Daily iron supplementation beneficial in menstruating women

Daily iron supplementation beneficial in menstruating women

Brian McAvoy
PEARLS No.
530
Clinical question

How effective is daily iron supplementation for anaemia, iron status and physical, psychological and neurocognitive health in menstruating women?

Bottom line

Daily iron supplementation effectively reduced the prevalence of anaemia and iron deficiency, raised haemoglobin and iron stores, improved exercise performance and reduced symptomatic fatigue. These benefits came at the expense of increased gastrointestinal side effects such as constipation and abdominal pain. Evidence that iron supplementation improved cognitive performance in women was uncertain, as studies could not be meta-analysed and individual studies reported conflicting results. There was no evidence of difference in efficacy between different iron salts.

Caveat

There were no data on the effects of iron on mortality or whether taking iron for at least 5 days a week was as effective. Doses varied from 1mg elemental iron to approximately 300mg elemental iron a day. Duration of iron supplementation also varied, ranging from 1 week to 24 weeks.

Context

Iron-deficiency anaemia is highly prevalent among menstruating women worldwide, although the prevalence is highest in lower-income settings. Iron-deficiency anaemia has been associated with a range of adverse health outcomes, which restitution of iron stores using iron supplementation has been considered likely to resolve.

Cochrane Systematic Review

Low MSY et al. Daily iron supplementation for improving anaemia, iron status and health in menstruating women. Cochrane Reviews, 2016, Issue 4. Art. No.: CD009747.DOI: 10.1002/14651858. CD009747.pub2. This review contains 67 studies involving 8506 participants.