Anaemia: iron treatment increased haemoglobin.

Clinical bottom line (level 2b)

  1. In patients with iron deficiency anaemia, iron treatment for 80 days increased haemoglobin levels, and decreased peak heart rate after a five minute exercise test.
  2. Iron treatment had no clear effect on hand and shoulder strength.
Gardner et al: American Journal of Clinical Nutrition 1975; 28: 982-988
Expires June 2003

The study

Unblinded ?concealed un-randomised trial without intention-to-treat
Setting: rural population, South America

29 patients (aged range 17 to 46 years, 55% female) haemoglobin levels between 4 and 12 g/100 ml blood, and identified as having iron deficiency anaemia due to hookworm infestation
Control Group: (n = 13, 13 analysed): placebo for 80 days
Experimental Group: (n = 16, 16 analysed): iron treatment- intramuscular injections of iron dextran for 80 days
Patients underwent vermifuge for the hookworm infestation.
100% followed for 80 days

The evidence

Outcome Control Group
(SD)		 Experimental Group
(SD)		 Mean Difference
(95% CI)
women- Hb g/100 ml before and after iron treatment 7.70
(2.10) 		12.4
(0.60) 		4.70
(3.25 to 6.15)
men- Hb g/100 ml before and after iron treatment 7.10
(1.80) 		14.0
(0.70) 		6.90
(5.14 to 8.66)
women- peak heart rate (beats/ min) after exercise test (5 min, 40 cm step test), before and after iron 152
() 		123
() 		29.0
( to )
men- peak heart rate after exercise test, before and after iron 155
() 		113
() 		42.0
( to )

  • Placebo had no clear effect on haemoglobin levels or peak heart rate after exercise test.
  • Iron treatment had no clear effect on hand and shoulder strength.

    • Comments

    1. The study is of poor quality as it was not randomised or blinded, so results should be viewed cautiously.
    2. Iron dextran may be used as an alternative therapy to oral iron. It should be reserved for those rare patients who can not tolerate even low doses of oral iron.

    Citation

    1. Gardner GW, Edgerton R, Barnard RJ, et al: Cardiorespiratory, hematological and physical performance responses of anemic subjects to iron treatment. American Journal of Clinical Nutrition 1975; 28: 982-988
    Contributor: Clare Wotton and Musab Hayatli, June 2000
    Reviewer: Martin Dawes and Santiago Alvarez Montero

    Clinical Question.
    Patient anaemia
    Intervention or Exposure iron treatment
    Comparison placebo
    Outcome haemoglobin levels