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Hierro


¿Qué es?

El hierro es un mineral. La mayor parte del hierro en el organismo se encuentra en la hemoglobina de los glóbulos rojos y en la mioglobina de las células musculares. El hierro es necesario para el transporte del oxígeno y del dióxido de carbono. También tiene otras funciones importantes en el cuerpo.

La gente toma suplementos de hierro para prevenir y tratar los bajos niveles de hierro (deficiencia de hierro) y la consiguiente anemia por deficiencia de hierro. En las personas con anemia por deficiencia de hierro, los glóbulos rojos no pueden transportar suficiente oxígeno al cuerpo, porque no tienen suficiente hierro. Las personas con este trastorno a menudo se sienten muy cansadas.

El hierro se usa también para mejorar el rendimiento atlético y para tratar el trastorno por déficit de atención con hiperactividad (TDAH) y las aftas. Algunas personas también utilizan hierro para la enfermedad de Crohn, la depresión, la fatiga, y la incapacidad para quedar embarazada.

A veces las mujeres toman suplementos de hierro para compensar la pérdida de hierro cuando tienen períodos menstruales con mucha pérdida de sangre. También utilizan alimentos ricos en hierro, como la carne de cerdo, jamón, pollo, pescado, frijoles, y en especial la carne de vacuno, de cordero y el hígado.

¿Qué tan efectivo es?

Natural Medicines Comprehensive Database (La Base Exhaustiva de Datos de Medicamentos Naturales) clasifica la eficacia, basada en evidencia científica, de acuerdo a la siguiente escala: Eficaz, Probablemente Eficaz, Posiblemente Eficaz, Posiblemente Ineficaz, Probablemente Ineficaz, Ineficaz, e Insuficiente Evidencia para Hacer una Determinación.

La clasificación de la eficacia para este producto es la siguiente:

Eficaz para...

  • La anemia causada por una enfermedad crónica. Muchas enfermedades tales como el cáncer, los problemas renales o los problemas cardiacos pueden producir anemia. El tomar hierro junto con otros medicamentos tales como la epoetina alfa (eritropoyetina, EPO, Epogen, Procrit) puede ayudar a aumentar la formación de glóbulos rojos y revertir la anemia en las personas con problemas renales o que están bajo tratamiento para el cáncer con quimioterapia. El uso de hierro por vía intravenosa (IV) es más efectivo que la ingesta de suplementos.
  • Deficiencia de hierro. El tomar suplementos de hierro es eficaz para el tratamiento y la prevención de anemia por deficiencia de hierro.

Posiblemente eficaz para...

  • Tos producida por los inhibidores de la enzima convertidora de angiotensina (IECA). Los medicamentos que se utilizan para la presión arterial alta y que se llaman inhibidores de la enzima convertidora de angiotensina (IECA) a veces pueden producir tos como un efecto secundario. Estos medicamentos incluyen captoprila (Capoten), enalaprila (Vasotec), lisinoprila (Prinivil, Zestril) y muchos otros.
  • Problemas de aprendizaje. La ingesta de hierro podría ayudar a mejorar la capacidad de razonamiento, el aprendizaje y la memoria en niños con bajos niveles de hierro.
  • Insuficiencia cardiaca. Hasta cerca de un 20% de las personas que tienen insuficiencia cardiaca tienen también bajos niveles de hierro en la sangre. Algunas investigaciones muestran que el dar hierro por vía intravenosa puede mejorar algunos síntomas de insuficiencia cardiaca. Pero todavía no se sabe si el tomar un suplemento de hierro por vía oral ayudaría.
  • Carencia de hierro durante el embarazo. La ingesta de hierro reduce el riesgo de anemia causado por los bajos niveles de hierro en mujeres embarazadas.

Insuficiente evidencia para hacer una determinación para...

