Effect of Daily Supplementation with Iron and Zinc on Iron Status of Childbearing Age Women Effect of oral iron therapy on the symptoms of anaemia. Iron supplementation improves endurance after training in iron-depleted, nonanemic women. Changes in iron status during competitive season in female collegiate swimmers. Oral iron supplementation after blood donation: a randomized clinical trial. Marginal iron deficiency without anemia impairs aerobic adaptation among previously untrained women. A WHO collaborative study on iron supplementation in Burma and in Thailand. Iron, copper, and zinc status: response to supplementation with zinc or zinc and iron in adult females. Tissue iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women. Electrolytic iron or ferrous sulfate increase body iron in women with moderate to low iron stores. Functional consequences of iron supplementation in iron-deficient female cotton mill workers in Beijing, China. Iron treatment normalizes cognitive functioning in young women. Iron supplementation improves progressive fatigue resistance during dynamic knee extensor exercise in iron-depleted, nonanemic women. Iron status in exercising women: the effect of oral iron therapy vs increased consumption of muscle foods. Iron supplementation does not affect the susceptibility of LDL to oxidative modification in women with low iron status. Long-term weekly iron supplementation improves and sustains nonpregnant women's iron status as well or better than currently recommended short-term daily supplementation. Efficacy and acceptability of two iron supplementation schedules in adolescent school girls in Lima, Peru. Clinical evaluation of iron treatment efficiency among non-anemic but iron-deficient female blood donors: a randomized controlled trial An 8-week course of 45 mg of carbonyl iron daily reduces iron deficiency in female whole blood donors aged 18 to 45 years: results of a prospective randomized controlled trial. Effects of iron and ascorbic acid supplementation on hemoglobin level and work efficiency of anemic women. Improvement in iron deficiency anemia through therapy with ferric ammonium citrate and vitamin C and the effects of aerobic exercise. Effect of oral iron supplementation on unstimulated salivary flow rate: a randomized, double-blind, placebo-controlled trial. Components of variance and intraclass correlations for the design of community-based surveys and intervention studies: data from the Health Survey for England 1994. Iron supplementation improves energetic efficiency in iron-depleted female rowers. Iron state in female adolescents. A Study of the Effects of Latent Iron Deficiency on Measures of Cognition: A Pilot Randomised Controlled Trial of Iron Supplementation in Young Women A rapid, simple questionnaire to assess gastrointestinal symptoms after oral ferrous sulphate supplementation Comparison of Two Doses of Elemental Iron in the Treatment of Latent Iron Deficiency: Efficacy, Side Effects and Blinding Capabilities Iron-deficiency anaemia and its effect on worker productivity and activity patterns. Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial Clinical Trial of Iron Therapy on Psychomotor Function in Anaemic Women Anemia prophylaxis in adolescent school girls by weekly or daily iron-folate supplementation. Effect of iron supplementation on endurance capacity in iron-depleted female runners. A Randomized Controlled Trial in Young Women of the Effects of Consuming Pork Meat or Iron Supplements on Nutritional Status and Feeling of Well-being Definition and prevalence of anemia in Bolivian women of childbearing age living at high altitudes: the effect of iron-folate supplementation. Iron supplementation for menstruating female blood donors. Iron repletion decreases maximal exercise lactate concentrations in female athletes with minimal iron-deficiency anemia. Iron supplementation maintains ventilatory threshold and improves energetic efficiency in iron-deficient nonanemic athletes Effect of an iron supplement on body iron status and aerobic capacity of young training women Weekly vs daily iron and folic acid supplementation in adolescent Nepalese girls. Response of serum transferrin receptor to iron supplementation in iron-depleted, nonanemic women. Effects of iron repletion on VO2max, endurance, and blood lactate in women. [Effect of iron supplementation on iron deficiency anemia of childbearing age women in Shanghai]. Iron supplementation and running performance in female cross-country runners. Effects of iron supplementation in female athletes with low serum ferritin concentration. Can Dietary Treatment of Non-Anemic Iron Deficiency Improve Iron Status? Influence of an iron intervention on the zinc status of young adult New Zealand women with mild iron deficiency. The effect of iron therapy on the exercise capacity of nonanemic iron-deficient adolescent runners. Short-term ferrous sulfate supplementation in female blood donors. Multivitamin and Iron Supplementation to Prevent Periconceptional Anemia in Rural Tanzanian Women: A Randomized, Controlled Trial Carbonyl iron for short-term supplementation in female blood donors. Effects of administration of iron, iodine and simultaneous iron-plus-iodine on the thyroid hormone profile in iron-deficient adolescent Iranian girls Effect of iron supplementation on iron status during the first week after blood donation. Running performance in Gambian children: effects of water-soluble vitamins or iron. Randomized, double-blind, placebo-controlled trial of iron supplementation in female soldiers during military training: effects on iron status, physical performance, and mood. The effects of prelatent/latent iron deficiency on physical work capacity. Effects of 4 weeks iron supplementation on haematological and immunological status in elite female soccer players. Effects of low-dose iron supplementation in women with low serum ferritin concentration. Worker productivity and the nutritional status of Kenyan road construction laborers. Effects of long-term moderate exercise on iron status in young women. Iron supplementation in female blood donors deferred by copper sulfate screening. Prevention of iron deficiency with carbonyl iron in female blood donors. Effect of daily and intermittent iron supplementation on iron status of high school girls. Randomised study of cognitive effects of iron supplementation in non-anaemic iron-deficient adolescent girls The effect of iron and folic acid therapy on combined iron and folate deficiency anaemia: the results of a clinical trial. Supplementation with iron and folic acid enhances growth in adolescent Indian girls. Iron supplementation decreases plasma zinc but has no effect on plasma fatty acids in non-anemic women.
The objective was to determine the effect of daily supplementation with 30 mg of iron ( Fe ) plus 30 mg of zinc ( Zn ) for 3 months on Fe status of women of childbearing age . This was a r and omized double-blind , placebo-controlled trial . Eighty-one women ( 18–45 years ) were r and omly assigned to receive either a daily single dose of 30 mg of Fe ( group 1 ; n = 28 ) and 30 mg of Fe plus 30 mg of Zn ( group 2 ; n = 26 ) or placebo ( n = 27 ) for 3 months . Hemoglobin ( Hb ) , mean corpuscular volume , serum Fe , total iron-binding capacity , transferrin saturation , erythrocyte Zn protoporphyrin , serum ferritin ( SF ) , serum transferrin receptor ( TfR ) , total body Fe , serum Zn , and high-sensitivity C-reactive protein were measured at baseline and at the end of the study . At baseline , 3.7 , 28.4 , and 3.7 % of women had iron-deficiency anemia ( IDA ) , Fe deficiency without anemia , and depleted Fe stores , respectively . No significant differences on Fe status were found between groups before supplementation . After supplementation , group 2 showed a significant increase of Hb and total body Fe and a significant decrease of TfR compared with placebo ( p < 0.05 ) . Moreover , serum Zn increased significantly in group 2 compared with group 1 ( p < 0.01 ) and placebo ( p < 0.01 ) . In conclusion , daily supplementation with 30 mg of Fe plus 30 mg of Zn for 3 months improved significantly the Fe and Zn status of women , compared with those who received placebo . The positive effect of Fe supplementation on Fe status is enhanced by combined Zn supplementation In a study published elsewhere ( Wood and Elwood , 1966 ) the associations between the severity of various symptoms and haemoglobin levels in subjects who took part in a community survey is described . The present paper describes a double-blind r and omized clinical trial of the effects on these symptoms of  oral iron therapy  in a sample of the women seen during the community survey . In addition some limited data relating to a separate trial conducted in severely anaemic women identified in a hospital out-patient clinic are presented Our objective was to investigate the effects of iron depletion on adaptation to aerobic exercise , assessed by time to complete a 15-km cycle ergometer test . Forty-two iron-depleted ( serum ferritin < 16 microg/l ) , nonanemic ( Hb > 12 g/dl ) women ( 18 - 33 yr old ) received 100 mg of ferrous sulfate ( S ) or placebo ( P ) per day for 6 wk in a r and omized , double-blind trial . Subjects trained for 30 min/day , 5 days/wk at 75 - 85 % of maximum heart rate for the final 4 wk of the study . There were no group differences in baseline iron status or in 15-km time . Iron supplementation increased serum ferritin and decreased transferrin receptors in the S compared with the P group . The S and P groups decreased 15-km time and respiratory exchange ratio and increased work rate during the 15-km time trial after training . The decrease in 15-km time was greater in the S than in the P group ( P = 0.04 ) and could be partially attributed to increases in serum ferritin and Hb . These results indicate that iron deficiency without anemia impairs favorable adaptation to aerobic exercise We examined changes in iron status in 25 female varsity collegiate swimmers over the course of a competitive season via weekly capillary blood sampling . We also studied the effectiveness of moderate iron supplementation ( 39 mg/day ) in preventing expected changes in iron status via a double-blinded crossover design . On entry into the study , 17 of the swimmers had depleted iron stores ( plasma ferritin < 12 micrograms/L ) and 5 were anemic ( Hb < 120 g/L ) . After 5 wk of placebo treatment , hemoglobin decreased ( > or = 6 g/L ) in 44 % and increased in 12 % of the subjects . After 5 wk of iron supplementation , hemoglobin decreased in 16 % and increased in 24 % of the subjects . Likewise , after placebo treatment , plasma ferritin decreased ( > or = 5 micrograms/L ) in 24 % and increased in 4 % of the subjects , whereas iron supplementation result ed in decreases in 4 % and increases in 68 % of the subjects . In the absence of iron supplementation , hemoglobin levels decreased despite mean dietary iron intakes of 16.3 mg/day . These results show that moderate iron supplementation is effective in preventing decline in the iron status of female collegiate swimmers during a competitive season , but a higher dose of iron may be necessary to reverse their iron-deficient state IMPORTANCE Although blood donation is allowed every 8 weeks in the United States , recovery of hemoglobin to the currently accepted st and ard ( 12.5 g/dL ) is frequently delayed , and some donors become anemic . OBJECTIVE To determine the effect of oral iron supplementation on hemoglobin recovery time ( days to recovery of 80 % of hemoglobin removed ) and recovery of iron stores in iron-depleted ( " low ferritin , " ≤26 ng/mL ) and iron-replete ( " higher ferritin , " > 26 ng/mL ) blood donors . DESIGN , SETTING , AND PARTICIPANTS R and omized , nonblinded clinical trial of blood donors stratified by ferritin level , sex , and age conducted in 4 regional blood centers in the United States in 2012 . Included were 215 eligible participants aged 18 to 79 years who had not donated whole blood or red blood cells within 4 months . INTERVENTIONS One tablet of ferrous gluconate ( 37.5 mg of elemental iron ) daily or no iron for 24 weeks ( 168 days ) after donating a unit of whole blood ( 500 mL ) . MAIN OUTCOMES AND MEASURES Time to recovery of 80 % of the postdonation decrease in hemoglobin and recovery of ferritin level to baseline as a measure of iron stores . RESULTS The mean baseline hemoglobin levels were comparable in the iron and no-iron groups and declined from a mean ( SD ) of 13.4 ( 1.1 ) g/dL to 12.0 ( 1.2 ) g/dL after donation in the low-ferritin group and from 14.2 ( 1.1 ) g/dL to 12.9 ( 1.2 ) g/dL in the higher-ferritin group . Compared with participants who did not receive iron supplementation , those who received iron supplementation had shortened time to 80 % hemoglobin recovery in both the low-ferritin ( mean , 32 days , interquartile range [ IQR ] , 30 - 34 , vs 158 days , IQR , 126->168 ) and higher-ferritin groups ( 31 days , IQR , 29 - 33 , vs 78 days , IQR , 66 - 95 ) . Median time to recovery to baseline ferritin levels in the low-ferritin group taking iron was 21 days ( IQR , 12 - 84 ) . For participants not taking iron , recovery to baseline was longer than 168 days ( IQR , 128->168 ) . Median time to recovery to baseline in the higher-ferritin group taking iron was 107 days ( IQR , 75 - 141 ) , and for participants not taking iron , recovery to baseline was longer than 168 days ( IQR , > 168->168 ) . Recovery of iron stores in all participants who received supplements took a median of 76 days ( IQR , 20 - 126 ) ; for participants not taking iron , median recovery time was longer than 168 days ( IQR , 147->168 days ; P < .001 ) . Without iron supplements , 67 % of participants did not recover iron stores by 168 days . CONCLUSIONS AND RELEVANCE Among blood donors with normal hemoglobin levels  , low-dose iron supplementation , compared with no supplementation , reduced time to 80 % recovery of the postdonation decrease in hemoglobin concentration in donors with low ferritin ( ≤26 ng/mL ) or higher ferritin ( > 26 ng/mL ) . