From the Guidelines
Lactoferrin is not definitively better than traditional iron supplements like ferrous sulfate for increasing serum ferritin levels in most patients with iron deficiency. For most adults with iron deficiency, ferrous sulfate (typically 325 mg containing 65 mg elemental iron, taken 1-3 times daily between meals) remains the first-line treatment due to its established efficacy, lower cost, and wider availability 1. Lactoferrin, while showing promise in some studies with potentially fewer gastrointestinal side effects, currently has less robust evidence supporting its use as a primary iron replacement therapy. Key points to consider when evaluating lactoferrin versus traditional iron supplements include:
- Efficacy: Traditional iron supplements have a more established record of effectively increasing serum ferritin levels.
- Side effects: Lactoferrin may offer an advantage in terms of fewer gastrointestinal side effects for some patients.
- Absorption mechanism: Lactoferrin is absorbed through specific receptors, potentially causing less oxidative stress in the gut compared to ferrous sulfate.
- Dosing: Standardized dosing guidelines for lactoferrin are not as well established as they are for traditional iron supplements, with typical supplemental doses ranging from 100-200 mg daily. For significant iron deficiency requiring rapid repletion, traditional iron supplements or even intravenous iron, as discussed in the context of managing iron deficiency anemia 1, would likely be more effective than lactoferrin. Intravenous iron is indicated if a patient cannot tolerate oral iron or if blood counts or iron stores do not improve with oral iron supplementation, highlighting the importance of considering the severity of iron deficiency and the patient's response to initial treatments when deciding between lactoferrin and traditional iron supplements.
From the Research
Comparison of Lactoferrin and Ferrous Sulfate
- Lactoferrin has been shown to be a better choice than traditional iron supplements, such as ferrous sulfate, for increasing serum ferritin levels in some studies 2, 3, 4.
- A meta-analysis found that lactoferrin supplementation had better effects on serum iron, ferritin, and hemoglobin concentration compared to ferrous sulfate 2.
- A clinical trial in children with inflammatory bowel disease found that lactoferrin significantly increased hemoglobin, serum iron, and serum ferritin compared to ferrous sulfate, with fewer side effects 3.
- Another study found that bovine lactoferrin had the same efficacy as ferrous sulfate in restoring iron deposits, but with significantly fewer gastrointestinal side effects 5.
- However, not all studies have found a significant difference in iron absorption between lactoferrin and ferrous sulfate 6.
Mechanism of Action
- The anti-inflammation effect of lactoferrin may be the potential mechanism to explain its efficacy on iron status and erythropoiesis 2.
- Lactoferrin has been shown to decrease IL-6 levels and increase hepcidin levels, which may contribute to its effectiveness in treating iron deficiency anemia 3, 4.