What dose of vitamin C (ascorbic acid) should be taken with iron supplements for iron deficiency anemia?

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From the Guidelines

Taking 80 mg of vitamin C with iron supplements is recommended to improve iron absorption for patients with iron deficiency anemia. This dose of vitamin C has been shown to enhance iron absorption by forming a chelate with iron and reducing ferric to ferrous iron, as suggested by a recent iron isotope study 1. While evidence supporting vitamin C administration to improve iron absorption is mixed, this specific dose has been identified as beneficial. It is essential to take vitamin C at the same time as iron supplements, and on an empty stomach, to maximize absorption.

Some key points to consider when taking iron supplements with vitamin C include:

  • Avoid consuming tea and coffee within an hour after taking iron, as they can inhibit iron absorption 1
  • Do not take iron more than once a day, as this can increase side effects without improving absorption 1
  • Ferrous iron salts, such as ferrous sulfate, ferrous fumarate, and ferrous gluconate, are reasonable choices for oral iron supplementation due to their low cost and comparable effectiveness to other products 1

Overall, taking 80 mg of vitamin C with iron supplements can help improve iron absorption and support the management of iron deficiency anemia, as indicated by recent clinical practice updates 1.

From the Research

Vitamin C Dosage with Iron Supplements for Anemia

  • The ideal dose of vitamin C to take with iron supplements for iron deficiency anemia is not clearly established, as the evidence is limited and inconclusive 2.
  • A study published in 2020 suggests that providing morning doses of 60-120 mg iron as a ferrous salt given with ascorbic acid on alternate days may be an optimal oral dosing regimen for women with iron-deficiency and mild IDA 3.
  • Another study from 2020 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 IDA, with a dose of 200 mg of vitamin C per day 4.
  • Vitamin C may have a dual action in iron supplement therapeutics, not only increasing absorbable ferrous iron but also preventing liver damage induced by iron overload 5.
  • The response to iron supplementation in iron-deficiency anemia can vary depending on the underlying cause of anemia, with some studies suggesting that a ≥1.0-g/dL increase in hemoglobin at day 14 of oral iron may be a useful predictor of satisfactory overall hemoglobin response 6.

Key Findings

  • The evidence suggests that vitamin C may enhance iron absorption, but the optimal dose and frequency of administration are unclear 2, 3.
  • Some studies suggest that vitamin C may not be essential for patients with IDA, and that oral iron supplements alone may be sufficient 4.
  • Vitamin C may have additional benefits in preventing liver damage induced by iron overload, but more research is needed to confirm this 5.
  • The response to iron supplementation can vary depending on the underlying cause of anemia, and individualized treatment approaches may be necessary 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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