Q: What is the role of carbonyl iron? Is it superior to ferrous sulphate/fumerate?What is the daily requirement of iron during the time of pregnancy?

A:Iron for oral therapy is formulated in the form of several molecules such as ferrous sulphate, ferrous fumarate, ferrous gluconate etc. In fact there are over 13 formulations. Ferrous carbonate is one of them. These preparations differ from each other mainly, though not entirely, in the quantity of equivalent iron content. For example 200mg of ferrous sulphate provides 60mg of elemental iron while 183mg of ferrous fumarate is equivalent to 60mg of elemental iron. In the case of ferrous carbonate, 60mg of elemental iron is provided by 125mg of ferrous carbonate.

The daily requirement of iron is 1mg in the case of adults and 1.5 to 2mg in the case of menstruating women. This amount is available in the normal diet. Please keep in mind that body iron is recycled; hence not much additional intake is necessary unless a person is suffering from iron deficiency anaemia. The only problem is that the absorption of iron from dietary source is 5 to 15%. Thus in order to obtain 1mg of iron in the blood, one needs to consume 10mg of iron. Similarly the daily requirement of a menstruating female is 15mg.

Theoretically, no additional iron is required during pregnancy. In the west, iron supplementation during pregnancy is not in vogue. However due to a variety of reasons (poor nutrition, vegetarian diet, hookworm infestation etc), women in India, particularly in the lower strata of society and in rural areas, are anaemic even when they are not pregnant. Therefore, a rational formulation of iron along with folic acid and zinc such as Elferri-Z should be administered to pregnant women, particularly if the Hb level is below 13g.