Effects of Iron Supplementation With or Without Vitamin C on Oxidative Stress and Iron Status in Iron Deficient Female College Students

Iron excess disturbs the antioxidant system through pro-oxidants mechanisms. In this study, oxidative stress indices were compared between iron deficient and healthy subjects and effects of iron supplementation with and/or without ascorbic acid on performance of the antioxidant defense system, levels of oxidative stress and iron status in iron deficient female students were determined. In this double-blind randomized clinical trial, 60 NAID and 30 normal students (control) were selected from 289 female students at the dormitory of Shaheed Beheshti University (MC), Tehran. Hemoglobin and serum ferritin concentrations were measured by cell counter and ELISA, respectively. After matching, NAIDM students were randomly assigned into the intervention group receiving 50 mg/d elemental iron supplements without (group I) and/or with (group II) 500 mg/d ascorbic acid for 12 weeks. Serum malondialdehyde (MDA), Total Antioxidant Capacity (TAC) and serum ascorbic acid were measured at the beginning and the end of the 6th and 12th weeks in the groups studied. Student's t and repeated measurements tests were employed to analyze the data using SPSS software. Mean TAC in group III was significantly higher in NAID subjects at the beginning of the study (3.87±0.47 vs 3.4±0.41 mmol/mL p<0.001). At the end, serum TAC significantly increased in supplemented subjects, not only compared to the baseline values (within group), but also in comparison with controls (between groups) (5.1±.3 vs 4.7±0.04 mmol/mL p<0.001). In contrast, serum MDA concentrations decreased from 1.7±0.14 to 1.1±0.09 nmol/mL (p<0.001) and from 1.9±0.18 to 1.7±0.15 nmol/mL (p<0.001) in groups I and II, respectively, after 6 weeks of supplementation. Serum MDA concentration however increased to 1.7±0.15 nmol/mL at the 12th week (p<0.001) although the same results were seen in group II, but the mean MDA concentration was significantly less than the value at the beginning (1.4±0.1 vs 1.9±0.18 nmol/mL p<0.03). It seems that the status of the anti-oxidant defense systems significantly improves among NAID young female subjects within the first few weeks after iron supplementation especially with ascorbic acid, an approach recommended for more efficient control of iron deficiency.