Comparative analysis of oral iron therapy regimens in premenopausal women with iron deficiency anemia

Iron deficiency anemia (IDA) is prevalent among women of reproductive age. Treatment aims to replenish iron stores and normalize hemoglobin levels, with oral iron therapy being the preferred route in most cases. This study aimed to compare the efficacy and side effects of three common oral treatment regimens in premenopausal women with IDA. An observational study was conducted on patients initiated on oral ferrous glycine sulfate therapy (100 mg elemental iron). Patients were divided into three groups based on treatment regimen: alternate-day (n = 40), daily single-dose (n = 41), and daily twice dose (n = 40). Hemoglobin, ferritin, and transferrin saturation levels were measured before and after one month of therapy. The primary outcome was to compare laboratory changes from baseline to post-treatment within and between groups. The secondary outcome was to compare the frequency of gastrointestinal side effects. The mean age was 41.2 ± 8 years, with a mean hemoglobin level of 10.4 ± 1.1 g/dl, and a mean ferritin level of 7 ± 3.2 ng/mL at the time of diagnosis. After one month of therapy, hemoglobin, ferritin, and transferrin saturation levels significantly increased in all groups (p < 0.001 for all). However, the increase in hemoglobin and ferritin levels was significantly lower in the alternate-day group compared to the other groups (p < 0.001). Gastrointestinal side effects were more prevalent in the daily twice group (66.1%) compared to the alternate-day (16.7%) and daily single-dose (23.4%) groups (p < 0.001). Daily single-dose oral ferrous glycine sulfate therapy emerged as an effective and well-tolerated treatment regimen for premenopausal women with IDA.