The Indian Journal of Pediatrics

, Volume 80, Issue 5, pp 385–390 | Cite as

Treatment of Iron Deficiency Anemia in Children: A Comparative Study of Ferrous Ascorbate and Colloidal Iron

Original Article



To compare the efficacy of ferrous ascorbate and colloidal iron in the treatment of iron deficiency anemia in children.


Eighty one children, aged 6 mo to 12 y, were screened for iron deficiency anemia (IDA) and those diagnosed with IDA were randomized to receive ferrous ascorbate or colloidal iron for a period of 12 wk, such that each child received elemental iron 3 mg/kg body weight/d. Increase in hemoglobin (Hb) level was the primary outcome measure. Assessment was performed at baseline, wk 4, wk 8 and wk 12.


Of 81 children screened, 73 were included in the study. The mean rise in Hb at the end of the 12 wk was significantly higher in ferrous ascorbate group than the colloidal iron group [3.59 ± 1.67 g/dl vs. 2.43 ± 1.73 g/dl; P < 0.01]. Significantly higher proportion of children receiving ferrous ascorbate (64.86 % vs. 31.03 %; P < 0.01) became non-anemic in comparison to colloidal iron.


Ferrous ascorbate provides a significantly higher rise in hemoglobin levels in comparison to colloidal iron. The study supports the use of ferrous ascorbate in the pediatric age group, providing evidence for its role as an efficient oral iron supplement in the treatment of iron deficiency anemia.


Anemia Children Hemoglobin Ferrous ascorbate Colloidal iron 


  1. 1.
    International Institute for Population Sciences (IIPS) and Macro International. 2007. National Family Health Survey (NFHS-3), 2005–06, India: Key Findings. Mumbai: IIPS. Available from: URL: Accessed February 7, 2011.
  2. 2.
    Gupta R, Gupta RK. Current issues for the prevention of iron deficiency anemia amongst young children. JK Sci. 2004;6:174–5.Google Scholar
  3. 3.
    Allen LH. Iron supplements: scientific issues concerning efficacy and implications for research and programs. J Nutr. 2002;132:813S–9.PubMedGoogle Scholar
  4. 4.
    Agarwal MB, Rathi SA. An open label, randomized, comparative clinical study to assess the efficacy and tolerability of ferrous ascorbate versus carbonyl iron in the treatment of iron deficiency anemia. Int J Gynaecol Obstet. 2006;9:13–20.Google Scholar
  5. 5.
    Wienk KJ, Marx JJ, Santos M, et al. Dietary ascorbic acid raises iron absorption in anaemic rats through enhancing mucosal iron uptake independent of iron solubility in the digesta. Br J Nutr. 1997;77:123–31.PubMedCrossRefGoogle Scholar
  6. 6.
    HERS Study Group India. The HERS trial report: a prospective, open label study on efficacy and tolerability of ferrous ascorbate (Ferrous Ascorbate Folic Acid). Int J Gynaecol Obstet. 2005;8:23–30.Google Scholar
  7. 7.
    Hurrell R. How to ensure adequate iron absorption from iron-fortified food. Nutr Rev. 2002;60:S7–15. discussion S43.PubMedCrossRefGoogle Scholar
  8. 8.
    Guinea JM, Lafuente P, Mendizábal A, Pereda A, Sainz Arroniz MR, Pérez Clausell C. Results of preoperative autotransfusion with ferrous ascorbate prophylaxis in orthopedic surgery patients. Sangre (Barc). 1996;41:25–8.Google Scholar
  9. 9.
    Goddard AF, McIntyre AS, Scott BB, for the British Society of Gastroenterology. Guidelines for the management of iron deficiency anaemia. Gut. 2000;46:iv1–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Adamson JW. Iron deficiency and other hypoproliferative anemias. In: Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s principles of internal medicine. 16th ed. New York: Health Professions Division; 2005. p. 586–92.Google Scholar
  11. 11.
    Hallberg L, Rossander L. Improvement of iron nutrition in developing countries: comparison of adding meat, soy protein, ascorbic acid, citric acid, and ferrous sulphate on iron absorption from a simple Latin American-type of meal. Am J Clin Nutr. 1984;39:577–83.Google Scholar
  12. 12.
    Pizarro F, Uicich R, Olivares M, et al. Iron absorption of ferric glycinate is controlled by iron stores. Nutr Res. 1998;18:3–9.CrossRefGoogle Scholar
  13. 13.
    Hallberg L, Brune M, Rossander L. Low bioavailability of carbonyl iron in man: studies on iron fortification of wheat flour. Am J Clin Nutr. 1986;43:59–67.PubMedGoogle Scholar
  14. 14.
    Bovell-Benjamin AC, Viteri FE, Allen LH. Iron absorption from ferrous bisglycinate and ferric trisglycinate in whole maize is regulated by iron status. Am J Clin Nutr. 2000;71:1563–9.PubMedGoogle Scholar
  15. 15.
    Choudhury P, Gera T. Rationale of iron dosage and formulations in under three children. Available from: URL: Accessed January 13, 2011.
  16. 16.
    Stoltzfus R, Dreyfuss M. Guidelines for the use of iron supplements to prevent and treat iron deficiency anemia. INACG/WHO/UNICEF Report, 1998. Available from: URL: Accessed January 13, 2011.
  17. 17.
    Guidelines and Protocols Advisory Committee, British Columbia Medical Association. Iron Deficiency-Investigation and Management. Available from: URL: Accessed January 13, 2011.
  18. 18.
    Bhargava S, Meurer LN, Jamieson B, Hunter-Smith D. Clinical inquiries. What is appropriate management of iron deficiency for young children? J Fam Pract. 2006;55:629–30.PubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2012

Authors and Affiliations

  1. 1.Department of PediatricsDr. Yewale’s Hospital & Vashi Criticare (Tertiary Care Hospital)Navi MumbaiIndia
  2. 2.Department of Medical ServicesZuventus Healthcare LtdMumbaiIndia

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