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01555060 BACKGROUND Iron deficiency without anemia has been shown to reduce both muscle-tissue oxidative capacity and endurance in animals . However , the consequences of iron deficiency in humans remain unclear . OBJECTIVE We investigated the effects of iron supplementation on adaptation to aerobic training among marginally iron-depleted women . We hypothesized that iron supplementation for 6 wk would significantly improve iron status and maximal oxygen uptake ( VO(2)max ) after 4 wk of concurrent aerobic training . DESIGN Forty-one untrained , iron-depleted , nonanemic women were r and omly assigned to receive either 50 mg FeSO(4 ) or a placebo twice daily for 6 wk in a double-blind trial . All subjects trained on cycle ergometers 5 d/wk for 4 wk , beginning on week 3 of the study . RESULTS Six weeks of iron supplementation significantly improved serum ferritin and serum transferrin receptor ( sTfR ) concentrations and transferrin saturation without affecting hemoglobin concentrations or hematocrit . Average VO(2)max and maximal respiratory exchange ratio improved in both the placebo and iron groups after training ; however , the iron group experienced significantly greater improvements in VO(2)max . Both iron-status and fitness outcomes were analyzed after stratifying by baseline sTfR concentration ( > and < or = 8.0 mg/L ) , which showed that the previously observed treatment effects were due to iron-status and fitness improvements among subjects with poor baseline iron status . CONCLUSIONS Our findings strongly suggest that iron deficiency without anemia but with elevated sTfR status impairs aerobic adaptation among previously untrained women and that this can be corrected with iron supplementation Studies on the treatment and prevention of iron deficiency anemia , in pregnant and nonpregnant women and in men , were conducted in Thail and and Burma . The effects of the dose of Fe , duration of Fe administration , additional supplementation with folate , mode of supplement delivery ( either supervised or unsupervised ) , and the presence of Hb(AE ) were studied . The frequency and severity of side effects were also recorded . Fe administration result ed in an increase in hemoglobin concentration in all anemic individuals but approximately 20 % failed to reach normality . The length of administration and the dose influenced the results . Frequency and severity of side effects increased with the dose of Fe administered . Folate supplementation did not affect the results . It appears possible to integrate a program of prevention and treatment of Fe deficiency anemia in a primary health-care system but the constraints and limitations of achievable results should be recognized Response of iron , copper , and zinc status to supplementation with Zn or a combination of Zn and Fe was assessed in adult females in a 10-wk study . Group Z received 50 mg Zn/d as Zn gluconate ; group F-Z received 50 mg Fe as ferrous sulfate monohydrate in addition to the Zn . For Group Z , serum ferritin , hematocrit , and erythrocyte Cu , Zn-superoxide dismutase ( ESOD ) were significantly lower ( p less than 0.05 ) after 10 wk supplementation compared with pretreatment levels . Serum Zn increased ( p less than 0.01 ) but no change occurred in serum ceruloplasmin , hemoglobin , or salivary sediment Zn with treatment . For Group F-Z ESOD decreased with treatment as did salivary sediment Zn ( p less than 0.05 ) . Serum ferritin and serum Zn increased significantly , but hemoglobin , hematocrit , and ceruloplasmin were not affected by this treatment . Supplementation with Zn poses a risk to Fe and Cu status . Inclusion of Fe with Zn ameliorates the effect on Fe but not on Cu status BACKGROUND We previously showed that iron supplementation significantly improves iron status and maximal work capacity in previously untrained , marginally iron-deficient women with a baseline serum transferrin receptor concentration > 8.0 mg/L. However , the effect of transferrin receptor status on adaptation in endurance capacity after aerobic training in these subjects has not been fully explored . OBJECTIVE Our objective was to examine the effect of baseline serum transferrin receptor status on adaptations in endurance capacity . DESIGN Forty-one untrained , iron-depleted , nonanemic women were r and omly assigned to receive either 100 mg FeSO(4 ) or a placebo for 6 wk in a double-blind trial . All subjects trained on cycle ergometers 5 d/wk for the last 4 wk of the study . Endurance capacity was assessed at baseline and after treatment by using a 15-km time trial conducted on a cycle ergometer . RESULTS Significant treatment effects were observed for time to complete the 15-km time trial , work rate , and percentage of maximal oxygen uptake in subjects with a baseline serum transferrin receptor concentration > 8.0 mg/L. No significant treatment effects were observed in subjects with a normal baseline transferrin receptor concentration . CONCLUSIONS Our findings suggest that , in the presence of overt tissue iron deficiency , iron deficiency without anemia impairs adaptation in endurance capacity after aerobic training in previously untrained women . This impairment can be corrected with iron supplementation Commercial elemental iron powders ( electrolytic and reduced iron ) , as well as heme iron supplements , were tested for efficacy in improving the  iron status of women . In a r and omized , double-blind trial , 51 women with moderate to low iron stores received daily for 12 wk : 1 ) placebo , 2 ) 5 mg iron as heme iron or 50 mg iron as 3 ) electrolytic iron , 4 ) reduced iron , or 5 ) FeSO(4 ) . Treatments were provided in 2 capsules ( heme carrier ) and 3 wheat rolls ( other iron sources ) . Differences in iron status , food nonheme iron absorption , and fecal properties were evaluated . Body iron , assessed from the serum transferrin receptor : ferritin ratio , increased significantly more in subjects administered FeSO(4 ) ( 127 + /- 29 mg ; mean + /- SEM ) and electrolytic ( 115 + /- 37 mg ) , but not the reduced ( 74 + /- 32 mg ) or heme ( 65 + /- 26 mg ) iron forms , compared with those given placebo ( 2 + /- 19 mg ) . Based on body iron determinations , retention of the added iron was estimated as 3.0 , 2.7 , 1.8 , and 15.5 % , in the 4 iron-treated groups , respectively . Iron treatments did not affect food iron absorption . The 50 mg/d iron treatments increased fecal iron and free radical-generating capacity in vitro , but did not affect fecal water cytotoxicity . In subjects administered FeSO(4 ) , fecal water content was increased slightly but significantly more than in the placebo group . In conclusion , electrolytic iron was approximately 86 % as efficacious as FeSO(4 ) for improving body iron , but the power of this study was insufficient to detect any efficacy of the reduced or heme iron within 12 wk . With modification , this methodology of testing higher levels of food fortification for several weeks in healthy women with low iron stores has the potential for economically assessing the efficiency of iron compounds to improve iron status Eighty iron-deficient , nonpregnant female workers were r and omly assigned to ferrous sulphate ( 60 or 120 mg Fe/d ) or placebo treatment for 12 wk . Energy expenditure was estimated during 3 d by heart rate ( HR ) recording . Production efficiency ( PE ) was calculated as the ratio of productivity to energy expenditure . In the iron-treated group mean hemoglobin ( Hb ) increased from 114 to 127 g/L ( P < 0.001 ) , mean serum ferritin increased from 9.7 to 30.0 micrograms/L ( P < 0.001 ) , and mean free erythrocyte protoporphyrin decreased from 1.01 to 0.49 mumol/L ( P < 0.001 ) . Mean HR at work decreased from 95.5 to 91.1 beats/min ( P < 0.001 ) , which was inversely correlated with the change in Hb ( r = -0.60 , P < 0.001 ) . PE increased significantly in the iron-treated group ( P < 0.001 ) and its change paralleled the change in Hb ( r = 0.58 , P < 0.001 ) . The results show that iron supplementation enabled these women to do the same work at a lower energy cost BACKGROUND Evidence suggests that brain iron deficiency at any time in life may disrupt metabolic processes and subsequently change cognitive and behavioral functioning . Women of reproductive age are among those most vulnerable to iron deficiency and may be at high risk for cognitive alterations due to iron deficiency . OBJECTIVE We aim ed to examine the relation between iron status and cognitive abilities in young women . DESIGN A blinded , placebo-controlled , stratified intervention study was conducted in women aged 18 - 35 y of varied iron status who were r and omly assigned to receive iron supplements or a placebo .  Cognition was assessed by using 8  cognitive performance tasks  ( from Detterman 's Cognitive Abilities Test ) at baseline ( n = 149 ) and after 16 wk of treatment ( n = 113 ) . RESULTS At baseline , the iron-sufficient women ( n = 42 ) performed better on cognitive tasks ( P = 0.011 ) and completed them faster ( P = 0.038 ) than did the women with iron deficiency anemia ( n = 34 ) . Factors representing performance accuracy and the time needed to complete the tasks by the iron-deficient but nonanemic women ( n = 73 ) were intermediate between the 2 extremes of iron status . After treatment , a significant improvement in serum ferritin was associated with a 5 - 7-fold improvement in cognitive performance , whereas a significant improvement in hemoglobin was related to improved speed in completing the cognitive tasks . CONCLUSIONS Iron status is a significant factor in cognitive performance in women of reproductive age . Severity of anemia primarily affects processing speed , and severity of iron deficiency affects accuracy of cognitive function over a broad range of tasks . Thus , the effects of iron deficiency on cognition are not limited to the developing brain BACKGROUND Tissue iron depletion may negatively affect endurance performance and muscle fatigability . OBJECTIVE We investigated tissue-level iron depletion and progressive fatigue of the quadriceps during dynamic knee-extension exercise in young women . DESIGN Twenty iron-depleted ( serum ferritin < 20 micro g/L ) , nonanemic ( hemoglobin > 110 g/L ) women ( macro x + /- SEM age : 29.1 + /- 1.2 y ) received iron ( iron group ) or placebo ( placebo group ) for 6 wk in a r and omized , double-blind trial ( n = 10 per group ) . A protocol integrating 2 - 3-s maximal voluntary static contractions ( MVCs ) with dynamic knee extensions was used to assess fatigue . RESULTS No significant differences between the groups in baseline iron status , MVC at rest , or MVC at the end of the protocol were observed . After treatment , serum iron and transferrin saturation increased significantly in the iron group ( P = 0.02 and P = 0.03 , respectively ) . Serum transferrin receptor concentrations increased significantly in the placebo group ( P < 0.01 ) but not in the iron group . After treatment , the rate of decrease in MVC was attenuated in the iron group but not in the placebo group ( P = 0.01 ) . In the iron group , MVC at the sixth