  • Trastorno de déficit de atención e hiperactividad (TDAH). La investigación preliminar en desarrollo muestra que el tomar sulfato de hierro (un compuesto químico que contiene hierro), mejora algunas de los problemas del trastorno por déficit de atención con hiperactividad (TDAH) en los niños con deficiencia de hierro después de 1-3 meses de tratamiento.
  • Espasmos del sollozo. La investigación preliminar sugiere que la ingesta o la inyección de hierro reduce los espasmos del sollozo en niños.
  • Desarrollo del niño. La investigación preliminar muestra que el hierro no mejora el rendimiento mental en bebés y niños sin anemia. No obstante, podría observarse una mejora en el desarrollo de las habilidades motrices como la coordinación.
  • Fatiga. Hay evidencia que demuestra que los suplementos de hierro podrían mejorar la fatiga inexplicada en las mujeres no anémicas.
  • Crecimiento de niño. La evidencia preliminar sugiere que la ingesta de suplementos con hierro de manera aislada no mejora el crecimiento en los niños.
  • Rendimiento físico. La investigación preliminar sugiere que la ingesta diaria de suplementos de hierro o de alimentos ricos en hierro durante 1-2 meses disminuye el ritmo cardiaco en niños que corren.
  • Aftas.
  • Enfermedad del tracto digestivo llamada enfermedad de Crohn.
  • Depresión.
  • Infertilidad femenina.
  • Abnndante sangrado menstrual.
  • Síndrome de las piernas inquietas.
  • Otras afecciones.
Se necesita más evidencia para poder evaluar al hierro para estos usos.

¿Cómo funciona?

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El hierro ayuda a los glóbulos rojos a transportar el oxígeno desde los pulmones a las células de todo el cuerpo. Una vez que el oxígeno es entregado, el hierro ayuda entonces a los glóbulos rojos a llevar los desechos de dióxido de carbono a los pulmones para su espiración. El hierro también juega un papel en muchas reacciones químicas importantes en el cuerpo.

¿Hay preocupación por la seguridad de su uso?

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El hierro PROBABLEMENTE ES SEGURO para la mayoría de la gente que lo ingiere por vía oral en cantidades presentes en los alimentos. Sin embargo, puede causar efectos secundarios como malestar y dolor estomacal, estreñimiento o diarrea, náuseas y vómitos. El tomar los suplementos de hierro con comida parece disminuir algunos de estos efectos secundarios. Sin embargo, Pero la comida puede disminuir la absorción del hierro. Si es posible, el hierro debería tomarse con el estómago vacío. Si produce muchos efectos secundarios, se puede ingerir junto con la comida. Evite tomarlo con alimentos que contienen productos lácteos, con café, té o cereales.

Entre los muchos tipos de productos de hierro están el sulfato ferroso, el gluconato ferroso, el fumarato ferroso y otros. Algunos productos, tales como aquellos que contiene un complejo polisacárido de hierro (Niferex-150, etc.) afirman que producen menos efectos secundarios que los otros. Pero no hay pruebas confiables que apoyen esta afirmación.

Algunos productos de cubierta entérica o de liberación sostenida podrían disminuir las nauseas en algunas personas; sin embargo, la absorción de estos productos por el cuerpo es menor.

Los suplementos de hierro líquidos pueden manchar los dientes.

Las dosis altas de hierro NO SON POSIBLEMENTE SEGURAS, especialmente para los niños. El hierro es la causa más común de muerte por envenenamiento en los niños. Dosis tan bajas como 60 mg/kg pueden ser fatales. La intoxicación con hierro puede causar muchos problemas graves, incluyendo problemas estomacales e intestinales, insuficiencia hepática, una presión arterial peligrosamente baja y muerte. Si usted sospecha que un adulto o un niño ha tomado más de la cantidad recomendada de hierro, llame de inmediato a su profesional de la salud o al centro de control de envenenamiento más cercano.

Existe cierta preocupación de que el alto consumo de hierro podría aumentar la probabilidad de desarrollar enfermedades cardiacas. Algunos estudios muestran que las personas con alta ingesta de hierro, especialmente a partir de fuentes de alimentos como la carne roja, son más propensas a tener enfermedades del corazón. Esto puede ser especialmente cierto para las personas con diabetes de tipo 2. Pero esto es controversial. Otros estudios no demuestran que el hierro aumenta el riesgo de enfermedades del corazón. Es demasiado pronto para saber con certeza si el hierro aumenta el riesgo de enfermedades del corazón.

Advertencias y precauciones especiales:

Embarazo y lactancia: El hierro ES PROBABLEMENTE SEGURO para las mujeres embarazadas y lactantes - que tienen suficiente hierro almacenado en el cuerpo - cuando se usa en dosis por debajo del nivel máximo de ingesta tolerable (UL) que es de 45 mg por día de hierro elemental. La UL es el más alto nivel de ingesta con la que no se esperan efectos secundarios perjudiciales. Sin embargo, el hierro PROBABLEMENTE NO ES SEGURO cuando se toma por vía oral en dosis altas. Si usted no tiene deficiencia de hierro, no tome más de 45 mg por día de hierro elemental. Las dosis más altas con frecuencia causan efectos secundarios estomacales e intestinales tales como náuseas y vómitos. Los niveles altos de hemoglobina en el momento del parto se asocian con malos resultados del embarazo. La hemoglobina es la molécula en los glóbulos rojos que contiene hierro.

