant gut phyla were Bacteroidota (45.7%) and Firmicutes (42.1%). Iron supplementation did not alter gut microbial diversity. Ferrous bisglycinate increased the relative abundance of Enterobacteriaceae, and there was a trend towards an increase in the relative abundance of Escherichia-Shigella. qPCR detected an increase in the enteropathogenic Escherichia coli (EPEC) virulence gene, bfpA, in the group that received ferrous sulfate. Thus, iron supplementation did not affect overall gut bacterial diversity in predominantly iron-replete Cambodian WRA, however, evidence does suggest an increase in relative abundance within the broad family Enterobacteriaceae associated with ferrous bisglycinate use. IMPORTANCE To the best of our knowledge, this is the first published study to characterize the effects of oral iron supplementation on the gut microbiomes of Cambodian WRA. Our study found that iron supplementation with ferrous bisglycinate increases the relative abundance of Enterobacteriaceae, which is a family of bacteria that includes many Gram-negative enteric pathogens like Salmonella, Shigella, and Escherichia

Iron deficiency in pregnancy is a major public health problem that causes maternal complications. The objective of this randomized, controlled trial was to examine the bioavailability, efficacy, and safety of oral ferrous bisglycinate plus folinic acid supplementation in pregnant women with iron deficiency. Subjects (12−16 weeks of gestation, n = 120) were randomly allocated to receive oral iron as ferrous bisglycinate (equiv. iron 24 mg) in supplement form with folinic acid and multivitamins (test group, n = 60) or as ferrous fumarate (equiv. iron 66 mg iron, control group, n = 60) after breakfast daily. Iron absorption was assessed by measuring fasted serum iron levels at 1 and 2 h immediately after supplementation. Hematological biomarkers and iron status were assessed before intervention, and at 3 and 6 months. Side effects were monitored throughout the intervention. A significant increase in serum iron was seen in both groups (p < 0.001) during the bioavailability assessment; however, the test group increases were comparatively higher than the control values at each timepoint (p < 0.001). Similarly, both test and control groups demonstrated a statistically significant increases in hemoglobin (Hb) (p < 0.001), erythrocytes (p < 0.001), reticulocytes (p < 0.001), mean corpuscular volume (MCV) (p < 0.001), mean corpuscular hemoglobin (MCH) (p < 0.001), mean corpuscular hemoglobin concentration (MCHC) (p < 0.001), % transferrin saturation (p < 0.001), and ferritin (p < 0.001) at 3 and 6 months after supplementation. However, in all cases, the test group increases were numerically larger than the control group increases at each timepoint. The test intervention was also associated with significantly fewer reports of nausea, abdominal pain, bloating, constipation, or metallic taste (p < 0.001). In conclusion, ferrous bisglycinate with folinic acid as a multivitamin nutraceutical format is comparable to standard ferrous fumarate for the clinical management of iron deficiency during pregnancy, with comparatively better absorption, tolerability, and efficacy and with a lower elemental iron dosage.

BACKGROUND: Compared with infant cereals based on refined grains, an infant cereal containing whole grains (WGs) and pulses with adequate amounts of ascorbic acid to protect against absorption inhibitors could be a healthier source of well-absorbed iron. However, iron absorption from such cereals is uncertain. OBJECTIVE: We measured iron bioavailability from ferrous fumarate (Fefum) added to commercial infant cereals containing 1) refined wheat flour (reference meal), 2) WG wheat and lentil flour (WG-wheat-lentil), 3) WG wheat and chickpea flour (WG-wheat-chickpeas), and 4) WG oat flour (WG-oat) and from ferrous bisglycinate (FeBG) added to the same oat-based cereal (WG-oat-FeBG). METHODS: In a prospective, single-blinded randomized crossover study, 6- to 14-mo-old Malawian children (n = 30) consumed 25-g servings of all 5 test meals containing 2.25 mg stable isotope-labeled iron and 13.5 mg ascorbic acid. Fractional iron absorption (FIA) was assessed by erythrocyte incorporation of isotopes after 14 d. Comparisons were made using linear mixed models. RESULTS: Seventy percent of the children were anemic and 67% were iron deficient. Geometric mean FIA percentages (-SD, +SD) from the cereals were as follows: 1) refined wheat, 12.1 (4.8, 30.6); 2) WG-wheat-lentil, 15.8 (6.6, 37.6); 3) WG-wheat-chickpeas, 12.8 (5.5, 29.8); and 4) WG-oat, 9.2 (3.9, 21.5) and 7.4 (2.9, 18.9) from WG-oat-FeBG. Meal predicted FIA (P ≤ 0.001), whereas in pairwise comparisons, only WG-oat-FeBG was significantly different compared with the refined wheat meal (P = 0.02). In addition, FIAs from WG-wheat-lentil and WG-wheat-chickpeas were significantly higher than from WG-oat (P = 0.002 and P = 0.04, respectively) and WG-oat-FeBG (P < 0.001 and P = 0.004, respectively). CONCLUSION: In Malawian children, when given with ascorbic acid at a molar ratio of 2:1, iron bioavailability from Fefum-fortified infant cereals containing WG wheat and pulses is ≈13-15%, whereas that from FeBG- and Fefum-fortified infant cereals based on WG oats is ≈7-9%. © The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.