minute of the fatigue protocol and MVC at the end of the protocol were approximately 15 % ( P = 0.04 ) and approximately 27 % higher ( P < 0.01 ) , respectively , after treatment . These improvements were not related to changes in iron-status indexes or tissue iron stores , although power was low ( < 0.50 ) to detect these relations . CONCLUSIONS Iron supplementation was associated with a significant improvement in muscle fatigability . Interpretation regarding the direct role of tissue iron status is limited by the study 's low power to detect relations between tissue iron improvement and decreased muscle fatigue Forty-seven previously sedentary women participating in a 12-wk moderate aerobic-exercise program were r and omly assigned to one of four dietary groups : 50-mg/d iron supplement and a low food-iron diet ( 50 FE + EX ) , 10-mg/d iron supplement and a low food-iron diet ( 10 FE + EX ) , placebo and unrestricted diet ( P + EX ) , and meat supplement and high food-iron diet ( M + EX ) . A sedentary control group ( n = 13 ) received no dietary interventions . Hematocrit , total iron-binding capacity , and hemoglobin , serum iron , serum ferritin , and serum albumin concentrations were measured every 4 wk . Hemoglobin values decreased at the end of 4 wk in all exercising groups compared with the control group . Iron status in the 50 FE + EX and M + EX groups improved after week 4 as indicated by an increase in serum ferritin , serum iron , and hemoglobin concentrations , and a decline in total iron-binding capacity . Thus , short-term , moderate aerobic exercise result ed in compromised iron status that was offset to varying degrees by ingesting iron or meat supplements . However , meat supplements were more effective in protecting hemoglobin and ferritin status than were iron supplements Elevated iron stores may or may not promote atherogenesis by increasing free radical formation and oxidative stress , but controlled diet and supplement trials are lacking . We tested the hypothesis that iron supplementation does not increase the susceptibility of LDL to undergo oxidative modification in women with low iron status . A r and omized , double-blind , 2-period crossover study design ( n=26 ) was used to examine the effects of the following diets on measures of LDL oxidation :  average American diet ( AAD ) [ 36 % of energy as fat ; 15 % saturated fatty acids ( SFA ) ] , and a Step 2 diet ( 26 % fat ; 7 % SFA ) . In addition , subjects received either a supplement containing 160 mg of ferrous sulfate ( 50 mg elemental iron ) or a placebo twice daily [ supplement group received a total of 320 mg ferrous sulfate ( 100 mg elemental iron ) daily ] . After supplementation , serum ferritin differed between the supplement and placebo groups ( P=0.008 ) . Measures of LDL oxidation were not affected by supplement intake ; however , they were affected by diet . Lag time was shorter after the women consumed the AAD diet than after the Step 2 diet ( P<0.0001 ) . The diets did not affect the rate of oxidation or total dienes . Although iron status was improved by aggressive iron supplementation , LDL oxidative susceptibility was not affected . As expected , lag time was increased after the women consumed the low fat , low SFA diet . Therefore , the results of this study do not support a relationship between iron status and LDL oxidation This 7-mo double-blind study compared the efficacy of two iron supplementation schemes in improving iron nutrition among 116 healthy fertile-age women . They were r and omly distributed in three groups , receiving : Group 1 , iron + folate ( 60 mg and 250 microg , respectively ) daily for 3 mo ( currently recommended scheme ) , and folate ( 250 microg ) weekly the subsequent 4 mo . Group 2 , folate daily , and 60 mg iron only once weekly for 3 mo , and then weekly iron + folate for 4 mo . Group 3 , folate daily for 3 mo and then weekly for 4 mo . At baseline , 16 % had depleted stores ( plasma ferritin < 15 microg/L ) and 16 % had hemoglobin levels < 125 g/L. Eight percent had hemoglobin levels < 120 g/L. In Group 1 hemoglobin and ferritin increased at 3 mo but returned to near basal conditions after 4 mo of weekly folate . In Group 2 , hemoglobin and ferritin increased progressively throughout the 7 mo but mostly after 3 mo . Group 3 did not change . Side effects were highest with daily iron . Weekly iron supplementation over 7 mo ( 30 doses ) improved and sustained iron nutrition at least as effectively and was better tolerated than 90 daily iron supplements consumed during 3 mo To assess the efficacy and acceptability of a daily and intermittent iron supplementation , a double-blind , placebo-controlled trial was conducted in a public school located in periurban Lima , Peru . Adolescent girls ( n = 312 ) , 12 - 18 y old , were r and omly assigned to one of the following three groups : 1 ) 60 mg iron as ferrous sulfate daily from Monday to Friday ; 2 ) 60 mg iron as ferrous sulfate 2 d/wk and 3 d placebo ( intermittent ) ; 3 ) placebo , from Monday to Friday . Field workers gave the girls supplements during school hours for 17 wk ; 296 girls completed the trial . Girls took 94 % of the expected dose of 85 pills . Few side effects were reported . Postintervention , hemoglobin ( Hb ) , serum ferritin ( SF ) and free erythrocyte protoporphyrin ( FEP ) were improved significantly in the iron-supplemented groups compared with placebo ( P<0.05 ) . Daily supplements led to higher Hb increases than intermittent supplements ( P<0.05 ) , but SF and FEP were similar between the two groups . Thus , both iron supplementation schedules were efficacious in preventing iron deficiency in adolescent girls through the school system , and the daily schedule was better than the intermittent schedule at increasing Hb values and reducing anemia Background Iron deficiency without anemia is related to adverse symptoms that can be relieved by supplementation . Since a blood donation can induce such an iron deficiency , we investigated the clinical impact of iron treatment after a blood donation . Methods One week after donation , we r and omly assigned 154 female donors with iron deficiency without anemia , aged below 50 years , to a four-week oral treatment of ferrous sulfate versus a placebo . The main outcome was the change in the level of fatigue before and after the intervention . Aerobic capacity , mood disorder , quality of life , compliance and adverse events were also evaluated . Hemoglobin and ferritin were used as biological markers . Results The effect of the treatment from baseline to four weeks of iron treatment was an increase in hemoglobin and ferritin levels to 5.2 g/L ( P < 0.01 ) and 14.8 ng/mL ( P < 0.01 ) , respectively . No significant clinical effect was observed for fatigue ( -0.15 points , 95 % confidence interval -0.9 points to 0.6 points , P = 0.697 ) or for other outcomes . Compliance and interruption for side effects was similar in both groups . Additionally , blood donation did not induce overt symptoms of fatigue in spite of the significant biological changes it produces . Conclusions These data are valuable as they enable us to conclude that donors with iron deficiency without anemia after a blood donation would not clinical ly benefit from iron supplementation . Trial Registration Clinical Trials.gov : BACKGROUND Blood donation is known to contribute to iron deficiency in regular blood donors . This study investigated the safety and efficacy of postdonation iron replacement to mitigate iron deficiency in blood donors . STUDY DESIGN AND METHODS A total of 282 female whole blood donors aged 18 to 45 were prospect ively r and omized in a double-blinded placebo controlled trial to receive an 8-week postdonation course of carbonyl iron ( 45 mg daily ) or placebo . The primary endpoint was prevalence of iron deficiency ( ferritin < 15 ng/mL ) at 12 weeks postdonation . Secondary endpoints were eligibility to donate based on capillary hemoglobin ( Hb ) and incidence of gastrointestinal ( GI ) complaints . RESULTS Ferritin levels at Week 12 were significantly higher in donors receiving carbonyl iron ( 17.0 ± 10.9 ng/mL ) compared with those receiving placebo ( 10.6 ± 8.4 ng/mL ; p < 0.001 ) . The proportion of iron-deficient donors was significantly lower in the carbonyl iron group ( 51.9 % ) compared to the placebo ( 80.5 % ; p < 0.001 ) . The mean Hb level in the carbonyl iron group ( 134.6 ± 8.7 g/L ) was significantly higher than in the placebo arm ( 130.0 ± 9.9 g/L ; p < 0.001 ) , significantly improving eligibility to donate at Week 12 . Significantly more donors receiving carbonyl iron had at least one GI side effect ( p < 0.001 ) . Importantly , 86.7 % of donors receiving carbonyl iron indicated that they would take iron on an ongoing basis . CONCLUSION An 8-week postdonation course of 45 mg of carbonyl iron significantly reduced iron deficiency and was well tolerated in female whole blood donors . Postdonation iron replacement may have a role in a broader strategy to optimize donor iron status This study was conducted to examine the relationship between anemia , supplementation with iron and vitamin C , and productivity . Using the cyanmethemoglobin method , 671 female garment factory workers were examined . On the basis of the World Health Organization ( WHO ) st and ard , 98 were found to be mildly or moderately/severely anemic . An equal number was r and omly chosen from the nonanemic workers . The subjects were then r and omly assigned to either the placebo group or the group receiving 525 mg of ferrous sulfate ( 105 mg elemental iron ) and 500 mg ascorbic acid . Only 118 of the 196 subjects completed the three-month study . The mean hemoglobin ( Hb ) and work output , as indicated by efficiency rating ( ER ) , of the placebo group did not change significantly . Mildly anemic workers with supplements showed a significant improvement in mean Hb , but not in mean ER . The moderately/severely anemic group receiving supplements had significant increases in both Hb and ER In 781 female college students , there were 41 cases of iron deficiency anemia , 209 of latent iron deficiency , 3 of other anemias , and 528 normal cases . Fifty-four volunteers recruited from the iron deficiency anemia and severe latent iron deficiency groups were r and omly divided into 4 study groups . Groups I and III received 500 mg of vitamin C daily , and groups II and IV received ferric ammonium citrate ( FeAC ; equivalent to 6 mg iron ) in addition to vitamin C for 9 weeks . Groups I and II were loaded by aerobic exercise at 50 % VO2 max . Significant differences between groups were noted in serum ferritin ( SF ) in III/IV , hematocrit ( Ht ) in II/III and III/IV , and reticulocytes ( RET ) in I/II , I/IV , and III/IV . Hemoglobin ( Hb ) and other iron-related blood indices tended to normalize in groups II and IV when compared with the pre-values . VO2 max was elevated in groups I and II regardless of iron treatment , but was augmented more in group II than group BACKGROUND No treatment is known to permanently increase salivary flow in patients with hyposalivation . The objective of this study was to investigate the effect of iron supplementation on salivary flow rate . METHODS A double-blind , r and omized , placebo-controlled trial was carried out on 50 individuals with a low unstimulated whole salivary flow rate and low serum ferritin . Half the individuals received 60 mg iron orally twice a day for 3 months , while the other half received placebo . RESULTS No statistically significant difference was found between the groups after treatment for the unstimulated flow rate and in the subjective assessment s of oral dryness . The serum ferritin values increased significantly in the iron group but not in the placebo group . CONCLUSION Oral supplementation with iron for 3 months has no effect on salivary flow rate among individuals with hyposalivation and low serum ferritin values The authors estimated components of variance and intraclass correlation coefficients ( ICCs ) to aid in the design of complex surveys and community intervention studies by analyzing data from the Health Survey for Engl and 1994 . This cross-sectional survey of English adults included data on a range of lifestyle risk factors and health outcomes . For the survey , households were sample d in 720 postal code sectors nested within 177 district health authorities and 14 regional health authorities . Study subjects were adults aged 16 years or more .  