Role of vitamin A supplementation in management of iron deficiency anemia in children

Arnab Biswas


Background: The objective of the study were to study the effect of the supplementation of vitamin A along with standard dose of iron on hematopoiesis in children with documented iron deficiency anemia, a hospital based prospective study is carried out for 6 months on children with documented iron deficiency anemia in OPD and indoor patients of the department of paediatric medicine, Medical College Kolkata..

Methods: Thirty children (1-12 years age) presenting with iron deficiency anemia (hemoglobin less than 10 g/dl, mean corpuscular volume (MCV) <75 fl, and serum iron <55 mcg/dl) were studied in two groups of 15 each. Group I was supplemented with iron (ferrous sulphate 3 mg/kg/d) while group II in addition to iron was also supplemented with vitamin A (5000 IU/d).Collected data were expressed as mean±SE. Comparison of variables was done by using student t test or chi square test as applicable. P<0.0001 was taken as statistically significant.

Results: Hemoglobin concentration was found to be significantly increased after 4 weeks of iron supplementation. Rise in hemoglobin was comparatively more in group II, as compared to group I, after 4 and 8 weeks.

Conclusions: The result of this study suggests that supplementation of vitamin A improves hematopoiesis.


Vitamin A, Anemia, Iron

Full Text:



Marcus R, Coulston AM. Fat-soluble vitamins - Vitamin A, K and E. In Goodman and Gilman’s Pharmacological basis of Therapeutics. Hardman JG, Limbird LE, Motinoff Goodman and Gilman’s PB, Ruddon RW, Gilman AG, eds. McGraw Hill, New York. 1996: 1573-1590.

Ghatpande S, Ghatpande A, Sher J, Zile MH, Evans T. Retinoid signaling regulates primitive (yolk sac) hematopoiesis. Blood. 2002;99:2379-86.

Jang JT, Green JB, Beard JL and Green MH. Kinetic analysis shows that iron deficiency, decreases liver vitamin A mobilization in rats. J Nutr. 2002;130:1291-6.

Roodenburg AJ, West CE, Hovenier R, Beynen AC. Supplemental vitamin A enhances the recovery from iron deficiency in rats with chronic vitamin A deficiency. Br J Nutr Pr. 1996;75(4):623-36.

Van den Broek N. Anaemia and micronutrient deficiencies.Br Med Bull. 2003;67:149-60.

Gamble MV, Palafox NA, Dancheck B, Ricks MO, Briand K, Semba RD. Relationship of vitamin A deficiency, iron deficiency, and inflammation to anemia among preschool children in the Republic of the Marshall Islands. Eur J Clin Nutr. 2004;58(10):1396-401.

Hashizume M, Chiba M, Shinohara A, Iwabuchi S, Sasaki S, Shimoda T, et al. Anaemia, iron deficiency and vitamin A status among school-aged children in rural Kazakhstan. Public Health Nutr. 2005;8(6):564-71.

Higgins T. Novel chromogen for serum iron determination. Clin Chem. 1981;27:1619-20.

Kafwembe EM. Iron and vitamin A status of breastfeeding mothers in Zambia. East Afr Med J. 2001;78(9):454-7.

Staab DB, Hodges RE, Metcalf WK, Smith JL. J Nutr. Relationship between vitamin A and iron in the liver. 1984;114(5):840-4.

Mohanram M, Kulkarni KA, Reddy V. Hematological studies in vitamin A deficient children.Int J VitamNutr Res. 1977;47(4):389-93.

Wieringa FT, Dijkhuizen MA, West CE, Thurnham DI, Muhilal, Van der Meer JW. Redistribution of vitamin A after iron supplementation in Indonesian infants. Am J ClinNutr. 2003;77(3):651-7

Majía LA, Hodges RE, Arroyave G, Viteri F, Torún B. Vitamin A deficiency and anemia in Central American children. Am J ClinNutr. 1977;30(7):1175-84.

Suharno D, West CE, Muhilal H, Karyadi D, Hautvast JGAG. Supplementation with vitamin A and iron for nutritional anemia in pregnant women in West Jawa, Indonesia. Lancet. 1993;342:1325-8.

Persson V1, Ahmed F, Gebre-Medhin M, Greiner T. Relationships between vitamin A, iron status and helminthiasis in Bangladeshi school children. Public Health Nutr. 2000;3(1):83-9.

Mejia LA, Arroyave G. The effect of vitamin A fortification of sugar on iron metabolism in preschool children in Guatemala. Am J Clin Nutr. 1982;36:87-93

Bloem MW, Wedel M, Egger RJ, Speek AJ, Schrijver J, Saowakontha S, et al. Iron metabolism and vitamin A deficiency in children in northeast Thailand. Am J Clin Nutr. 1989;50:332-8.

Wolde-Gebriel Z, West CE, Speek AJ, Gebru H, Tadesse AS, Fisseha T, et al. Interrelationship between vitamin A, iodine and iron status in school children in Shoa Region, central Ethiopia. Br J Nutr. 1993;70:593-607

Zimmerman MB, Biebinger R, Rohner F, Dib A, Zeder C, Hurrell RF, Chouuki N. Vitamin A supplementation in children with poor iron status increases erythropoietin and hemoglobin concentration without changing total body iron. Ame J Clin Nutr. 2006;84(3):580-6.

Davidson L, Adou P, Zeder C, Walczyk T, Hurrell R. The effect of retinylpalmitate added to iron-fortified maize porridge on erythrocyte incorporation of iron in African children with vitamin A deficiency. Br J Nutr. 2003;90:337-43.