Comparison of Oral Iron Supplement Formulations for Normalization of Iron Status Following Roux-EN-y Gastric Bypass Surgery: a Randomized Trial

  • Renee A. Mischler
  • Seth M. Armah
  • Bruce A. Craig
  • Arthur D. Rosen
  • Ambar Banerjee
  • Don J. Selzer
  • Jennifer N. Choi
  • Nana Gletsu-Miller
Original Contributions

Abstract

Background

The evidence behind recommendations for treatment of iron deficiency (ID) following roux-en-y gastric bypass surgery (RYGB) lacks high quality studies.

Setting

Academic, United States

Objective

The objective of the study is to compare the effectiveness of oral iron supplementation using non-heme versus heme iron for treatment of iron deficiency in RYGB patients.

Methods

In a randomized, single-blind study, women post-RYGB and iron deficient received non-heme iron (FeSO4, 195 mg/day) or heme iron (heme-iron-polypeptide, HIP, 31.5 to 94.5 mg/day) for 8 weeks. Measures of iron status, including blood concentrations of ferritin, soluble transferrin receptor (sTfR), and hemoglobin, were assessed.

Results

At baseline, the mean ± standard deviation for age, BMI, and years since surgery of the sample was 41.5 ± 6.8 years, 34.4 ± 5.9 kg/m2, and 6.9 ± 3.1 years, respectively; and there were no differences between FeSO4 (N = 6) or HIP (N = 8) groups. Compliance was greater than 94%. The study was stopped early due to statistical and clinical differences between groups. Values before and after FeSO4 supplementation, expressed as least square means (95% CI) were hemoglobin, 10.8 (9.8, 11.9) to 13.0 (11.9, 14.0) g/dL; sTfR, 2111 (1556, 2864) to 1270 (934, 1737) μg/L; ferritin, 4.9 (3.4, 7.2) to 15.5 (10.6, 22.6) μg/L; and sTfR:ferritin ratio, 542 (273, 1086) to 103 (51, 204); all p < 0.0001. With HIP supplementation, no change was observed in any of the iron status biomarkers (all p > 0.05).

Conclusions

In accordance with recommendations, oral supplementation using FeSO4, but not HIP, was efficacious for treatment of iron deficiency after RYGB.

Keywords

Iron deficiency Iron supplementation Nutritional complications Bariatric surgery 

Abbreviations

RYGB

Roux-en-y gastric bypass

BMI

Body mass index

CRP

C-reactive protein

sTfR

Soluble transferrin receptor

TIBC

Total iron binding capacity

HIP

Heme iron polypeptide

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Nutrition SciencePurdue UniversityWest LafayetteUSA
  2. 2.Department of NutritionUniversity of North Carolina at GreensboroGreensboroUSA
  3. 3.Department of StatisticsPurdue UniversityWest LafayetteUSA
  4. 4.Department of Biological SciencesPurdue UniversityWest LafayetteUSA
  5. 5.School of MedicineIndiana UniversityIndianapolisUSA

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