ICCs and components of variance were estimated from a nested r and om-effects analysis of variance . Results are presented at the district health authority , postal code sector , and household levels . Between-cluster variation was evident at each level of clustering . In these data , ICCs were inversely related to cluster size , but design effects could be substantial when the cluster size was large . Most ICCs were below 0.01 at the district health authority level , and they were mostly below 0.05 at the postal code sector level . At the household level , many ICCs were in the range of 0.0 - 0.3 . These data may provide useful information for the design of epidemiologic studies in which the units sample d or allocated range in size from households to large administrative areas PURPOSE Studies in both animals and humans show a relationship between iron depletion without anemia ( IDNA ) and physical performance . Compared with their sedentary counterparts , female endurance athletes are at greater risk of IDNA , and consequences relevant to endurance athletes include reduced work capacity and energetic efficiency ( EF ) . We conducted a r and omized placebo-controlled trial to investigate the effects of iron ( Fe ) supplementation on Fe status and performance in nonanemic female rowers during training . METHODS At the beginning of a training season , 40 rowers were r and omized to receive either 100 mg·d FeSO4 ( n = 21 ) or placebo ( n = 19 ) using a double-blind design . Thirty-one ( n = 15 Fe , 16 placebo ) completed the 6-wk trial . Fe status ( hemoglobin , serum ferritin , soluble transferrin receptor ) , body composition , and laboratory tests of physical performance ( 4-km time trial , V˙O2peak , energetic EF , and blood lactate ) were assessed at baseline and after training . RESULTS Rowers in both groups increased their fat-free mass ( P < 0.001 ) and V˙O2peak ( P < 0.001 ) after training . Multiple regression analyses revealed improvements in Fe stores ( serum ferritin ) in the Fe treatment group after controlling for baseline Fe stores ( P = 0.07 ) . Rowers in the Fe group had slower lactate response during the first half of the time trial and after 5 min of recovery ( P = 0.05 ) and showed greater improvements in energy expenditure ( P = 0.01 for group-by time ) and energetic EF compared with placebo ( P = 0.03 for group-by time ) . CONCLUSIONS Female rowers with depleted Fe stores who consumed supplemental Fe during training improved their Fe status and energetic EF during endurance exercise . These results are important for endurance athletes whose dietary patterns and physical training increase their risk of IDNA and suggest that Fe supplementation may maximize the benefits of endurance training OBJECTIVE To document a subjective response to iron therapy in female adolescents . DESIGN Double-blind , placebo-controlled prospect i ve study . SETTING High school classes in an urban community in Israel . PARTICIPANTS Twenty-nine girls , aged 16 and 17 years , who ingested syrup containing iron ( daily for 2 months ) and 30 girls who received a placebo .  MAIN RESULTS By the end of the study , a statistically significant improvement in three subjective parameters , ie , lassitude , the ability to concentrate in school , and mood was reported by the girls who ingested iron compared with the controls . Sixty-five percent , 100 % , and 65 % of the girls , respectively , who reported improvement in the above-mentioned parameters were hypoferremic initially and became normoferremic by the end of the study . CONCLUSION Iron supplementation may be of benefit to female adolescents , as evidence d by their responses to subjective parameters Rates of iron deficiency are high amongst healthy young women .  Cognitive impairment occurs secondary to iron deficiency in infants and children , but evaluation of the impact on cognition among young women is inconsistent . The aim was to determine the suitability of the IntegNeuro test battery for assessing cognitive function in iron-deficient and iron-sufficient young women . A pilot double-blinded , placebo-controlled intervention trial was conducted in iron-deficient ( serum ferritin ≤ 20 μg/L and haemoglobin > 120 g/L ) and iron-sufficient young women ( 18–35 years ) . Cognitive function and haematological markers of iron status were measured at baseline and follow-up . Iron-deficient participants ( n = 24 ) were r and omised to receive placebo , 60 mg or 80 mg elemental iron daily supplements for 16 weeks . A control group of iron-sufficient participants ( n = 8) was allocated to placebo . Change scores for Impulsivity and Attention were significantly greater in plasma ferritin improvers than in non-improvers ( p = 0.004 , p = 0.026 ) . IntegNeuro was easy to administer and acceptable to young women . Based on the differences in Memory and Attention scores between iron-deficient participants on iron treatment and those on placebo , it was decided that between 26 and 84 participants would be required in each iron treatment group for an adequately powered extension of this pilot RCT Background Oral iron supplementation is often associated with rapid onset of  gastrointestinal side-effects . The aim of this study was to develop and trial a short , simple question naire to capture these early side-effects and to determine which symptoms are more discriminating . Methods The study was a double-blind placebo-controlled  r and omized parallel trial with one week treatment followed by one week wash-out . Subjects were r and omized into two treatment groups ( n = 10/group ) to receive either ferrous sulphate ( 200 mg capsules containing 65 mg of iron ) or placebo , both to be taken at mealtimes twice daily during the treatment period . Subjects completed the question naires daily for 14 days . The question naire included gastrointestinal symptoms commonly reported to be associated with the oral intake of ferrous iron salts ( i.e. nausea , vomiting , heartburn , abdominal pain , diarrhoea , and constipation ) . Results Seventy five per cent of participants reporting the presence of one or more symptoms in the first week of the study were in the ferrous sulphate group . In the second week of the study ( i.e. wash-out ) , 67 % of the participants reporting one or more symptom(s ) were in the ferrous sulphate group . In the first week of the study ( treatment ) the number of symptoms reported by participants in the ferrous sulphate group ( mean ± SEM = 6.7 ± 1.7 ) was significantly higher than that for participants in the placebo group ( 1.2 ± 0.5 ) ( p = 0.01 ) . In the second week of the study ( wash-out ) the number of symptoms reported by participants in the ferrous sulphate group ( 4.6 ± 2.0 ) appeared higher than for participants in the placebo group ( 1.0 ± 0.7 ) although this did not reach significance ( p = 0.12 ) . Events for which the gastrointestinal symptom question naire was most discriminatory between ferrous sulphate and placebo groups were : heartburn , abdominal pain and the presence of black stools ( all p ≤ 0.03 ) . Conclusions A tool for the detection of commonly-occurring side effects should not require large study numbers to be effective . With just 10 subjects per group ( iron or placebo )  , this simple question naire measures gastrointestinal side-effects associated with oral iron ( ferrous sulphate ) supplementation , and would be appropriate for use in intervention studies or clinical trials . Trial registration Clinical Trials.gov Identifier : NCT02146053 ( 21/05/2014 ) Adherence to iron supplementation can be compromised due to side effects , and these limit blinding in studies of iron deficiency . No studies have reported an efficacious iron dose that allows participants to remain blinded . This pilot study aim ed to determine a ferrous sulfate dose that improves iron stores , while minimising side effects and enabling blinding . A double-blinded RCT was conducted in 32 women ( 18–35 years ) : 24 with latent iron deficiency ( serum ferritin < 20 µg/L ) and 8 iron sufficient controls . Participants with latent iron deficiency were r and omised to 60 mg or 80 mg elemental iron or to placebo , for 16 weeks . The iron sufficient control group took placebo . Treatment groups ( 60 mg n = 7 and 80 mg n = 6 ) had significantly higher ferritin change scores than placebo groups ( iron deficient n = 5 and iron sufficient n = 6 ) , F(1 , 23 ) = 8.46 , p ≤ 0.01 . Of the 24 who completed the trial , 10 participants ( 77 % ) on iron reported side effects , compared with 5 ( 45 % ) on placebo , but there were no differences in side effects ( p = 0.29 ) , or compliance ( p = 0.60 ) between iron groups . Nine ( 69 % ) participants on iron , and 11 ( 56 % ) on placebo correctly guessed their treatment allocation . Both iron doses were equally effective in normalising ferritin levels . Although reported side-effects were similar for both groups , a majority of participants correctly guessed their treatment group The effects of  iron-deficiency anaemia on  workers productivity  were studied in a tea plantation in Sri Lanka . The quantity of tea picked per day was studied before and after iron supplementation or placebo treatment . After one month 's treatment significantly more tea was picked when the haemoglobin ( Hb ) concentration was increased by iron supplementation than when it was not . The degree of improvement was greater in more-anaemic subjects ( those with concentrations of 6.0 - 9.0 g Hb/dl ) . The level of physical activity of anaemic subjects in their everyday environment was also recorded for four or 24 hours continuously both before and after treatment . After three weeks these levels was significantly greater in the iron-treated than matched placebo-treated subjects . The economic implication s of increased work productively with iron treatment are evident , particularly in developing countries . These results also provide strong evidence for the clinical impression that people with iron-deficiency anaemia suffer from tiredness and weakness Abstract Objective To determine the subjective response to iron therapy in non-anaemic women with unexplained fatigue . Design Double blind r and omised placebo controlled trial . Setting Academic primary care centre and eight general practice s in western Switzerl and . Participants 144 women aged 18 to 55 , assigned to either oral ferrous sulphate ( 80 mg/day of elemental iron daily ; n=75 ) or placebo ( n=69 ) for four weeks . Main outcome measures Level of fatigue , measured by a 10 point visual analogue scale . Results 136 ( 94 % ) women completed the study . Most had a low serum ferritin concentration ; ≤ 20 μg/l in 69 ( 51 % ) women . Mean age , haemoglobin concentration , serum ferritin concentration , level of fatigue , depression , and anxiety were similar in both groups at baseline . Both groups were also similar for compliance and dropout rates . The level of fatigue after one month decreased by −1.82/6.37 points ( 29 % ) in the iron group compared with −0.85/6.46 points ( 13 % ) in the placebo group ( difference 0.95 points , 95 % confidence interval 0.32 to 1.62 ; P=0.004 ) . Subgroups analysis showed that only women with ferritin concentrations ≤ 50 μg/l improved with oral supplementation . Conclusion Non-anaemic women with unexplained fatigue may benefit from iron supplementation . The effect may be restricted to women with low or borderline serum ferritin concentrations A variety of aspects of psychomotor function were assessed in 47 women before and after iron therapy .  These women , all of whom had initial haemoglobin levels below 10·5 g./100 ml . , had been drawn from a population sample of 2,283 women seen at a haematological screening survey . There was no evidence of any beneficial effect of a rise in haemoglobin level on psychomotor function or on symptoms . Possibly this is because if an effect does occur it is unlikely to be apparent unless the haemoglobin level is very low . If this is true then anaemia is probably a rare cause of symptoms or impairment in psychomotor function in the community OBJECTIVE To examine the benefits of anemia prophylaxis in adolescent school.girls by weekly or daily iron-folate supplementation . DESIGN Prospect i ve study . SETTING Government girl schools of northeast Delhi . SUBJECTS 2088 subjects ( with hemoglobin greater than 7.9 g/dL ) , including 702 on daily and 695 on weekly iron-folate administration ; 691 girls served as controls .  