Iron deficiency remains a major global health problem affecting an estimated 2 billion people. The World Health Organization ranked it as the seventh most important preventable risk for disease, disability, and death in 2002. Since an important factor in its causation is the poor bioavailability of iron in the cereal-based diets of many developing countries, SUSTAIN set up a Task Force, consisting of nutritional, medical, industry, and government experts to consider strategies for enhancing the absorption of fortification iron. This paper summarizes the findings of this Task Force. Detailed reviews of each strategy follow this overview. Highly soluble compounds of iron like ferrous sulfate are desirable food fortificants but cannot be used in many food vehicles because of sensory issues. Thus, potentially less well-absorbed forms of iron commonly are used in food fortification. The bioavailability of iron fortificants can, however, be enhanced with innovative ingredient technologies. Ascorbic acid, NaFeEDTA, ferrous bisglycinate, and dephytinization all enhance the absorption of fortification iron, but add to the overall costs of fortification. While all strategies cannot be recommended for all food fortification vehicles, individual strategies can be recommended for specific foods. For example, the addition of ascorbic acid is appropriate for dry blended foods such as infant foods and other dry products made for reconstitution that are packaged, stored, and prepared in a way that maximizes retention of this vitamin. NaFeEDTA can be recommended for fortification of fish sauce and soy sauce, whereas amino acid chelates may be more useful in milk products and beverages. With further development, dephytinization may be possible for low-cost, cereal-based complementary foods in developing countries. Encapsulation of iron salts in lipid coatings, while not an iron absorption-enhancing strategy per se, can prevent soluble forms of iron from interacting undesirably with some food vehicles and hence broaden the application of some fortificants. Research relevant to each of these strategies for enhancing the bioavailability or utility of iron food fortificants is reviewe

INTRODUCTION: The WHO recommends daily oral iron supplementation for 12 weeks in women and adolescents where anaemia prevalence is greater than 40%. However, if iron deficiency is not a major cause of anaemia, then, at best, untargeted iron supplementation is a waste of resources; at worst, it could cause harm. Further, different forms of iron with varying bioavailability may present greater risks of harm. METHODS AND ANALYSIS: A 12-week three-arm, double-blind, randomised controlled supplementation trial was conducted in Cambodia to determine if there is potential harm associated with untargeted iron supplementation. We will recruit and randomise 480 non-pregnant women (ages 18-45 years) to receive one of three interventions: 60 mg elemental iron as ferrous sulfate (the standard, commonly used form), 18 mg ferrous bisglycinate (a highly bioavailable iron amino acid chelate) or placebo. We will measure ferritin concentrations (to evaluate non-inferiority between the two forms of iron), as well as markers of potential harm in blood and stool (faecal calprotectin, gut pathogen abundance and DNA damage) at baseline and 12 weeks. Mixed-effects generalised linear models will be used to assess the effect of iron on ferritin concentration and markers of potential harm at 12 weeks. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of British Columbia Clinical Research Ethics Board (H18-02610), the Children's and Women's Health Centre of British Columbia Research Ethics Board (H18-02610) and the National Ethics Committee for Health Research in Cambodia (273-NECHR). Findings will be published in peer-reviewed journals, presented to stakeholders and policymakers globally and shared within participants' communities. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT04017598). © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Iron deficiency is a major global health concern, particularly in inflammation-related anemia (IRA), where iron absorption and mobilization are impaired. Liposomal encapsulation may help enhance the bioavailability and efficacy of iron supplements. This study aimed to evaluate the therapeutic efficacy of orally administered liposomal iron bisglycinate hydrochloride (LIBH), compared to free iron bisglycinate hydrochloride (FIBH), in restoring serum iron levels in a mouse model of lipopolysaccharide (LPS)-induced anemia of inflammation (LIAI). Male C57BL/6 mice received intraperitoneal LPS (5 mg/kg) to induce LIAI and were simultaneously treated with either FIBH or LIBH (1 mg/kg, oral). Liposomes (150-200 nm) exhibited high encapsulation efficiency (93%) and stability (-38 to -45 mV zeta potential). Serum iron levels were measured 24 hours post-treatment. LPS administration significantly reduced serum iron levels. LIBH restored serum iron levels by 35 - 65% compared to baseline (p < 0.005), outperforming FIBH (0 - 16%, p = NS). Electron microscopy confirmed the structural integrity of LIBH liposomes. It seems that LIBH supplementation significantly improves serum iron levels in LIAI and may represent a superior alternative to traditional free iron therapy, particularly in inflammatory conditions. Further studies are warranted to assess its efficacy in other models of anemia.

