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Research

Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial

Paul Vaucher, Pierre-Louis Druais, Sophie Waldvogel and Bernard Favrat
CMAJ August 07, 2012 184 (11) 1247-1254; DOI: https://doi.org/10.1503/cmaj.110950
Paul Vaucher
From the Department of Community Medicine and Primary Care (Vaucher), University of Geneva, Switzerland; the National College of General Practitioners (Druais), Le Port Marly, France; the Blood Transfusion Service of the Swiss Red Cross (Waldvogel), Lausanne, Switzerland; and the Department of Ambulatory Care and Community Medicine (Favrat), University of Lausanne, Switzerland.
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Pierre-Louis Druais
From the Department of Community Medicine and Primary Care (Vaucher), University of Geneva, Switzerland; the National College of General Practitioners (Druais), Le Port Marly, France; the Blood Transfusion Service of the Swiss Red Cross (Waldvogel), Lausanne, Switzerland; and the Department of Ambulatory Care and Community Medicine (Favrat), University of Lausanne, Switzerland.
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Sophie Waldvogel
From the Department of Community Medicine and Primary Care (Vaucher), University of Geneva, Switzerland; the National College of General Practitioners (Druais), Le Port Marly, France; the Blood Transfusion Service of the Swiss Red Cross (Waldvogel), Lausanne, Switzerland; and the Department of Ambulatory Care and Community Medicine (Favrat), University of Lausanne, Switzerland.
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Bernard Favrat
From the Department of Community Medicine and Primary Care (Vaucher), University of Geneva, Switzerland; the National College of General Practitioners (Druais), Le Port Marly, France; the Blood Transfusion Service of the Swiss Red Cross (Waldvogel), Lausanne, Switzerland; and the Department of Ambulatory Care and Community Medicine (Favrat), University of Lausanne, Switzerland.
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  • For correspondence: Bernard.Favrat@hospvd.ch
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Abstract

Background: The true benefit of iron supplementation for nonanemic menstruating women with fatigue is unknown. We studied the effect of oral iron therapy on fatigue and quality of life, as well as on hemoglobin, ferritin and soluble transferrin receptor levels, in nonanemic iron-deficient women with unexplained fatigue.

Methods: We performed a multicentre, parallel, randomized controlled, closed-label, observer-blinded trial. We recruited from the practices of 44 primary care physicians in France from March to July 2006. We randomly assigned 198 women aged 18–53 years who complained of fatigue and who had a ferritin level of less than 50 ug/L and hemoglobin greater than 12.0 g/dL to receive either oral ferrous sulfate (80 mg of elemental iron daily; n = 102) or placebo (n = 96) for 12 weeks. The primary outcome was fatigue as measured on the Current and Past Psychological Scale. Biological markers were measured at 6 and 12 weeks.

Results: The mean score on the Current and Past Psychological Scale for fatigue decreased by 47.7% in the iron group and by 28.8% in the placebo group (difference –18.9%, 95% CI −34.5 to −3.2; p = 0.02), but there were no significant effects on quality of life (p = 0.2), depression (p = 0.97) or anxiety (p = 0.5). Compared with placebo, iron supplementation increased hemoglobin (0.32 g/dL; p = 0.002) and ferritin (11.4 μg/L; p < 0.001) and decreased soluble transferrin receptor (−0.54 mg/L; p < 0.001) at 12 weeks.

Interpretation: Iron supplementation should be considered for women with unexplained fatigue who have ferritin levels below 50 μg/L. We suggest assessing the efficiency using blood markers after six weeks of treatment. Trial registration no. EudraCT 2006–000478–56.

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Canadian Medical Association Journal: 184 (11)
CMAJ
Vol. 184, Issue 11
7 Aug 2012
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Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial
Paul Vaucher, Pierre-Louis Druais, Sophie Waldvogel, Bernard Favrat
CMAJ Aug 2012, 184 (11) 1247-1254; DOI: 10.1503/cmaj.110950

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Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial
Paul Vaucher, Pierre-Louis Druais, Sophie Waldvogel, Bernard Favrat
CMAJ Aug 2012, 184 (11) 1247-1254; DOI: 10.1503/cmaj.110950
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