Ferrous fumarate vs ferrous sulfate
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Comparative Analysis of Ferrous Fumarate and Ferrous Sulfate
Bioavailability of Ferrous Fumarate vs. Ferrous Sulfate
Iron Absorption in Different Populations
Research comparing the bioavailability of ferrous fumarate and ferrous sulfate in non-anemic Mexican women and children found no significant differences in iron absorption between the two compounds. The relative bioavailability (RBV) was 86% in women, 97% in infants, and 106% in young children, indicating that ferrous fumarate is as well absorbed as ferrous sulfate in these groups. Similarly, a study on Bangladeshi children showed no significant differences in maintaining hemoglobin concentrations above 105 g/L between ferrous fumarate, ferric pyrophosphate, and ferrous sulfate.
Iron Absorption in Preschoolers
Contrary to the above findings, another study on Mexican preschoolers indicated that ferrous sulfate had significantly higher bioavailability compared to ferrous fumarate. Iron absorption from ferrous sulfate was 7.9%, whereas it was only 2.43% from ferrous fumarate. This suggests that while ferrous fumarate may be effective in some populations, ferrous sulfate might be more reliable in others, particularly in young children.
Efficacy in Treating and Preventing Iron Deficiency
Preventing Iron Deficiency
Ferrous fumarate has been recommended for fortifying foods for infants and young children due to its good sensory properties and similar iron absorption rates to ferrous sulfate in adults. However, studies have shown that iron-deficient children may absorb iron from ferrous fumarate less effectively than from ferrous sulfate, suggesting that higher amounts of ferrous fumarate might be needed to achieve the same efficacy.
Treating Anemia
In treating anemia, both ferrous sulfate drops and ferrous fumarate sprinkles have shown similar efficacy. A study in Ghana found that 58% of children treated with ferrous fumarate sprinkles and 56% of those treated with ferrous sulfate drops successfully overcame anemia, with minimal side effects in both groups. This indicates that ferrous fumarate can be an effective alternative to ferrous sulfate in treating anemia, especially when considering ease of use and adherence.
Adherence and Side Effects
Adherence to Supplementation
Adherence to iron supplementation is crucial for its effectiveness. A study comparing adherence to ferrous fumarate sprinkles and ferrous sulfate drops in low-income infants found no significant improvement in adherence with sprinkles. High adherence was slightly better in the drops group (22%) compared to the sprinkles group (9.5%). This suggests that while ferrous fumarate sprinkles might be easier to administer, they do not necessarily improve adherence.
Side Effects
Ferrous fumarate has been found to cause fewer side effects compared to ferrous sulfate. In a study on enamel exposure to beverages supplemented with these compounds, ferrous fumarate resulted in less mineral loss and surface microhardness reduction than ferrous sulfate. Additionally, ferrous fumarate was less toxic and irritant in animal studies compared to ferrous sulfate.
Conclusion
Both ferrous fumarate and ferrous sulfate are effective in preventing and treating iron deficiency, with some variations in bioavailability and adherence depending on the population. Ferrous fumarate is generally well-absorbed and causes fewer side effects, making it a suitable alternative to ferrous sulfate, especially in food fortification. However, ferrous sulfate may offer higher bioavailability in certain groups, such as preschoolers. Further research is needed to optimize iron supplementation strategies for different populations.
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