Iron deficiency anaemia is a global health issue affecting millions of people. Though effective, conventional iron sources used for supplementation often cause gastrointestinal side effects. This preclinical study evaluated the efficacy and tolerability of three iron supplements-ferrous bisglycinate, LIPOFER™ microcapsules (Def-LFe1), and a commercially available microencapsulated iron pyrophosphate (Def-Fe2)-in reversing diet-induced iron deficiency in rats compared to FeSO4. The study included three phases: (a) First, animals underwent a 24-day iron depletion period; (b) then, animals were exposed to a 21-day repletion period, receiving treatments at a human-equivalent dose of 80 mg of elemental iron; and (c) finally, to evaluate gastrointestinal tolerability, animals were supplemented with each treatment for 9 weeks. All supplements reversed iron deficiency within 14 days without adverse gastrointestinal effects. However, based on the decrease in TIBC and transferrin levels, coupled with the higher haemoglobin levels, Def-LFe1 demonstrated a higher absorption rate than Def-Fe2. In addition, the group supplemented with LIPOFER™ showed higher feed efficiency, especially compared to the control and FeSO4 groups. FeSO4 increased IL-6 gene expression in the colon, while Def-LFe1 did not. These findings highlight LIPOFER™ as a promising alternative to conventional iron supplementation. Further studies should be conducted to clarify these issues. © 2025. The Author(s).

BACKGROUND: Alopecia areata and seborrheic dermatitis are inflammatory skin disorders that can be chronic and are often influenced by immune dysregulation, micronutrient deficiencies, and an imbalanced gut-skin axis. Conventional therapies offer symptomatic relief but fail to address root causes, leading to frequent relapse. Emerging evidence supports the use of functional nutrition and integrative strategies to modulate immune responses and restore skin and hair health. CASE PRESENTATION: A 21-year-old male with a known diagnosis of alopecia areata since 2021 presented with patchy hair loss affecting the scalp, eyebrows, and body hair, along with newly worsening seborrheic dermatitis. He also reported chronic mouth and tongue ulcers, persistent fatigue, bloating, constipation, severe dry skin, acne, and restless sleep. His hair loss symptoms intensified following the COVID-19 vaccination. His blood parameters revealed elevated homocysteine, low vitamin D, high ferritin, elevated fasting and postprandial insulin levels, and dysregulated iron saturation. A three-month personalized functional nutrition protocol was initiated, including an anti-inflammatory elimination diet, nutraceuticals, and topical applications. DISCUSSION: Repeat laboratory analysis revealed significant improvements in homocysteine, vitamin D, insulin, and sugar levels, with improved iron saturation. Clinically, the patient experienced visible regrowth of eyebrow hair, reduced scalp flaking and itching, fewer ulcers, better digestion, improved skin texture, and enhanced energy levels. He also gained weight and established a healthier sleep pattern. CONCLUSION: This case illustrates how a root-cause-focused functional nutrition protocol c