RESULTS About 85 % girls were iron deficient out of which 49.3 % were anemic . Weekly administration took longer time to raise hemoglobin but was effective as well as practical . Plasma ferritin estimation in girls showed rise in level in both the treated groups . CONCLUSION Weekly administration of iron-folate was a practical and effective strategy for anemia prophylaxis in adolescent school girls The purpose of this investigation was to examine the effects of oral iron supplementation on endurance performance in initially iron-depleted , nonanemic female distance runners . Eighteen iron-depleted ( serum ferritin less than 20 ng.ml-1 , hemoglobin greater than or equal to 12 g.dl-1 ) women ( 22 - 39 yr ) performed a VO2max test and an endurance run to exhaustion . Subjects were pair-matched on the basis of endurance time and then r and omly assigned to an iron supplement or a placebo group . Following supplementation , the iron group had a significantly higher ( P = 0.03 ) mean serum ferritin concentration ( 23.4 vs 15.7 ng.ml-1 ) and lower ( P = 0.04 ) mean total iron-binding capacity than the placebo group . Both groups increased their time to exhaustion ( 25.5 % and 22.2 % for the iron and placebo groups , respectively ) but were not significantly different ( P = 0.72 ) from each other . There were also no differences ( P greater than 0.05 ) between the groups with respect to lactate concentrations and physiological measures taken during the two exercise tests . The results of this study suggest that 8 wk of oral iron supplementation improves iron status in iron-depleted female distance runners , but does not enhance endurance capacity Objectives : Limited information is available on the role of pork meat in influencing iron status . The aim of this study was to determine the effect of consuming pork meat as compared to iron supplementation on nutritional status and feeling of well-being . Methods : Young women were r and omly assigned to a control diet ( CG ) , a pork-containing diet ( PG ) , or a control diet with iron supplementation ( SG ) for 12 weeks . Sixty-five women aged 24.6 ± 4.4 years ( mean ± SD ) completed the trial . Results : Serum ferritin concentrations were increased significantly ( p = 0.001 ) in participants assigned to the SG as compared with the other groups , as assessed by repeated- measures analysis of variance . At week 12 , hemoglobin concentrations were significantly higher in PG and SG as compared with CG . Plasma zinc concentrations at the end of the intervention were similar to baseline concentrations for individuals in the CG and PG but were decreased significantly ( p < 0.05 ) in SG . Plasma- , erythrocyte-folate , and serum vitamin B6 and B12 concentrations were not significantly affected by the intervention , although the concentrations of vitamins B6 and B12 tended to increase in PG . Well-being , as measured using the Health Survey Short Form ( SF-36 ) and its 8 multi-item scales , showed significant improvement in vitality in SG ( p < 0.05 ) and bodily pain in PG ( p < 0.05 ) . No significant relationships were observed between these health concept scores and biomarkers of nutritional status . Conclusions : Consumption of pork meat by young women maintains hemoglobin levels to the same extent as low-dose iron supplementation and enhances the components of well-being , mainly their perception of bodily pain This paper discusses the effect that high altitudes have on iron metabolism and summarizes the results of an iron-folate supplementation trial . The two main objectives of the trial were to determine hemoglobin cut-off values for the diagnosis of anemia in Bolivian women of childbearing age living at high altitudes , and to estimate the prevalence of anemia in this population . The study showed that nutritional anemia is an important public health problem in such population s and that many methods of assessing it lead to an underestimation of prevalence . The cut-off values defined through this study , one of the few iron supplementation trials conducted at high altitudes , confirm the need to establish revised hemoglobin values for the diagnosis of anemia in population s living at high altitudes Depletion of body iron stores is a major factor limiting regular blood donations by menstruating females . To determine if regular iron supplementation would solve this problem , we conducted a double-blind study in which menstruating female donors were r and omly placed into one of three groups : one taking 39 mg elemental iron , a second taking 39 mg of iron plus 75 mg vitamin C , and a third taking 100 mg vitamin C daily . The women were requested to donate every 8 weeks for at least 1 year . Blood sample s were taken on each donation for measurements of hemoglobin , total iron binding capacity ( TIBC ) , and ferritin . In the two groups taking iron supplements hemoglobin and ferritin increased from baseline values and the TIBC decreased . The vitamin C control group showed decreases from baseline for hemoglobin and ferritin and increases in TIBC . Differences between groups taking iron supplements and the group not taking supplements were highly significant . Drop-out from the study was due to various causes ; however , iron intolerance was uncommon . Minimal daily iron supplementation was beneficial in maintaining body iron stores and hemoglobin levels in menstruating females on a schedule of blood donation as often as every 8 weeks We studied the effect of 2 weeks of iron therapy on exercise performance and exercise-induced lactate production in trained women athletes : six control subjects with normal parameters of iron status and nine with mild iron-deficiency anemia defined by low Fe/TIBC , ferritin , and minimally decreased Hgb values .  Iron therapy improved the abnormal measures of iron status and low Hgb in the second group to normal . Exercise performance in a progressive work-exercise protocol on a bicycle ergometer to exhaustion was unchanged after iron therapy in both groups ; however , blood lactate levels at maximum exercise in the iron-deficient group decreased significantly from 10.3 + /- 0.6 mmol/L before therapy to 8.42 + /- 0.7 after therapy ( p less than 0.03 ) . The control subjects did not significantly alter lactate levels after maximal exercise on iron compared to placebo : 8.3 + /- 0.8 mmol/L vs. 8.5 + /- 0.7 . Although there was not a significant difference in maximum exercise performance after iron therapy , these data support animal experiments implying that iron may play a role in oxidative metabolism and that minimal decreases in Hgb may impair arterial oxygen content enough to affect aerobic metabolism . In addition , these findings may have important implication s for competitive women athletes in whom mild iron deficiency may go unnoticed Objective : To determine the effect of iron supplementation on iron status and endurance capacity . Design : R and omized , double-blind iron supplementation . Setting : University of Missouri-Columbia and surrounding community . Subjects : Twenty iron-deficient ( serum ferritin , sFer<16 μg/l ; serum transferrin receptor , sTfR>8.0 mg/l ; or sTfR/log sFer index > 4.5 ) , nonanemic ( hemoglobin , Hb>120 g/l , women ; > 130 g/l , men ) men and women ( 18–41 years ) were recruited via fliers and newspaper advertisements ; 20 of 31 eligible subjects participated . Interventions : A 30 mg measure of elemental iron as ferrous sulfate or placebo daily for 6 weeks . Results : Dietary iron intake and physical activity did not differ between groups before or after supplementation . Iron supplementation significantly increased sFer compared to placebo ( P=0.01 ) , but did not affect Hb or hematocrit . Iron supplementation prevented the decline in ventilatory threshold ( VT ) observed in the placebo group from pre- to post-supplementation ( P=0.01 ) ; this effect was greater in individuals with lower sFer before intervention ( P<0.05 ) . Changes in sFer from pre- to post-treatment were positively correlated with changes in VT ( P=0.03 ) , independent of supplementation . The iron group significantly increased gross energetic efficiency during the submaximal test ( P=0.04 ) . Changes in sFer were negatively correlated with changes in average respiratory exchange ratio during the submaximal test ( P<0.05 ) . Conclusions : Iron supplementation significantly improves iron status and endurance capacity in iron-deficient , nonanemic trained male and female subjects . Sponsorship : Missouri University Alumni Association , by the Elizabeth Hegarty Foundation and by the Department of Nutritional Sciences Summary Serum iron deficiency has a high incidence in female athletes . We investigated the effects of a daily oral iron supplement , ( 160 mg ) administered during an intensive 7-week physical training programme , on body iron status , and the maximal aerobic capacity ( VO2max ) of 13 women ( group A ) compared to 15 who took a placebo ( group B ) . The subjects were 19 years old . Blood sample s were obtained before training began and on days 1 , 7 , 21 and 42 of training . They were analysed for packed cell volume ( PVC ) and for haemoglobin ( Hb ) , 2,3-diphosphoglycerate ( 2,3-DPG ) , haptoglobin , iron and ferritin concentrations . TheVO2max was measured on days 0 , 21 and 42 of training . Following 21 days of training Hb , PCV and ferritin were significantly higher ( P⩽0.01 ) in group A compared to group B. Over the training period Hb rose by 9.3 % and 2.4 % in groups A and B , respectively . At the end of training 66 % of group B exhibited ferritin concentrations below 10 ng·ml−1 , while none of group A had such low values . MeanVO2max of group A had increased by 7.5 % following 21 days of training ( P⩽0.01 ) and by 15.3 % after 42 days . No appreciable increase inVO2max had occurred in group B by day 21 ( significantly lower thanVO2max of group A;P⩽0.05 ) , however by day 42 it had increased by 14.3 % ( P⩽0.05 ) . In both groups 2,3-DPG·g Hb−1 had increased significantly ( P⩽0.005 ) by day 7 ( 22 % ) and remained at that level for an additional 35 days . We concluded that a daily oral iron supplement given to young women during intensive training improved several haematological variables and their body iron status . This improvement was associated with an increasedVO2max only during the early stages of their training ( day 21 ) compared with the placebo group OBJECTIVE To compare the effectiveness of weekly vs daily iron and folic acid supplementation for control of anemia in adolescent Nepalese girls . DESIGN R and omized controlled trial . SETTING A Government Girl School in Dharan , Nepal , an urban foothill town that is 305 m above sea level . SUBJECTS Consecutive healthy adolescent girls ( n = 209 , median age 15 years ) r and omized to 3 groups matched for age , anthropometry , and personal and sociodemographic characteristics . Of 209 subjects , 181 completed the trial . Two girls had adverse reactions to treatment and were excluded . INTERVENTION Group A ( n = 70 ) received a 350-mg ferrous sulfate and 1.5-mg folic acid combination once daily for 90 to 100 days . Group B ( n = 67 ) received the tablet under supervision once a week for 14 weeks . Group C ( n = 72 ) did not receive any drugs . OUTCOME VARIABLE Presupplementation and postsupplementation differences in prevalence of anemia and change in hematocrit . RESULTS Prevalence of anemia ( defined as hematocrit < 36 % ) declined from 68.6 % and 70.1 % in groups A and B to 20 % and 13.4 % , respectively , postsupplementation ( P<.001 ) , whereas the prevalence in group C changed little ( 68.1 % to 65.3 % , P = .81 ) . There was a significant rise in the mean hematocrit of both supplemented groups ( group A , 32.9 % + /- 3.5 % to 41.0 % + /- 5.6 % , P<.001 ; group B , 33.2 % + /- 3.6 % to 40.4 % + /- 4.9 % , P<.001 ) but no appreciable change in controls ( 34.2 % + /- 2.9 % to 34.1 % + /- 3.3 % , P = .91 ) . Net change in mean hematocrit in both the supplementation groups was comparable ( P = .57 ) . CONCLUSIONS The prevalence of anemia in adolescent Nepalese girls is high . Supervised iron and folic acid therapy once a week is an effective alternative to daily administration and helps lower the prevalence of anemia in adolescent girls Serum transferrin receptor ( sTfR ) concentration has been recognized recently as a reliable indicator of functional iron deficiency , but its response to iron supplementation has not been investigated in marginally iron-deficient women . In this r and omized , double-blinded trial , 37 female subjects aged 19 - 35 y with iron depletion without anemia ( hemoglobin > 120 g/L and serum ferritin < 16 microg/L ) received an iron supplement or placebo for 8 wk . Iron status was measured before treatment , after 4 wk of treatment , and posttreatment ( ie , after 8 wk of treatment ) . Iron supplementation of these iron-depleted , nonanemic women result ed in a progressive and significant decrease in sTfR and a significant