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Ferrous Sulfate Supplementation Causes Significant Gastrointestinal Side-Effects in Adults: A Systematic Review and Meta-Analysis

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  • Zoe Tolkien
  • Lynne Stecher
  • Adrian P Mander
  • Dora I A Pereira
  • Jonathan J Powell

Abstract

Background: The tolerability of oral iron supplementation for the treatment of iron deficiency anemia is disputed. Objective: Our aim was to quantify the odds of GI side-effects in adults related to current gold standard oral iron therapy, namely ferrous sulfate. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating GI side-effects that included ferrous sulfate and a comparator that was either placebo or intravenous (IV) iron. Random effects meta-analysis modelling was undertaken and study heterogeneity was summarised using I2 statistics. Results: Forty three trials comprising 6831 adult participants were included. Twenty trials (n = 3168) had a placebo arm and twenty three trials (n = 3663) had an active comparator arm of IV iron. Ferrous sulfate supplementation significantly increased risk of GI side-effects versus placebo with an odds ratio (OR) of 2.32 [95% CI 1.74–3.08, p

Suggested Citation

  • Zoe Tolkien & Lynne Stecher & Adrian P Mander & Dora I A Pereira & Jonathan J Powell, 2015. "Ferrous Sulfate Supplementation Causes Significant Gastrointestinal Side-Effects in Adults: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-20, February.
    • Handle: RePEc:plo:pone00:0117383
    DOI: 10.1371/journal.pone.0117383
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    1. Shivani Sharma & Ruchika Sharma, 2017. "Heavy Menstrual Bleeding: A Hematology Perspective- A Short Review," Open Access Blood Research & Transfusion Journal, Juniper Publishers Inc., vol. 1(3), pages 63-65, August.

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