Diabetes: Existe la preocupación de que una dieta rica en hierro podría aumentar el riesgo de enfermedades cardiacas en las mujeres con diabetes de tipo 2, aunque esto no ha sido probado. Si usted tiene diabetes, hable de su ingesta de hierro con su proveedor de atención médica.

Úlceras estomacales o intestinales: El hierro podría causar irritación y empeorar estas condiciones. Utilice el hierro con cuidado.

La inflamación intestinal, como la colitis ulcerosa o la enfermedad de Crohn: El hierro podría causar irritación y empeorar estas condiciones. Uso el hierro con cuidado.

Enfermedades que afectan la hemoglobina, como es la talasemia: El tomar hierro puede causar sobrecarga de hierro en las personas con estas enfermedades. Si usted tiene una enfermedad que afecta la hemoglobina, no tome hierro a menos que se lo indique su médico.

Los bebés prematuros: El dar hierro a los infantes prematuros con bajos niveles de vitamina E, puede provocar graves problemas. La deficiencia de vitamina E debe ser corregida antes de administrar hierro. Hable con su proveedor de atención médica antes de dar hierro a un bebé prematuro.

¿Existen interacciones con medicamentos?

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Moderadas

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Antibióticos (Antibióticos de quinolonas)
El hierro podría disminuir la cantidad de antibióticos que el cuerpo absorbe. El tomar hierro junto con algunos antibióticos puede disminuir la eficacia de algunos antibióticos. Para evitar esta interacción tome el hierro dos horas antes o dos horas después de tomar los antibióticos.

Algunos de estos antibióticos que pueden interactuar con el hierro incluyen ciprofloxacina (Cipro), enoxacina (Penetrex), norfloxacina (Chibroxin, Noroxin), esparfloxacina (Zagam), trovafloxacina (Trovan), y grepafloxacina (Raxar).

Antibióticos (Tetraciclina)
El hierro se puede unir a los antibióticos de tetraciclina en el estómago y disminuir la cantidad de antibióticos de tetraciclina que el cuerpo puede absorber. El tomar hierro junto con tetraciclinas podría disminuir la eficacia de los antibióticos de tetraciclina. Para evitar esta interacción tome el hierro dos horas antes o cuatro horas después de tomar las tetraciclinas.

Algunos antibióticos de tetraciclina son demeclociclina (Declomycin), minociclina (Minocin) y tetraciclina (Achromycin).

Bifosfonatos
El hierro puede disminuir la cantidad de bifosfonato que el cuerpo absorbe. El tomar hierro junto con bifosfonato puede disminuir la eficacia de los bifosfonatos. Para evitar esta interacción tome los bifosfonatos al menos dos horas antes de tomar el hierro o más tarde en el día.

Algunos bifosfonatos incluyen alendronato (Fosamax), etidronato (Didronel), risedronato (Actonel), tiludronato (Skelid) y otros.

El micofenolato mofetilo (CellCept)
No es clara la manera en que los suplementos de hierro afectan la absorción de micofenolato mofetil en el cuerpo. Se ha sugerido que el hierro podría disminuir la cantidad de micofenolato mofetilo que el cuerpo absorbe (CellCept). Por lo tanto, la ingesta de hierro con micofenolato mofetilo (CellCept) podría disminuir la efectividad del micofenolato mofetilo (CellCept). No obstante, no toda la investigación muestra que el hierro afecta la absorción de micofenolato en el cuerpo. Esto significa que no es claro si esta potencial interacción representa un problema grave. Hasta tanto no se disponga de más información, el hierro debería ingerirse al menos cuatro a seis horas antes o dos horas después de haber ingerido el micofenolato mofetil (CellCept).

Levodopa
El hierro podría disminuir la cantidad de levodopa que el cuerpo absorbe. El tomar hierro junto con levodopa podría disminuir la eficacia de la levodopa. No tome hierro y levodopa al mismo tiempo.

Levotiroxina
La levotiroxina se usa cuando el funcionamiento de la tiroides es bajo. El hierro puede disminuir la cantidad de levotiroxina que el cuerpo absorbe. El tomar hierro junto con levotiroxina podría disminuir la eficacia de la levotiroxina.

