Ingestion of ferrous sulfate increases ferremia in patients with short bowel syndrome

Because short bowel syndrome is associated with iron deficiency, the objective of the present study was to monitor ferremia after the ingestion of different iron compounds and doses in enterectomized patients.

This was a randomized, double-blind, cross-over study conducted in 13 patients of both sexes in the metabolic unit of Hospital das Clínicas de Faculdade de Medicina de Ribeirão Preto-Universídade de São Paulo and was divided into two stages. Three different iron compounds, ferrous sulfate (FS), sodium iron ethylenediaminetetra-acetic acid (EDTA), and dehydrated cell fraction (DCF), were studied. The patients were randomly assigned to one of four groups receiving high-dose DCF (120mg) and low-dose DCF (5mg) and the two iron compounds. The subjects (n=7) receiving high-dose DCF participated in 2 test days. All patients receiving the physiologic dose (low-dose DCF, n=6) participated in 3 test days with a 1-mo interval between compounds. After an 8-h fast, blood samples were collected at 0.25, 0.5, 1, and 2h. Serum iron curve and the sum of the area under the curve were calculated and adjusted according to a mixed-effect linear model (P<0.05).

Serum FS levels were higher in the 120-mg group compared with the others (P<0.005). The mean areas under the curve for FS and EDTA at the doses of 120 and 5mg of elemental iron were 238, 224, 177, and 153 microg/dL, respectively. The mean area under the curve for DCF was 165 microg/dL, with no significant difference between groups.

Regardless of dose, FS was the compound that resulted in higher ferremia compared with the other doses and compounds.