Reduced-dose alternate-day oral iron supplementation in women with iron deficiency: a randomized controlled trial.
Maria Chiara Valerii, Nikolas Kostantine Dussias, Anna Perri et al.
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In 30 seconds
This 42-day, randomized, parallel-group active-controlled trial compared two oral iron regimens in 66 women aged 18–50 years with iron deficiency (serum ferritin < 30 ng/mL). Participants received either 21 mg elemental iron every 48 h with a daily gut microbiota modulator or 30 mg daily. Serum ferritin increased over time in both groups (p < 0.001), with no significant between-group difference; other measured iron indices improved comparably, while hemoglobin remained stable. Both regimens were generally well tolerated, and the alternate-day strategy used lower cumulative iron exposure.
Key findings
- Serum ferritin increased significantly over time in both treatment groups (p < 0.001), with no significant difference between regimens.
- Serum iron, transferrin, transferrin saturation, and total iron-binding capacity showed comparable improvements between groups.
- Hemoglobin remained stable throughout the 42-day study.
- Both interventions were generally well tolerated, with mild transient gastrointestinal events and no clinically relevant inflammatory-marker changes.
Why it matters
The findings suggest that, over the study period, a lower-dose alternate-day regimen can improve measured iron status comparably to daily supplementation in women with iron deficiency. This is relevant because gastrointestinal effects and hepcidin-related absorption are concerns with oral iron, although the trial does not establish longer-term outcomes or superiority of either regimen.
What to keep in mind
The study included 66 women and followed them for 42 days; its findings therefore address short-term changes in iron indices rather than longer-term clinical outcomes.