Efficacy of vitamin C with Fe supplementation in patients with iron deficiency anemia: a systematic review and meta-analysis
Bibliographic record
Abstract
Oral iron (Fe) supplementation is one of the mainstays of treatment for iron deficiency anemia (IDA). However, its therapeutic effects are limited when there is poor absorption from the gastrointestinal tract. Vitamin C is hypothesized to improve uptake when combined as an adjunct agent. We aimed to determine the difference in hematological outcomes in IDA patients receiving oral iron, with or without vitamin C. MEDLINE, EMBASE, Web of Science and CENTRAL were searched from database inception to July 2023 for studies investigating the use of oral iron supplements with vitamin C in IDA patients. The primary outcome was the change in serum hemoglobin. Secondary outcomes include change in serum ferritin, reticulocyte percentage, and incidence of adverse events. 2231 studies were retrieved - 10 RCTs (n=1782) and one prospective cohort study (n=148) comprising 1930 patients were included. Vitamin C supplementation was associated with a significant increase in serum hemoglobin level (MD 0.14 g/dL [95%CI 0.08, 0.20], p<0.01,10 studies, 1490 patients) and serum ferritin levels (MD 3.23 μg/L [95%CI 1.63, 4.84], p<0.01, 9 studies, 1682 patients) in the iron + vitamin C group compared to the iron only group. The addition of vitamin C to iron supplementation was associated with a small and likely clinically insignificant increase in serum hemoglobin. The results of this study do not support routine supplementation of oral iron therapy with vitamin C in the treatment of IDA.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.016 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.026 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".