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Pharmaceuticals 2018, 11(3), 85; https://doi.org/10.3390/ph11030085

Iron Absorption in Iron-Deficient Women, Who Received 65 mg Fe with an Indonesian Breakfast, Is Much Better from NaFe(III)EDTA than from Fe(II)SO4, with an Acceptable Increase of Plasma NTBI. A Randomized Clinical Trial

1
Department of Internal Medicine, Faculty of Medicine, University of Indonesia/Dr Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
2
Department of Clinical Pathology, Faculty of Medicine, University of Indonesia/Dr Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
3
Eijkman Institute for Molecular Biology, Jakarta 10430, Indonesia
4
Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, University of Indonesia/Dr Cipto Mangunkusumo Hospital, Jakarta 10430, Indonesia
5
Department of Medical Microbiology, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
*
Author to whom correspondence should be addressed.
Received: 13 August 2018 / Revised: 4 September 2018 / Accepted: 7 September 2018 / Published: 10 September 2018
(This article belongs to the Special Issue Iron as Therapeutic Targets in Human Diseases)
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Abstract

Plasma non-transferrin-bound iron (NTBI) is potentially harmful due to the generation of free radicals that cause tissue damage in vascular and other diseases. Studies in iron-replete and iron-deficient subjects, receiving a single oral test dose of Fe(II)SO4 or NaFe(III)EDTA with water, revealed that FeSO4 was well absorbed when compared with NaFeEDTA, while only the Fe(II) compound showed a remarkable increase of NTBI. As NaFeEDTA is successfully used for food fortification, a double-blind randomized cross-over trial was conducted in 11 healthy women with uncomplicated iron deficiency. All subjects received a placebo, 6.5 mg FeSO4, 65 mg FeSO4, 6.5 mg NaFeEDTA, and 65 mg NaFeEDTA with a traditional Indonesian breakfast in one-week intervals. Blood tests were carried out every 60 min for five hours. NTBI detection was performed using the fluorescein-labeled apotransferrin method. Plasma iron values were highly increased after 65 mg NaFeEDTA, twice as high as after FeSO4. A similar pattern was seen for NTBI. After 6.5 mg of NaFeEDTA and FeSO4, NTBI was hardly detectable. NaFeEDTA was highly effective for the treatment of iron deficiency if given with a meal, inhibiting the formation of nonabsorbable Fe-complexes, while NTBI did not exceed the range of normal values for iron-replete subjects. View Full-Text
Keywords: iron deficiency anemia; nutrient iron; oral iron therapy; FeSO4; NaFeEDTA; non-transferrin-bound iron (NTBI); developing countries; Indonesia iron deficiency anemia; nutrient iron; oral iron therapy; FeSO4; NaFeEDTA; non-transferrin-bound iron (NTBI); developing countries; Indonesia
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Ginanjar, E.; Indrawati, L.; Setianingsih, I.; Atmakusumah, D.; Harahap, A.; Timan, I.S.; Marx, J.J.M. Iron Absorption in Iron-Deficient Women, Who Received 65 mg Fe with an Indonesian Breakfast, Is Much Better from NaFe(III)EDTA than from Fe(II)SO4, with an Acceptable Increase of Plasma NTBI. A Randomized Clinical Trial. Pharmaceuticals 2018, 11, 85.

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