Background Telogen effluvium (TE) is a non-scarring form of diffuse hair loss characterized by premature transition of hair follicles into the telogen phase, resulting in excessive shedding. Iron deficiency, reflected by low serum ferritin levels, is considered a potential contributor to TE in women. Aim The aim of this study was to evaluate serum ferritin levels in female patients with TE and compare them with controls. Methods A cross-sectional comparative study was conducted involving 100 female participants - 50 diagnosed with TE and 50 healthy controls. Serum ferritin and hemoglobin levels were measured in both groups. Demographic, lifestyle, hormonal, and clinical variables were recorded to account for potential confounders. Data analysis was performed using SPSS version 20.0 (IBM Inc., Armonk, New York), employing independent t-tests for continuous variables and Chi-squared tests for categorical variables. Results Mean serum ferritin levels were significantly lower in TE cases (24.30 ± 11.13 ng/mL) compared to controls (44.78 ± 19.89 ng/mL; p<0.001). Reduced ferritin levels (<15 ng/mL) were observed in 14 (28%) TE cases, while none of the controls exhibited such deficiencies. Additionally, 31 (62%) TE cases demonstrated significant hair shedding, with a positive hair pull test in the same proportion. Conclusion Low serum ferritin levels are significantly associated with telogen effluvium in women. Serum ferritin may serve as a useful biomarker for identifying iron deficiency in patients presenting with diffuse hair loss.

INTRODUCTION: Alopecia and iron deficiency are significant public health issues in northern Sudan, and no research about this topic has been conducted. The aim is to examine the prevalence of iron deficiency and alopecia and associated factors among adolescents in northern Sudan. METHODS: A cross-sectional study was conducted through a questionnaire and clinical examination. RESULTS: A total of 312 adolescents participated: 147 males (47.1%) and 165 females (52.9%). Among them, 21.2% of adolescents exhibited alopecia. Females experienced higher rates of alopecia, with 93.9% affected compared to 6.1% of males. Serum ferritin was significantly lower in adolescents with alopecia compared to those without it (6.05 [2.58‒12.63] vs. 9.40 [4.88‒23.40] μg/l, p = 0.002). Multivariate analysis indicated that iron deficiency (adjusted odds ratio [AOR] = 1.97, 95% confidence interval [CI] = 1.04-3.71) was associated with alopecia. However, age, body mass index, and parental education level showed no association. Among the adolescents with alopecia, 27.3% had patchy alopecia, 37.9% had diffuse alopecia, and 34.8% had traction alopecia. CONCLUSION: There is a significant prevalence of adolescent alopecia, predominantly among females. Iron deficiency was a key factor associated with alopecia, underscoring the importance of nutritional monitoring in this population.

Androgenetic alopecia (AGA) is a common hair loss condition. Iron deficiency contributes to hair loss; and sleep disorders, particularly obstructive sleep apnea (OSA), have systemic effects, especially hypoxia OSA-induced that links hair loss with iron metabolism. The study aimed to investigate how iron markers relate to OSA severity in AGA. Data from the 4th edition of the São Paulo Epidemiological Sleep Study (EPISONO) were analysed. Participants self-reported AGA, underwent polysomnography, and provided blood samples. Propensity score matching (PSM) was used to control for age, sex, and metabolic syndrome. From 769 participants, 747 self-reported AGA status; 81 were enrolled in the AGA group (17 women and 64 men) and 666 in the Non-AGA group (423 women and 243 men). After PSM, 160 individuals (80 matched pairs) were retained, including 34 women (n = 17 per group) and 126 men (n = 63 per group). In the AGA group, serum iron was significantly correlated with the apnea-hypopnea index (AHI) in both sexes, particularly in women. Ferritin levels were positively associated with AHI and desaturation index in women. Serum iron was negatively correlated with the desaturation index in men. In Non-AGA men, transferrin was positively correlated with AHI and negatively correlated with sleep efficiency. These associations remained significant even after PSM. In conclusion, serum components of iron metabolism, particularly iron and ferritin

BACKGROUND: Iron deficiency, the most widespread micronutrient deficiency globally, is especially common among women and seriously impacts their health considerably. The symptom spectrum in non-anemic iron deficiency (NAID) is less well described than in anemic forms. The aim of this study was to demonstrate the diversity and frequency of symptoms in NAID and compare with anemic cases and explore the association of symptoms with biomarkers. METHODS: This retrospective and cross-sectional study was conducted on female patients at a university hospital. Patients admitted to the iron deficiency outpatient clinic between March 2021 and August 2022 were analyzed. Patients aged 18 years and older with iron deficiency (ferritin < 30 mcg/L) were included. Iron parameters, hemoglobin levels, and symptoms were included into the dataset, and these independent variables were compared between patient groups categorized as NAID and iron deficiency anemia (IDA). RESULTS: The study sample consisted of 239 patients. The frequencies of IDA and NAID were 70.3% (n = 168) and 29.7% (n = 71), respectively. Forty-one distinct symptoms or symptom groups were documented, ranging from neuropsychiatric to gastrointestinal manifestations. The mean number of symptoms per person was 16.5 (7.03). The top ten most common symptoms were weakness (87.03%), fatigue (82.43%), easy fatigability (78.66%), amnesia (72.38%), feeling cold (71.55%), alopecia (70.29%), cold intolerance (69.04%), sleep problems (66.53%), nervosity (63.18%), and cold foot (59.83%). The IDA group had more diverse symptoms than the NAID group (P <.05). Most of the forty-one symptoms or symptom groups w

