Study of the Effect of Simultaneous Iron, Zinc and Folic Acid Supplementation With or Without Vitamin A and C on Hemoglobin Levels of Teenaged Girl Students in Shahinshahr City

Iron deficiency anemia (IDA) is the most common form of anemia and one of the most important health problems. Iron supplementation for high risk groups can prevent IDA and its complications in the community. We need to have a holistic approach to control IDA with minimum cost and complications. Considering the high prevalence rate of IDA in Iran, assessment of the effects of micronutrients in the treatment of IDA is essential. The current study was designed to study the complete iron therapy program in Iran and evaluate the effect of simultaneous administration of vitamin A and C on hemoglobin (Hb) levels.

A triple blind randomized clinical trial was conducted in secondary schools for girls in Shahinshahr city of Iran. 120 students were selected after initial screening for clinical presentation of anemia. They were assigned to three groups. All the cases were administered 50mg elemental iron, 0.5mg folic acid and 11mg elemental zinc. However, group A received placebo, group B received 250mg vitamin C and placebo of vitamin A and group C received 250mg vitamin C and 100000 IU vitamin A. The hemoglobin levels were measured on day one and eight weeks later. Data was analyzed using software SPSS version 11.5 and statistical test used was one way ANOVA test.

There were statistical significant differences between the final Hemoglobin levels of the three groups (P<0.001). Hb increase in group C was significantly higher as compared to the control group (P<0.012). There was a difference between the Hb levels of group B and C, but this difference was not significant.

The findings showed that simultaneous supplementation of iron, folic acid and zinc with vitamin A and C is very effective for increasing hemoglobin levels. Further investigations are needed to confirm this hypothesis for treatment of IDA.