Algunas marcas que contienen levotiroxina incluyen Armour Thyroid, Eltroxin, Estre, Euthyrox, Levo-T, Levothroid, Levoxyl, Synthroid, Unithroid, y otros.

Metildopa (Aldomet)
El hierro puede disminuir la cantidad de metildopa (Aldomet) el cuerpo absorbe. El tomar hierro junto con metildopa (Aldomet) podría disminuir la eficacia de la metildopa (Aldomet). Para evitar esta interacción tome el hierro por lo menos dos horas antes o después de tomar metildopa (Aldomet).

Penicilamina (Cuprimine, Depen)
La penicilamina se utiliza para la enfermedad de Wilson y para la artritis reumatoide. El hierro podría disminuir la cantidad de penicilamina que el cuerpo absorbe y disminuir la eficacia de la penicilamina. Para evitar esta interacción tome el hierro dos horas antes o dos horas después de tomar la penicilamina.

Menores

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Cloranfenicol
El hierro es importante para producir nuevas células sanguíneas. El cloranfenicol podría disminuir la producción de nuevas células sanguíneas. El tomar cloranfenicol durante mucho tiempo podría disminuir los efectos del hierro en la formación de nuevas células sanguíneas. Pero la mayoría de las personas sólo toman cloranfenicol por un tiempo corto, así que esta interacción no es un gran problema.

¿Existen interacciones con hierbas y suplementos?

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Acacia
La acacia forma un gel insoluble con algunas formas de hierro. No se sabe si esto conduce a una interacción significativa cuando los dos son ingeridos juntos.

Beta-caroteno
El beta-caroteno puede ayudar al cuerpo a tomar (absorber) el hierro del trigo, de la harina de maíz y del arroz enriquecidos con hierro. Pero el tomar beta-caroteno adicional probablemente no haría mucha diferencia en la absorción de hierro a menos que los niveles de beta-caroteno sean demasiado bajos.

Calcio
El calcio hace que sea más difícil para el cuerpo absorber el hierro ya sea de alimentos o suplementos. En personas que tienen suficiente hierro almacenado, esto probablemente no es un problema. No obstante, si tiene deficiencia de hierro o podría desarrollarla, trate de minimizar esta interacción mediante la separación de su ingesta de hierro y de calcio. No tome suplementos de calcio con las comidas o cuando toma suplementos de hierro.

Riboflavina
El tomar suplementos de riboflavina puede mejorar la manera como trabajan los suplementos de hierro en algunas personas con anemia. Pero este efecto es probablemente significativo sólo en las personas con bajos niveles de riboflavina.

Soja
La proteína de soja parece reducir la capacidad del cuerpo para absorber el hierro. Si tienen deficiencia de hierro, elija los productos de soja fermentada. Parece que ellos interfieren menos con la absorción del hierro. Sin embargo, la verdadera importancia de la interacción entre la soya y el hierro no ha sido determinada.

Vitamina A
La vitamina A parece estar involucrada en el transporte de hierro de donde se almacena en el cuerpo a los glóbulos rojos que se están desarrollando en la médula ósea. Allí, el hierro se utiliza para hacer la hemoglobina, la molécula en los glóbulos rojos que transporta el oxígeno. El dar suplementos de vitamina A parece mejorar los niveles de hierro en las personas cuyos niveles de hierro están demasiado bajos. Las investigaciones en desarrollo sugieren que la vitamina A y el beta-caroteno puede mejorar la absorción de hierro del trigo, de la harina de maíz y del arroz enriquecido con hierro. Es poco probable que el dar suplementos de vitamina A tendría un efecto significativo en el nivel de hierro en aquellas personas que, para empezar, ya tienen suficiente vitamina A.

Vitamina C
El tomar hierro y vitamina C, juntos ayuda al cuerpo a absorber el hierro. No importa si la vitamina C proviene de los alimentos o de un suplemento. Sin embargo, para la mayoría de la gente probablemente no es necesario tomar un suplemento de vitamina C para mejorar la absorción de hierro, especialmente si su dieta contiene gran cantidad de vitamina C.

Zinc
Bajo algunas circunstancias, el hierro puede interferir con la forma en que el cuerpo absorbe el zinc, y viceversa. Sin embargo, la comida elimina esa interacción. Para obtener el máximo beneficio de los suplementos de zinc o de hierro, es una buena idea tomarlos con alimentos.