increase in serum ferritin , and prevented a fall in hemoglobin . The responsiveness of sTfR to iron treatment indicated that sTfR is a sensitive indicator of marginal iron deficiency in iron-depleted , nonanemic women , even when their body iron stores were being replenished To determine the effects of an 8-wk dietary iron supplementation ( 100 mg.d-1 ) on low plasma ferritin concentration ( < 20 ng.ml-1 ) and endurance , 20 active women ( 19 - 35 yr ) were studied while performing a VO2max test and an endurance test ( 80 % VO2max ) on a cycle ergometer . Subjects were r and omly placed in an iron supplement ( IG ) or a placebo group ( PG ) using a double-blind method . After treatment in the IG , ferritin levels were higher ( 22.5 + /- 3.4 vs 14.3 + /- 2.2 ng.ml-1 ; P < 0.05 ) , Hb increased ( 12.8 + /- 0.4 to 14.1 + /- 0.2 g.dl-1 ; P < 0.05 ) , and TIBC decreased ( 366.2 + /- 24.8 to 293.8 + /- 14.0 micrograms.dl-1 ; P < 0.05 ) . Also after treatment the IG 's VO2max was significantly greater ( P < 0.05 ) than the PG value and their postendurance blood lactate decreased ( 5.03 + /- 0.44 to 3.85 + /- 0.6 mM.l-1 ; P < 0.05 ) . Endurance time to exhaustion increased 38 % ( 37.28 + /- 5.03 to 51.4 + /- 7.45 min ) following iron treatment ; however , this change was not statistically significant . The results suggest that this level of iron supplementation can reverse mild anemia , increase VO2max , and reduce blood lactate concentration after submaximal exercise OBJECTIVE To investigate the effect of iron supplementation on iron deficiency anemia of childbearing age women , and to find out the optimal amount of iron intake for maintaining their health . METHODS 74 childbearing age women aged 21 to 45 years with anemia were r and omly assigned to intervention or control group by hemoglobin content , and a iron nutrition packet ( mainly composed of ferric pyrophosphate and ferrous fumarate , containing iron 8 mg ) or a placebo packet was given daily for six months , respectively . Hemoglobin , serum ferritin , food frequency and 24h dietary recall survey were performed before intervention and three and six months after intervention . RESULTS Hemoglobin and serum ferritin of the intervention group were significantly higher ( P < 0.01 ) than that in control group after six months . The number of women with hemoglobin > or = 120 g/L in intervention and control group was 15 ( 44.1 % ) and 5 ( 14.3 % ) , respectively ( P < 0.01 ) . The number of women with serum ferritin > or = 15 micro g/L in intervention and control group was 11 ( 34.4 % ) and 4 ( 12.5 % ) , respectively ( P < 0.05 ) . The average dietary iron intake was 14.0 mg/d , mainly from plant foods . There was a positive correlation of total iron intake  ( dietary iron plus iron supplements ) with hemoglobin ( r = 0.57 , P < 0.01 ) . More menstrual blood and dietary fiber were the risk factors for iron deficiency anemia ( P < 0.05 ) . CONCLUSION The anemic status in childbearing age women could be improved by providing iron 8 mg daily for six months consecutively . Daily dietary intake of iron 23.2 mg can meet the requirement of maintaining normal iron storage for childbearing age women The purpose of this study was to determine the effects of two weeks of high dosage iron supplementation on various blood iron indices and metabolic parameters in non-anemic , iron-depleted competitive female cross-country runners . The subjects were highly trained members of the Colorado State University cross-country team and were completing 40 to 50 miles of training weekly . A pretest , post-test single-blind crossover design was employed . Upon collection of baseline exercise blood and metabolic data , five subjects were r and omly assigned to iron supplementation ( 650 mg ferrous sulfate ; 130 mg elemental iron ) and five subjects to placebo treatment . At two weeks the treatments were reversed . Exercise blood and metabolic data were collected at two-week intervals . Dietary iron intake was assessed using a three-day dietary survey . Dietary analysis revealed deficiencies in vitamin B-6 , iron , magnesium , and zinc according to USRDA st and ards . Baseline blood sample s revealed no deficiencies in iron storage or transport proteins . Two weeks of iron supplementation result ed in no significant increases in blood iron indices . Metabolic parameters related to running performance were also unchanged after iron supplementation . High dosage , short-term iron supplementation appears to have no effect on blood or metabolic parameters in iron-depleted but non-anemic female cross-country runners Low serum ferritin concentrations are commonly found in female athletes . By study ing the effects of an 8-week iron or placebo supplementation in 31 female athletes ( aged 17 - 31 years ) , with an initial serum ferritin concentration less than or equal to 25 micrograms/l and blood hemoglobin 120 g/l , we investigated whether low serum ferritin values hinder aerobic performance . Serum ferritin concentration increased from 14 ( 25th and 75th percentile : 11 , 21 ) to 26 ( 18 , 36 ) micrograms/l in the iron-supplemented group , but remained at a low 11 ( 9 , 17 ) micrograms/l in the placebo group ( group difference after supplementation : p = 0.001 ) . Before supplementation , blood hemoglobin concentration was not different in the two groups . After supplementation , however , the concentration in the iron group was 139 ( 135 , 144 ) g/l and 128 ( 126 , 134 ) g/l in the placebo group ( group difference : p = 0.001 ) . Iron supplementation did not affect blood lactate concentration or VO2max during an incremental ergometer test . Hence , aerobic performance was not impaired in nonanemic female athletes with serum ferritin 25 micrograms/l Objective : To investigate the efficacy of , first , a dietary regimen involving increased consumption of iron-rich foods and enhancers of iron absorption and decreased consumption of inhibitors of iron absorption and , second , a low dose iron chelate iron supplement , for increasing iron stores in young adult New Zeal and women with mild iron deficiency ( MID ) . Methods : The study was a 16 week r and omized placebo-controlled intervention . Seventy-five women aged 18 to 40 years with MID ( serum ferritin < 20 μg/L and hemoglobin ≥120 g/L ) were assigned to one of three groups : Placebo , Supplement ( 50 mg iron/day as amino acid chelate ) or Diet . Participants in the Diet Group were given individual dietary counseling to increase the intake and bioavailability of dietary iron  . Dietary changes were monitored by a previously vali date d computer-administered iron food frequency question naire . Results : Diet Group members significantly increased their intake of flesh foods , heme iron , vitamin C and foods cooked using cast-iron cookware and significantly decreased their phytate and calcium intakes . Serum ferritin increased in the Supplement and Diet Groups by 59 % ( p=0.001 ) and 26 % ( p=0.068 ) , respectively , in comparison to the Placebo Group . The serum transferrin receptor : serum ferritin ratio decreased by 51 % in the Supplement Group ( p=0.0001 ) , and there was a non-significant decrease of 22 % ( p=0.1232 ) in the Diet Group . Conclusions : This study is the first , to our knowledge , to demonstrate that an intensive dietary program has the potential to improve the iron status of women with iron deficiency Interventions to combat mild Fe deficiency in women of childbearing age may affect Zn nutriture . We used dietary and laboratory indices to assess change in Zn status during a 4-month partially blinded placebo-controlled Fe intervention in women with low Fe stores ( serum ferritin < 20 microg/l and Hb > or = 120 g/l ) from Dunedin , New Zeal and . Subjects aged 18 - 40 years were r and omly assigned to three groups : dietary advice ( diet group ; DG ; n 29 ) , daily Fe supplement with meals ( supplement group ; SG ; n 23 ; 50 mg Fe as amino acid chelate ) and placebo ( placebo group ; PG , n 26 ) . A vali date d semi-quantitative FFQ ( SFFQ ) was administered at baseline , and at 4 , 8 and 15 weeks ; fasting morning blood sample s were assayed for serum Zn , alkaline phosphatase ( ALP ) and C-reactive protein at baseline , and at 4 , 8 , 12 and 16 weeks ; hair Zn and taste detection thresholds by electrogustometry were measured at baseline and at 16 weeks . Intakes of flesh foods and vitamin C but not Zn or Fe increased , whereas phytate and phytate : Zn molar ratios decreased ( all P < or = 0.01 ) in the DG compared with the PG and SG , based on three SFFQ . Serum Zn increased in both the DG and PG ( adjusted , P < or = 0.002 ) , so the between-group difference was not significant ; the lack of a parallel rise in the SG was significant when compared with the PG ( P = 0.02 ) . ALP activity ( but not hair Zn or taste acuity ) followed a similar trend . In conclusion , Zn status was not improved compared with placebo by an Fe-based dietary intervention . However , a daily moderate-dose Fe supplement with meals appeared to lower Zn status in these young adult women Iron-deficiency anemia impairs exercise capacity , but whether nonanemic iron depletion decreases endurance performance is unclear . In 14 iron-deficient ( serum ferritin level , less than 20 micrograms/L [ less than 20 ng/L])nonanemic runners , hematologic and treadmill running values were followed up during a competitive season . Following a four-week control period , runners were treated for one month in a double-blind protocol with ferrous sulfate ( 975 mg/d ) or placebo . During treatment , the mean ferritin level rose from 8.7 to 26.6 micrograms/L ( 8.7 to 26.6 ng/mL ) in those patients taking iron and fell from 10.6 to 8.6 micrograms/L ( 10.7 to 8.6 ng/mL ) in the placebo group . Treadmill endurance times improved significantly in the iron-treated runners compared with controls . Endurance time declined in all seven controls ( range , 0.07 to 1.30 minutes ) , while six of seven iron-treated subjects improved their performance ( range , 0.03 to 1.92 minutes ) . No significant differences in maximal or submaximal oxygen consumption , ventilation , or heart rate were observed between the groups except for a 4 % increase in maximum oxygen consumption during placebo treatment . These data indicate that nonanemic iron deficiency impairs exercise performance but does not influence gas exchange or cardiac measures BACKGROUND Iron deficiency is a public problem in women , which contributes to the high percentage of deferred blood donations in this group . This study evaluated the effect of iron supplementation in improving iron stores to promote safe blood donation in women . STUDY DESIGN AND METHODS A total of 412 female blood donors were r and omly recruited for the study . The volunteers were scheduled for an initial visit and three subsequent visits at 4-month intervals for possible repeat donation . Each volunteer was given 21 tablets of 150 mg of ferrous sulfate or placebo to be taken three times daily for 1 week after each blood donation . Their hemoglobin ( Hb ) concentration , hematocrit ( Hct ) , serum ferritin , total iron-binding capacity ( TIBC ) , and percent saturation of the TIBC were tested throughout the course of the study . RESULTS The group taking ferrous sulfate showed no significant difference between the mean initial and final result for any of the values other than Hb values , whereas there was a significant decline in mean Hb , Hct , serum iron , serum ferritin , and percent saturation in the group taking placebo .  