OBJECTIVE: Telogen effluvium, the most common cause of diffuse and non-scarring alopecia in women, is frequently diagnosed in dermatology outpatient clinics and can be caused by various etiological factors such as medications, trauma, emotional, and physiological stress. In patients presenting with complaints of telogen effluvium, we aimed to investigate abnormal levels of serum ferritin, vitamin B12, folic acid, thyroid function tests, and hemoglobin and determine which of these abnormal values might be significantly associated with telogen effluvium. MATERIAL AND METHODS: In this study, 2851 female patients diagnosed with telogen effluvium who applied to the Dicle University Dermatology outpatient clinic between January 1, 2010 and June 30, 2024 were retrospectively evaluated. The relationship between these laboratory abnormalities and telogen effluvium, as well as their significance in different age groups, was analyzed using the SPSS-27.0 program. Associations were analyzed using Kolmogorov-Smirnov test, dependent t-test, Wilcoxon test, Pearson chi-square (χ2) test, Yates chi-square (χ2) test, Fisher chi-square (χ2) test analysis, Mc-Nemar test, Pearson/spearman correlation analysis, and logistic regression analysis. A p value of < 0.05 was considered statistically significant. RESULTS: The mean age of 2851 female patients included in our study was 26.33 years, 12.8% (n = 366) were under 18 years of age, 83.5% (n = 2380) were between 18 and 45 years of age, and 3.7% (n = 105) were over 45 years of age. Hemoglobin values were determined in 2496 of 2851 patients and values below the reference range were found in 317 patients (11.1%). Ferritin was found to be low in 1123 (46.5%) of 2413 patients. Vitamin 12 deficiency was detected in 1

BACKGROUND: Androgenetic alopecia (AGA) is a multifactorial disorder expressed by several genes and various environmental factors apart from nutritional and endocrinological factors. Although association of iron deficiency (ID) as well as thyroid disorder has been evaluated in females, this is still an untouched topic as far as male pattern hair loss (MPHL) is concerned. This study tries to establish if any association of MPHL with ID and thyroid dysfunction. MATERIALS AND METHODS: This case-control study comprised 30 consecutive cases of MPHL and equal numbers of age-matched healthy controls attending dermatology outdoor department at a tertiary care hospital. Cases as well as controls were evaluated and screened for the levels of serum ferritin (SF) and thyroid-stimulating hormone (TSH). Value of SF (8-388 ng/mL) and TSH (0.358-3.7 uIU/mL) was used as standardized reference. RESULTS: In cases of AGA, SF level varied from 6.00 to 212.09 ng/mL (mean - 88.30 ng/mL). Whereas controls showed SF levels ranging between 23.67 and 185.05 ng/mL (mean 78.69 ng/mL). The range of TSH level in the case group was 0.379-5.078 uIU/L (mean 2.25 uIU/L), respectively, whereas control group showed serum TSH levels ranging between 0.30 and 4.30 uIU/L (mean - 1.78 uIU/L). Statistically considering two samples of equal variance P (2-tailed) for SF level was found to be 0.424, whereas 0.085 in case of TSH level depicting insignificant association. Spearman's correlations (P = 0.244) between alopecia grade and SF level were found to be statistically i