¿Existen interacciones con alimentos?

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Alimentos
El tomar hierro con alimentos puede disminuir en un 40% a 50% la cantidad de hierro que es absorbida por el cuerpo. Para una mejor absorción el hierro se debería tomar con el estomago vacío. Pero hay personas que no lo pueden tolerar sin comida debido a los efectos secundarios que produce tales como malestar estomacal y nauseas. Si es necesario tomar el hierro con alimentos para disminuir estos efectos secundarios, evite tomarlo con productos lácteos, café, té o cereal.

Café y té
La ingesta de suplementos de hierro con el café o el té puede reducir la cantidad de hierro que el cuerpo absorbe. Estas bebidas, incluso pueden reducir la cantidad de hierro que el cuerpo absorbe de los alimentos. Estos efectos pueden contribuir a la anemia por deficiencia de hierro, especialmente en las personas que tienen otros factores de riesgo.

Productos lácteos
El calcio en los productos lácteos como la leche y el queso pueden reducir la absorción de hierro de los alimentos y suplementos. Esto probablemente no es un problema para la gente que tiene suficiente hierro almacenado en sus cuerpos. No obstante, si su cuerpo necesita hierro, siempre que sea posible, tome los suplementos de hierro con una comida que es relativamente baja en productos lácteos. La gente puede decir que obtendrá la mejor absorción del hierro con el estómago vacío, pero esto aumenta el riesgo de irritación estomacal. No se arriesgue. Es mejor tomar el hierro con una comida baja en calcio.

¿Qué dosis se utiliza?

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Las siguientes dosis han sido estudiadas en investigaciones científicas:

POR VÍA ORAL:
  • Insuficiencia de hierro en adultos: Se utilizaron 50-100 mg de hierro elemental se administra tres veces al día. Se han usado dosis de 30-120 mg por semana en mujeres adultas. Para el tratamiento de los niños con anemia por deficiencia de hierro: la dosis es de 4-6 mg/kg/día dividida en tres dosis. Tanto para los adultos como los niños, el tratamiento durante 2 a 3 meses puede revertir la anemia pero no aumenta la cantidad de hierro almacenada. Por lo tanto, el tratamiento suele continuarse durante otros 6 meses para incrementar las reservas de hierro en el cuerpo.
  • Prevención de la deficiencia de hierro en los niños: la Academia Americana de Pediatras recomienda el uso de suplementos de hierro en algunos grupos. Para bebés lactantes, se recomienda 1 mg/kg/día de hierro elemental para bebés de 4-6 meses. Los bebés de 6-12 meses deben ingerir 11 mg/día de hierro de alimentos o suplementos. Para los bebés prematuros, se recomienda 2 mg/kg/día durante el primer año. Esto se debe continuar hasta que el bebé empieza a tomar leche maternizada o hasta que comience a ingerir suficiente hierro de fuentes alimenticias. La leche maternizada brinda al niño la cantidad de hierro que necesita durante ese periodo. Los niños de 1-3 años por lo general cumplen con los requisitos diarios recomendados de 7 mg de hierro por día solo consumiendo alimento; sin embargo, si es necesario se puede agregar un suplemento de hierro.
  • Para mejorar la capacidad de aprendizaje y razonamiento en adolescentes con deficiencia de hierro: ingerir 650 mg de sulfato ferroso dos veces al día.
  • Para la tos asociada con los inhibidores de la enzima convertidora de angiotensina (IECA): ingerir 256 mg de sulfato ferroso al día.
La ingesta adecuada (IA), de hierro para los bebés menores de 6 meses de edad es de 0,27 mg/día. Para los lactantes mayores y para los niños, el consumo diario recomendado (CDR) de hierro es: Bebés de 7 a 12 meses, 11 mg/día; niños de 1 a 3 años, 7 mg/día; de 4 a 8 años, 10 mg/día; de 9 a 13 años, 8 mg/día; hombres de 14 a 18 años, 11 mg/día; mujeres de 14 a 18 años, 15 mg/día. En los adultos, el consumo diario recomendado de hierro es de 8 mg/día en hombres mayores de 19 años y en mujeres mayores de 51 años. Para las mujeres de 19 a 50 años, el CDR es de 18 mg/día. Para las mujeres embarazadas, el CDR es de 27 mg/día. Para las mujeres lactantes, el CDR es de 10 mg/día para las mujeres de 14 a 18 años y de 9 mg/día para las mujeres de 19 a 50 años de edad.