Hb concentrations declined significantly in both groups ; however , it was more severe in the placebo group when compared to the ferrous sulfate group . The relative risk of iron deficiency in placebo group was 3.6 ( 95 % confidence interval = 1.73 - 7.74 ) . CONCLUSION The results indicate that supplementation therapy can be considered as one of the strategies to promote safe blood donation in women . A quantity of 150 mg of elemental iron per day as ferrous sulfate , however , is not the correct dose for Iranian female donors Objective Women ’s nutritional status during conception and early pregnancy can influence maternal and infant outcomes . This study examined the efficacy of pre-pregnancy supplementation with iron and multivitamins to reduce the prevalence of anemia during the periconceptional period among rural Tanzanian women and adolescent girls . Design A double-blind , r and omized controlled trial was conducted in which participants were individually r and omized to receive daily oral supplements of folic acid alone , folic acid and iron , or folic acid , iron , and vitamins A , B-complex , C , and E at approximately single recommended dietary allowance ( RDA ) doses for six months . Setting Rural Rufiji District , Tanzania . Subjects Non-pregnant women and adolescent girls aged 15–29 years ( n = 802 ) . Results The study arms were comparable in demographic and socioeconomic characteristics , food security , nutritional status , pregnancy history , and compliance with the regimen ( p>0.05 ) . In total , 561 participants ( 70 % ) completed the study and were included in the intention-to-treat analysis . Hemoglobin levels were not different across treatments ( median : 11.1 g/dL , Q1-Q3 : 10.0–12.4 g/dL , p = 0.65 ) . However , compared with the folic acid arm ( 28 % ) , there was a significant reduction in the risk of hypochromic microcytic anemia in the folic acid and iron arm ( 17 % , RR : 0.61 , 95 % CI : 0.42–0.90 , p = 0.01 ) and the folic acid , iron , and multivitamin arm ( 19 % , RR : 0.66 , 95 % CI : 0.45–0.96 , p = 0.03 ) . Inverse probability of treatment weighting ( IPTW ) to adjust for potential selection bias due to loss to follow-up did not material ly change these results . The effect of the regimens was not modified by frequency of household meat consumption , baseline underweight status , parity , breastfeeding status , or level of compliance ( in all cases , p for interaction>0.2 ) . Conclusions Daily oral supplementation with iron and folic acid among women and adolescents prior to pregnancy reduces risk of anemia . The potential benefits of supplementation on the risk of periconceptional anemia and adverse pregnancy outcomes warrant investigation in larger studies . Trial Registration Clinical Trials.gov A r and omized , double-blind trial of iron replacement after repeated blood donation was conducted in 75 menstruating women ; 51 completed the study . Volunteers were assigned r and omly to one of three treatment groups : 1 ) carbonyl iron ( nontoxic elemental iron powder ) , 600 mg ; 2 ) ferrous sulfate , 300 mg ( 60 mg Fe++ ) ; or 3 ) placebo , each given three times daily for 1 week immediately after blood donation . Blood sample s obtained initially and 56 days later were tested for hemoglobin , mean corpuscular volume ( MCV ) , free erythrocyte protoporphyrin , serum ferritin , serum iron , total iron binding capacity ( TIBC ) , and percent saturation of TIBC . The prevalence of gastrointestinal side effects was similar in both groups taking iron . At the end of the study there was no laboratory evidence of change in iron status in women who received carbonyl iron ( n = 15 ) . In those treated with ferrous sulfate ( n = 17 ) the mean TIBC increased ( p less than 0.001 ) , and in the placebo group ( n = 19 ) there were decreases in mean MCV ( p less than 0.01 ) , serum ferritin ( p less than 0.001 ) , and percent saturation ( p = 0.027 ) with an increase in mean TIBC ( p = 0.004 ) . Carbonyl iron seems to be effective for short-term iron replacement in repeat blood donors and may have the advantage of decreased or absent risk of poisoning if accidentally ingested by children Objective : To investigate whether iron supplementation can improve thyroid hormone function in iron-deficient adolescent girls . Design : A double-blind r and omized intervention study . Setting : The study was performed from 2002 through 2003 in the Islamic Republic of Iran . Subjects:103 iron-deficient non-anaemic girls who fulfilled all inclusion criteria were included , and 94 subjects successfully completed the study . Interventions : Patients were r and omly assigned to one of four groups and treated with a single oral dose of 190 mg iodine plus 300 mg ferrous sulphate 5 times/week ( n=24 ) , 300 mg ferrous sulphate 5 times/week ( n=23 ) , a single oral dose of 190 mg iodine ( n=25 ) , or a placebo ( n=22 ) for 12 weeks . Results : All groups were comparable at baseline . After the intervention , there was a significant increase in ferritin and transferrin saturation in the iron+iodine group ( 17.6 vs 8.7 μg/dl , and 18.8 vs 7.2 % , respectively , P<0.001 for both ) and in the iron group ( P<0.001 for both ) . Urinary iodine doubled in the iron+iodine group and in the iodine group ( P<0.001 for both ) . Thyroid indices tT4 , tT3 and T3RU increased and reverse RT3 decreased in the iron+iodine group ( 10 vs 8.9 μg/dl , P < 0.001 ; 143 vs 138 μg/dl , P<0.05 ; 32.3 vs 28.4 % , P<0.001 and 24.8 vs 44.2 ng/dl , P<0.001 , respectively ) and in the iron group . These two groups did not differ for any of the four indices , but both differed significantly from the iodine and placebo groups . Conclusions : Our results indicate that improvement of iron status was accompanied by an improvement in some indices of thyroid hormones . Sponsorship : This study was supported by the Dean of Research Affairs of the Tehran University of Medical Sciences INTRODUCTION Frequent blood donations may lead to a negative iron balance . Iron depletion may be prevented by iron supplementation after whole blood donations . The aim of this study was to compare the short time changes in iron status after donation in two groups r and omized to iron supplementation or no additional iron . A second objective was to evaluate the effect of iron supplementation in donors having HFE-variants compared to HFE wild types . METHODS Subjects of both genders ( 199 women , 200 men ) were r and omised to receive iron supplementation or no additional iron after donation . Iron status , defined by the concentration of haemoglobin , serum ferritin , soluble transferrin receptor , concentration of haemoglobin in reticulocytes ( CHr ) and percent hypochrome mature red blood cells , was determined at the start of donation and 8 + /- 2 days after donation . HFE genotyping was performed at reappearance . RESULTS There was a significant difference between the two study groups on all the iron status parameters . CHr was an efficient , early marker of ongoing synthesis of haemoglobin . Heterozygosity for the HFE variants C282Y and H63D had no statistically significant influence on the iron status . The donor 's baseline serum ferritin value may be basis for an individual iron supplementation regimen , as donors with serum ferritin > 50 microg/l do not seem to utilize the iron supplementation , but prefer endogenous iron to restore the loss of haemoglobin . CONCLUSION Iron supplementation had a significant positive impact on the restoration of iron status one week after donation Sixty-nine boys and girls between 10 and 14 years , with evidence of sub clinical vitamin deficiencies and poor iron status were enrolled into the study at the beginning of the rainy season . Children were allocated to three treatment groups to receive five times weekly either a placebo , 200 mg ferrous sulphate or 5 mg riboflavin and 150 mg ascorbic acid . Before receiving the supplement , and 9 weeks later , children performed an exercise regimen on a treadmill during which expired air was collected and heart rate measured . There was a general deterioration in the running performance of the children during the study period which was not affected by either the iron or the vitamin supplement BACKGROUND Decrements in iron status have been reported in female soldiers during military training . Diminished iron status adversely affects physical and cognitive performance . OBJECTIVE We wanted to determine whether iron supplementation could prevent decrements in iron status and improve measures of physical performance and cognitive status in female soldiers during basic combat training ( BCT ) . DESIGN In this 8-wk r and omized , double-blind , placebo-controlled trial , soldier volunteers ( n = 219 ) were provided with capsules containing either 100 mg ferrous sulfate or a placebo . Iron status indicator assays were performed pre- and post-BCT . Two-mile running time was assessed post-BCT ; mood was assessed by using the Profile of Mood States question naire pre- and post-BCT . RESULTS The BCT course affected iron status : red blood cell distribution width and soluble transferrin receptor were elevated ( P < 0.05 ) , and serum ferritin was lowered ( P < 0.05 ) post-BCT . Iron supplementation attenuated the decrement in iron status ; group-by-time interactions ( P < 0.01 ) were observed for serum ferritin and soluble transferrin receptor . Iron supplementation result ed in improved ( P < 0.05 ) vigor scores on the Profile of Mood States post-BCT and in faster running time ( P < 0.05 ) in volunteers reporting to BCT with iron deficiency anemia . CONCLUSIONS Iron status is affected by BCT , and iron supplementation attenuates the decrement in indicators of iron status in female soldiers . Furthermore , iron supplementation may prove to be beneficial for mood and physical performance during the training period . Future efforts should identify and treat female soldiers or athletes who begin training regimens with iron deficiency or iron deficiency anemia In order to examine the effects of mild iron deficiency on physical work capacity , 40 prelatent iron-deficient female endurance runners were studied before and after 8 wk of supplementation with either oral iron ( 320 mg ferrous sulfate ) or a matching placebo . Subjects underwent the following physical work capacity tests : the Wingate cycle ergometer test , the anaerobic speed test , the ventilatory threshold , VO2max , and maximal treadmill velocity during the VO2max test . Muscle biopsy sample s pre- and post-treatment were obtained from 17 of the subjects , and these were assayed for citrate synthase and cytoplasmic alpha-glycerophosphate dehydrogenase activity . Subjects were r and omly assigned to one of the treatment groups , and a double-blind method of administration of the supplements was used . The differences in improvement scores between the two groups on the work capacity and enzyme activity variables were statistically nonsignificant ( P greater than 0.05 ) . Serum ferritin values rose from a mean of 12.4 + /- 4.5 to 37.7 + /- 19.7 ng.ml-1 for the experimental group and from 12.2 + /- 4.3 to 17.2 + /- 8.9 ng.ml-1 for the controls ( P = 0.0025 ) , whereas hemoglobin levels remained fairly constant for both groups ( P = 0.6 ) . Eight weeks of iron supplementation to prelatent/latent iron-deficient , physically active females did not significantly enhance work capacity . Within the limitations of this study , the presence of a serum ferritin below 20 ng.ml-1 does not pose a significant h and icap to physical work capacity The effects of 4 weeks iron supplementation on haematological and immunological status were studied in 25 elite female soccer players aged 20 - 28 years . The subjects were r and omized and assigned to one of the following two groups ; subjects given 40 mg/day iron supplementation ( S group ) or those given placebo ( C group ) . The oral iron supplementation ( 40 mg elemental iron ) was taken in 15 ml solution once a day by the S group , and the C group took a placebo for 4 weeks . Daily energy and protein intakes met the Korean Recommended Dietary Allowances . Blood haemoglobin concentration did not change in the S group , but decreased significantly ( P<0.05 ) in the C group over the 4-week experimental period . Haematocrit , mean cell volume , mean cell haemoglobin and total iron binding capacity decreased significantly , and mean cell haemoglobin concentration increased significantly ( P<0.05 ) in both the S and C groups . Plasma ferritin concentration increased significantly ( P<0.05 ) in the S group , but did not change in the C group . The change of plasma immunological parameters and erythrocyte anti-oxidative enzyme activities were almost the same between the S and C groups . These results suggest that 4 weeks of iron supplementation by elite female soccer players significantly increased body iron stores and inhibited decrease of haemoglobin concentration induced by soccer training We studied effects of dose and treatment duration during low-dose iron supplementation in premenopausal , non-pregnant women , with initial serum ferritin and haemoglobin concentrations < 20 micrograms x l-1 and > or = 120 g x l-1 , respectively . The study was r and omized , double-blind and placebo-controlled . Three groups completed a 6-month study : placebo ( n = 27 ) , FE-9 ( 9 mg iron x day-1 , n = 18 ) and FE-27 group ( 27 mg iron x day-1 , n = 19 ) . The supplement consisted of 11 % heme and 89 % inorganic iron . In FE-27 , serum ferritin increased from ( mean , 95 % confidence interval ) 11.8 ( 9.7 ; 14.4 ) to 25.3 ( 18.6 ; 34.4 ) micrograms x l-1 in 1 month , and remained stable after that ( ANOVA : group effect , P = 0.0003 ) . In both FE-9 and FE-27 , blood haemoglobin levels increased from 136 ( 132 ; 140 ) to 142 ( 139 ; 145 ) g x l-1 in 1 month , remaining constant after that ( group effect , P = 0.001 ) . Hence , the 27 mg daily dose of organic/inorganic iron corrected both mild anaemia and storage iron depletion , whereas the 9 mg dose did not affect iron stores . Elongation of treatment duration above 1 month brought about only minor changes The effects of energy supplementation ( group I received 200 kcal/day and group II received 1000/kcal day ) were examined on road workers in Kenya .  