AIM: The etiology of telogen effluvium (TE) includes situations that may cause physiological stress, surgical trauma, inflammatory, infectious, iatrogenic causes, medications and nutritional deficiencies. TE has been associated with iron deficiency, vitamin B12 deficiency and thyroid diseases. In recent years, the use of over-the-counter food supplements containing vitamins and minerals such as biotin, vitamin D, zinc (Zn), copper (Cu) and selenium (Se) has been increasing in TE patients. The aim of this study is to investigate whether there are differences in nutritional status, vitamin and mineral levels by comparing individuals with TE and a control group. MATERIALS AND METHODS: This case-control study included 90 female patients diagnosed with chronic telogen effluvium (CTE), and 90 female controls volunteered to participate in the study who consulted for reasons other than TE. Both groups aged 18 and over and applied to dermatology polyclinic between 01.09.2022 and 01.09.2023. A detailed anamnesis was taken from all patients, a hair pull test was performed, and TE was diagnosed after a dermoscopic examination was performed on all areas of the scalp. Then, serum vitamin D, Zn, Cu, Se levels and biotin levels in serum and urine were measured. Hemoglobin (Hb), ferritin, vitamin B12 and thyroid function tests were retrospectively scanned from the hospital database. RESULTS: It w

Telogen effluvium is characterized by excessive hair shedding usually following a stressful event. Ferritin has been used in clinical practice as a biomarker of nonanemic iron deficiency in cases of telogen effluvium. During the years of the COVID19 pandemic, telogen effluvium was reported as a part of post covid manifestations. As ferritin was also a biomarker for inflammation in cases with covid infection, this study was designed to evaluate the value of ferritin in cases with postcovid telogen effluvium one hundred patients recovering from covid 19 for 4-12 weeks were included in the study, detailed drug and laboratory history was obtained and serum ferritin level was measured. the mean serum level of ferritin among telogen effluvium patients was significantly lower than controls (68.52 ± 126 and 137 ± 137.597 ug/L respectively). Patients with telogen effluvium used significantly more azithromycin and ivermectin and significantly less vitamin C, D, lactoferrin and zinc than the controls Although serum ferritin is lower among telogen effluvium patients, it was still higher than the cutoff value for diagnosing nonanemic iron deficiency, we suggest that it will not be a good biomarkers in these cases. Our secondary outcomes showed that dietary supplements

OBJECTIVE: Telogen effluvium (TE) is a type of alopecia that is frequently seen in women. Among factors resulting in hair loss, many reasons such as endocrine diseases, nutrition disorders, stress, anemia, low ferritin levels, vitamin B12 deficiency, and thyroid diseases are found. A digital phototrichogram is one of the non-invasive methods of diagnosis in the evaluation of alopecia. In this study, it was aimed to compare biochemical parameters of female patients with diffuse hair loss with phototrichogram findings. METHODS: 108 female patients with diffuse hair loss were included in the study. Patients were divided into two groups: acute and chronic TE, and a hair pull test was applied. Total blood count, blood biochemistry, iron, iron binding capacity, ferritin, thyroid stimulating hormone (TSH), sT3, sT4, folic acid, and vitamin B12 levels were examined. The telogen/anagen ratios and hair densities of patients were determined with a phototrichogram. RESULTS: The serum biochemical parameters (aspartate aminotransferase, alanine aminotransferase, urea, creatinine), TSH, sT3, sT4, and folic acid levels of patients were within normal limits. Telogen ratio, anagen ratio, hair density, number of shed hairs, family history, blood ferritin, TSH, and vitamin B12 levels were found to be similar between groups having acute and chronic TE. In our study, while mean anagen and telogen ratios with trichoscan were similar to literature data, no statistically significant correlation was determined between patients' ages and examined tr

OBJECTIVES: Alopecia is a soft but meaningful complaint affecting women's physical and psychological health. Female alopecia (FA) has diverse etiologies. Nonetheless, FA is stereotyped as female pattern hair loss, also known as female androgenetic alopecia, and has not been thoroughly investigated. This study aimed to identify the etiologies of FA at a tertiary medical center in Eastern Taiwan. MATERIALS AND METHODS: This retrospective study enrolled female patients with hair loss who visited the dermatology department of (blinded information). A complete history taking was obtained, including the onset and duration of alopecia, menstruation, gynecologic diseases, psychological stress, underlying diseases, vaccination, and dietary habits, etc., Blood tests were performed, including hemoglobin (Hb), ferritin, Zn, autoimmune and thyroid profiles, etc., Iron deficiency (ID) was defined as serum ferritin level <60 ng/mL. The hair condition, ferritin, and Hb levels were monitored every 3 months after supplementation. RESULTS: A total of 155 patients were recruited. The etiologies of FA were diverse; the top five etiologies were nutrient deficiencies (83.9%), autoimmune (14.8%) and thyroid (7.7%) diseases, psychological stress (12.3%), and coronavirus disease 2019 (COVID-19) vaccination (6.5%). ID accounted for 70.3% of cases. The disease duration was an important prognostic factor for the improvemen

Ferritin is a key regulator of iron homeostasis that serves as an important clinical indicator of body iron status. Low serum ferritin is a highly specific and sensitive marker for diagnosing iron deficiency. In patients presenting with diffuse hair loss, serum ferritin may be a clinically useful tool for ruling out underlying iron deficiency as a cause of alopecia. As an acute-phase reactant, ferritin may be nonspecifically elevated in a wide range of inflammatory conditions; however, the role of ferritin in disorders of the skin and hair is not well understood. In this article, we review the structure and function of ferritin, and we provide a guide for clinical use.