Los niveles superiores de ingesta tolerable (UL), que es la ingesta de hierro más alta de la cual no se esperan efectos secundarios no deseados son: Para bebés y niños desde el nacimiento hasta los 13 años, 40 mg/día, para personas mayores de 14 años (incluido durante el embarazo y la lactancia), 45 mg/día. Los UL recomendados no se aplican en personas bajo supervisión médica por deficiencia de hierro.

Hay diferentes tipos de suplementos de hierro que contienen diferentes cantidades de hierro elemental: 1 gramo de gluconato ferroso = 120 mg de hierro elemental (12% de hierro); 1 gramo de sulfato ferroso = 200 mg de hierro elemental (20% de hierro); 1 gramo de fumarato ferroso = 330 mg de hierro elemental (33% de hierro). La eficacia y los efectos secundarios de estos diferentes tipos son similares siempre que se consuman en dosis iguales de hierro elemental.

Otros nombres

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Atomic Number 26, Carbonate de Fer Anhydre, Citrate de Fer, Elemental Iron, Fe, Fer, Fer Élémentaire, Ferric Orthophosphate, Ferrous Carbonate Anhydrous, Ferrous Citrate, Ferrous Fumarate, Ferrous Gluconate, Ferrous Pyrophosphate, Ferrous Sulfate, Ferrum Phosphoricum, Fumarate de Fer, Gluconate de Fer, Glycérophosphate de Fer, Heme Iron Polypeptide, Iron Glycerophosphate, Orthophosphate de Fer, Orthophosphate Ferrique, Numéro Atomique 26, Polypeptide de Fer de Heme, Pyrophosphate de Fer, Sulfate de Fer.

Metodología

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Para saber más sobre cómo este artículo fue escrito, refiérase a la metodología metodología (http://www.nlm.nih.gov/medlineplus/spanish/druginfo/natural/methodology-sp.html) de la Base exhaustiva de datos de medicamentos naturales.

Referencias

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Para ver todas las referencias de la página de Hierro, por favor diríjase a http://www.nlm.nih.gov/medlineplus/spanish/druginfo/natural/912.html.
  1. Murahovschi, J., Stein, M. L., Careffa, R. C., De Andrade, V. L., Da Compos Guerra, C. C., and Falci, M. Tratamento da ferropenia e da anemia ferropenica com o complexo de hidroxido de ferro polimaltosado por via oral, de crianc;as em fase de recuperac; ao de infecc;oes respiratorias. Ensaio duplo-cego, comparativo com sulfato ferroso [Treatment of iron deficiency and iron deficiency anemia with an iron hydroxide polymaltose complex given orally in children recovering from respiratory infections. Double blind trial, compared with ferrous sulfate]. Rev Paul Ped 1987;:97-104.
  2. Langstaff, R. J., Geisser, P., Hell, W. G., and Bowdler, J. M. Treatment of iron-deficiency anemia: a lower incidence of adverse effects with Ferrum Hausmann than ferrous sulfate. Brit J Clin Res 1993;:191-198.
  3. Geisser, P., Hohl, H., and Muller, A. Klinische Wirksamkeit dreier verschiedener Eisenpraparate an Schwangeren[Clinical efficacy of three different iron preparations on pregnant women]. Schweizerische Apotheker-Zeitung 2011;125:393-398.
  4. Borbolla, J. R., Cicero, R. E., Dibildox, M. M., Sotres, R. D., and Gutierrez, G. R. Complejo polimaltosado ferrico vs sulfato ferroso en el tratarniento de la anemia por deficiencia de hierro en lactantes [Iron hydroxide polymaltose complex vs iron sulfate in the treatment of iron deficiency anemia in infant]. Revista Mexicana de pediatria 2000;67:63-67.
  5. Bogdanova, O. M. and Pashenko, I. G. A comparative study of iron salts vs hydroxide polymaltose iron complex efficacy in the treatment of iron deficiency anemia in presenile and senile patients. Gematologiya I Transfuziologiya 2004;49:29-31.
  6. Andrade, J. V. D., Rodrigues, P. P. B., Fontoura, I. B., D'Agnoluzzo, R., Horta, V. E., and Alves, J. Tratarnento da anemia ferropriva com hidroxidode ferro polimaltosado [Treatment on iron deficiency anemia with iron hydroxide polymaltose complex]. ABP-Supl. Arq bras Med 1992;66:253-258.
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