Anthropometric , dietary , worker productivity , clinical hematology , and parasitology data were collected from 224 workers of both sexes or , sub sample s of these workers at base-line , midpoint , and final measurement periods . Sixty-seven percent of the work force was less than 85 % of weight for height . Females tended to be better nourished than males . Multiple regression analysis showed that increases in arm circumference and Hb levels were associated with significant productivity gains of about 4 % . At the midpoint , group II males gained 1.10 kg ( p less than 0.0003 ) while group I males showed no change . Weight loss during the latter part of the study result ed in no significant final weight change for males . " Successful " supplementation was weakly associated with a productivity increase for group II workers of 12.5 % ( p less than 0.10 ) The impact of long-term ( 6-month ) moderate exercise on the iron status of previously sedentary women was determined by r and omly assigning 62 college-age women into one of the following four groups : 1 ) 50 mg.d-1 iron supplement , low iron diet ( N = 16 ) ; 2 ) Placebo , free choice diet ( N = 13 ) ; 3 ) Meat supplement to achieve 15 mg.d-1 iron intake ( N = 13 ) ; and 4 ) Control , free choice diet ( N = 20 ) . All groups except the Control group exercised 3 d.wk-1 at 60%-75 % of their heart rate reserve . VO2max was measured at baseline and week 24 . Blood was sample d at baseline and every 4 wk thereafter for 24 wk to measure iron status and to eluci date the causes for alterations in iron status . Subjects had depleted iron stores throughout the study as indicated by their serum ferritin levels ( < 15 ng.ml-1 ) . Serum iron , total iron binding capacity and transferrin saturation were not compromised with exercise . Mean hemoglobin level in the Placebo/Ex group was significantly ( P < 0.05 ) lower than the 50 Fe/Ex and the Meat/Ex groups by week 24 . However , changes in serum albumin , haptoglobin , and erythropoietin data from the study can not explain these changes Female blood donors with low hematocrit levels detected by copper sulfate screening were selected r and omly to receive either 75 mg of iron per day , as ferrous gluconate , or a calcium phosphate placebo . Their ferritin , serum iron , total iron-binding capacity , zinc protoporphyrin , and hemoglobin values , as well as their suitability to donate blood , were determined initially ( Visit 1 ) and at four follow-up visits ( Visits 2 - 5 ) . By the second visit , the serum ferritin and iron values of donors receiving iron supplementation differed significantly from those of donors receiving placebo . By the fifth visit , a less marked but significant increase in hemoglobin had occurred in the iron group , but not in the placebo group . At no time was there a significant difference between the groups ' suitability to donate blood , with each group donating at almost half of their visits . The authors conclude that iron supplementation at this dose level in deferred female blood donors improves their iron status and hemoglobin levels , but does not significantly increase their suitability to donate blood as compared with the suitability of placebo-treated donors The effectiveness of elemental , nontoxic carbonyl iron in replacing iron lost at blood donation was examined . In a r and omized double-blind design , 99 women , aged 18 to 40 , were given placebo or low-dose carbonyl iron ( 100 mg orally ) at bedtime for 56 days after phlebotomy . Compliance was equivalent for the two regimens . Mild side effects were slightly greater with carbonyl iron . At Day 56 , estimated net iron absorption from therapy or diet , or both , was sufficient to replace iron in 85 percent of those receiving carbonyl iron but in only 29 percent of those taking placebo ( p less than 0.001 ) . The rates of deferral from repeat donation were 8 percent in the carbonyl iron group and 36 percent in the placebo group ( p less than 0.01 ) , and the positive predictive value of routine screening in identifying participants without iron deficiency was 83 versus 13 percent ( p less than 0.01 ) . It can be concluded that short-term carbonyl iron supplementation in female blood donors can replace the iron lost at phlebotomy , protect the women against iron deficiency , and enhance their ability to give blood This experimental study was design ed to investigate the effects of daily versus intermittent iron supplementation on iron status of high school girls in Zahedan and Rasht cities in 1996 - 1997 . The subjects were selected r and omly from among students of grade s 1 - 3 of four high schools in each city .  Anemia was determined by measuring hematological indices . 260 anemic and a similar number of non-anemic subjects of 4 high schools were selected and allocated r and omly to 4 treatment groups . During a 3-month period , the test groups were given 150 mg ferrous sulfate tablets ( 50 mg Fe ) . Subjects in group 1 received a daily dose , groups 2 & 3 received twice or once weekly doses respectively . The control group received no iron supplement . For these subjects , in addition to hematological indices biochemical iron indices were measured in the beginning and at the end of the study . The increases in hemoglobin concentration in anemic subjects were not significantly different among supplemented groups but were different from the control group ( p < 0.00001 ) . Among anemic subjects , changes in serum ferritin levels in 3 supplemented groups were significantly different from the control group . Serum ferritin in Group 1 was also increased to a greater extent than groups 2 and 3 ( P < 0.00001 ) . It is concluded that over the study period a weekly iron dose was as effective as a daily dose in treating anemia but the daily dose was more effective in improving iron stores than a weekly dose in the short run BACKGROUND Up to 25 % of adolescent girls in the USA are iron deficient . This double-blind , placebo-controlled clinical trial assessed the effects of iron supplementation on cognitive function in adolescent girls with non-anaemic iron deficiency . METHODS 716 girls who enrolled at four Baltimore high schools were screened for non-anaemic iron deficiency ( serum ferritin < or = 12 micrograms/L with normal haemoglobin ) . 98 ( 13.7 % ) girls had non-anaemic iron deficiency of whom 81 were enrolled in the trial . Participants were r and omly assigned oral ferrous sulphate ( 650 mg twice daily ) or placebo for 8 weeks . The effect of iron treatment was assessed by question naires and haematological and cognitive tests , which were done before treatment started and repeated after the intervention . We used four tests of attention and memory to measure cognitive functioning . Intention-to-treat and per- protocol analyses were done . FINDINGS Of the 81 enrolled girls with non-anaemic iron deficiency , 78 ( 96 % ) completed the study ( 39 in each group ) . Five girls ( three control , two treatment ) developed anaemia during the intervention and were excluded from the analyses . Thus , 73 girls were included in the per- protocol analysis . Ethnic distribution , mean age , serum ferritin concentrations , haemoglobin concentrations , and cognitive test scores of the groups did not differ significantly at baseline . Postintervention haematological measures of iron status were significantly improved in the treatment group ( serum ferritin 27.3 vs 12.1 micrograms/L , p < 0.001 ) . Regression analysis showed that girls who received iron performed better on a test of verbal learning and memory than girls in the control group ( p < 0.02 ) . INTERPRETATION In this urban population of non-anaemic iron-deficient adolescent girls , iron supplementation improved verbal learning and memory Pregnant women with anaemia due to combined iron and folate deficiencies were r and omly divided into 3 groups receiving either combination therapy with iron and pteroylglutamic acid , or treatment with iron or pteroylglutamic acid olone .  A fourth group of pregnant women with levels of Hb above 10 g/100 ml received  placebo . Combined iron and folate administration result ed in a marked therapeutic response , while mild or insignificant improvement was associated with either iron or folic acid teratment alone . The Hb concentration of the women receiving placebo dropped gradually in most instances . The results reported here suggest that in population s with a high prevalence of iron and folate deficiencies both these compounds should be supplied in order to prevent anaemia . The possible causal relationship between iron and folate deficiencies are discussed in the light of the present results and relevant literature The prevalence of anemia is high in adolescent girls in India , with over 70 % anemic .  Iron-folic acid ( IFA ) supplements have been shown to enhance adolescent growth elsewhere in the world . To confirm these results in India , a study was conducted in urban areas of Vadodora , India to investigate the effect of IFA supplements on hemoglobin , hunger and growth in adolescent girls 10 - 18 y of age . Results show that there was a high dem and for IFA supplements and > 90 % of the girls consumed 85 out of 90 tablets provided . There was an increment of 17.3 g/L hemoglobin in the group of girls receiving IFA supplements , whereas hemoglobin decreased slightly in girls in the control group . Girls and parents reported that girls increased their food intake . A significant weight gain of 0.83 kg was seen in the intervention group , whereas girls in the control group showed little weight gain . The growth increment was greater in the 10- to 14-y-old age group than in the 15- to 18-y-old group , as expected , due to rapid growth during the adolescent spurt . IFA supplementation is recommended for growth promotion among adolescents who are underweight Limited information is available on the role of iron in fatty acid metabolism in humans . We hypothesized that iron supplementation will increase desaturase activity , and so , the aim of this study was to determine the effect of iron supplementation on fatty acid desaturase activity in young women . Participants were r and omly assigned to a  control group ( CG ) or supplementation group ( SG ) who were provided with 37.4 mg of elemental iron daily for 12 weeks . Forty women completed the trial , n = 19 in CG and n = 21 in SG . The mean ages were 25.2 and 24.6 years , and body mass indices were 21.8 and 21.2 ( kg/m(2 ) ) in CG and SG , respectively  . Serum ferritin concentrations increased significantly ( P < .01 ) in subjects assigned to SG but were unchanged in CG . Serum iron concentrations were not significantly changed . Plasma zinc concentrations at the end of the intervention were similar to baseline values for individuals in CG but were decreased significantly ( P = .004 ) in SG . Plasma fatty acids , phospholipid fatty acids , and desaturase activities , expressed as precursor-to-product ratios , were not significantly affected by the intervention , although in SG the concentration of serum ferritin was correlated positively ( P < .05 ) with Δ6-desaturase activity . Supplementing non-anemic women with low dose iron improves iron status but has no significant effect on desaturase activity . The lack of a clear effect on an indirect indicator of desaturase activity may be related to the antagonism between iron and zinc , as illustrated by the decrease in plasma zinc concentrations in women who were supplemented with iron
BACKGROUND Iron-deficiency anaemia is highly prevalent among non-pregnant women of reproductive age ( menstruating women ) worldwide , although the prevalence is highest in lower-income setting s. 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 .
Although there have been many trials reporting effects of iron in non-pregnant women , these trials have never been synthesis ed in a systematic review .
OBJECTIVES To establish the evidence for effects of daily supplementation with iron on anaemia and iron status , as well as on physical , psychological and neurocognitive health , in menstruating women .