Retraction in Cureus. 2024 Feb 6;16(2):r136. doi: 10.7759/cureus.r136. Objective We designed this study to evaluate the association of serum ferritin levels with non-scarring alopecia in women. Methodology All patients were diagnosed by performing a clinical examination of the crown part width and occiput. Ludwig's classification was used to categorize the cases into grades I-III. Different laboratory tests were performed for the baseline investigation, including serum iron, total iron-binding capacity (TIBC), hemogram, and thyroid function tests. Of the 5 ml of venous blood drawn for routine biochemical tests, 3 ml was stored at -20°C for measuring serum ferritin, while the other 2 ml was sent for a complete blood count. Student's t-test, a chi-square test, and Fisher's exact test were used for comparing the variables. Results This study recruited 100 cases of alopecia. Out of them, 46% of patients were diagnosed with alopecia areata, 25% of cases reported androgenetic alopecia, and 29% of cases of telogen effluvium were also observed. We observed overall mean serum ferritin levels of 20.47±17.50 and 27.87±17.51 in the case versus the control group with a statistically significant difference of 0.005. Conclusion Our study shows that iron stores are one of the independent hazards of alopecia in non-menopausal women. Thus, proper laboratory examination is needed to manage the disease prevalence and prognosis.

BACKGROUND/OBJECTIVES: Telogen effluvium (TE) is a diffuse, rapidly occurring non-scarring alopecia that can be a significant source of distress for patients and caregivers. To date, the disorder has not been extensively studied in a US pediatric patient population. This study aims to characterize the epidemiology, management, and disease course of pediatric TE. METHODS: A retrospective single-center analysis was conducted at the University of Miami including pediatric medical records from 2009 to 2021 with at least one clinic visit coded with the diagnosis of TE. RESULTS: 76 patients presented with a wide range of age at onset and hair loss duration. 67% of patients (n = 51) had an identified trigger, the most common being emotional stress and acute febrile illness, followed by nutritional deficiencies (specifically iron, ferritin, and vitamin D). Observation was the most common therapeutic approach. Of patients who had a follow-up evaluation (39%), different treatments resulted in similar rates of improvement. CONCLUSIONS: The results of this study demonstrate the variability in potential TE triggers, physical exam findings, and management in children, similar to what is currently observed and practiced in adult patients. Appropriate work-up for common triggers should be included during the initial visit. Greater evidence-based treatment approaches are needed for pediatric TE. © 2022 Wiley Periodicals LLC.

BACKGROUND: Androgenetic alopecia (AGA) is the most common form of alopecia, affecting 50% of the adult population world-wide. The exact mechanisms of this common hair disorder are yet to be fully elucidated. It is believed to be related to high circulating androgen levels in the blood and it is genetically determined. Deficiencies of micronutrients such as iron in the development of AGA have been a subject of debate. OBJECTIVE: This study sought to determine the association between serum ferritin levels and androgenetic alopecia among patients attending the Dermatology clinic at a tertiary health facility in South-Western Nigeria. METHODS: This was a hospital based cross sectional study with a total of 114 participants, which consisted of 57 subjects with AGA and 57 age and sex-matched healthy adults without AGAwho met the inclusion criteria. The diagnosis of AGA was made clinically and with the aid of a Dermatoscope (Wi-Fi Digital Microscope RoHS YPC_X03 V2018, HD Colour CMOS sensor with 50X-1000X magnification and HD resolution 1920x1080P). RESULTS: The mean age of the study participants was 41.68 ± 12.86 years with age ranging from 24 to 80 years. The mean serum ferritin levels among the subjects and control group were 188.65 ±97.92ng/ml and 194.49 ± 76.67ng/ml respectively but this difference was not statistically significant (p = 0.724). However, subjects with premature AGA had a significantly lower