From the Guidelines
Vitamin C is essential for increasing iron absorption and reducing the risk of iron deficiency anemia, and its intake should be increased, especially when consuming iron-rich plant-based foods. According to a recent study published in The Lancet Planetary Health 1, combining vitamin C with iron-rich plant-based foods can significantly enhance iron bioavailability. The study highlights that vitamin C is a powerful enhancer of non-haeme iron absorption, which is found in plant foods.
Key points to consider:
- Vitamin C can increase iron absorption by converting dietary iron from the ferric to the ferrous form, making it more readily absorbed by the intestines.
- A systematic review and meta-analysis concluded that increasing vitamin C intake is a practical approach to lowering the risk of iron deficiency and minimizing the occurrence of iron-deficiency anemia 1.
- Iron-rich plant-based foods, such as pulses and grains, should be consumed in combination with sources of vitamin C to maximize iron absorption.
- Common vitamin C-rich foods include citrus fruits, strawberries, bell peppers, and broccoli, which can be incorporated into meals containing iron sources for maximum benefit.
It is crucial to note that while vitamin C can help with iron absorption, it alone cannot treat anemia caused by other factors like B12 deficiency or chronic diseases. Proper diagnosis is essential before self-treating, as different types of anemia require different treatments.
From the Research
Vitamin C and Anemia
- Vitamin C is known to enhance iron absorption and is often prescribed with iron for anemia patients 2, 3, 4, 5.
- A systematic review and meta-analysis of experimental studies found that the treatment efficacy of oral vitamin C or ascorbate given as co-intervention with iron compared to providing only iron among participants with anemia was not statistically significant 2.
- The study found that the pooled estimate for standardized mean difference of hemoglobin and Serum Ferritin for intervention-type ferrous ascorbate and oral iron and vitamin C were not statistically significant 2.
- Another study found that high-dose vitamin C intakes do not cause iron imbalance in healthy persons and probably in persons who are heterozygous for hemochromatosis 3.
- Vitamin C has been shown to have a dual action in iron supplement therapeutics for iron deficiency anemia, preventing liver damage induced by iron overload 4.
- A randomized clinical trial found that oral iron supplements alone were equivalent to oral iron supplements plus vitamin C in improving hemoglobin recovery and iron absorption in patients with iron deficiency anemia 5.
- The trial suggested that on-demand vitamin C supplements are not essential to take along with oral iron supplements for patients with iron deficiency anemia 5.
Mechanism of Action
- Vitamin C aids in increasing absorbable ferrous iron in iron deficiency anemia by acting as a reducing agent 4.
- Vitamin C also acts as an antioxidant, preventing liver damage caused by iron excess and targeting the mitochondria to prevent mitochondrial swelling and ROS burst 4.
- The antioxidant effects of vitamin C may help to prevent oxidative damage and reduce the risk of diseases such as coronary heart disease and cancer 3.
Clinical Implications
- The use of vitamin C with iron supplements may not be essential for patients with iron deficiency anemia 5.
- However, vitamin C may still have a role in preventing liver damage induced by iron overload in patients with iron deficiency anemia 4.
- Further studies are needed to fully understand the treatment efficacy of oral vitamin C or ascorbate given as co-intervention with iron for anemia 2.