Non-anemic women attending a public antenatal clinic were given, daily, a multivitamin tablet containing 78 mg. of elemental iron. The follow-up studies included an analysis of their diets. A total of 311 patients were included, of which one group received a supplement of 0.5 mg. folic acid and 0.005 mg. vitamin B(12). The incidence of megaloblastic bone marrow change in the unsupplemented group was 26% and of low blood folates approximately 50%. The incidence of megaloblastic changes was sharply reduced in the supplemented group and the blood folates were elevated to supranormal levels, indicating that the dose of folic acid used may have been above the minimal requirement. Formiminoglutamic acid (FIGLU) excretion could not be correlated with other parameters of folate deficiency. Neutrophil lobe counts did not relate to megaloblastic changes or low folate levels unless there was more than 5% hypersegmentation. The dietary intake was suboptimal in total calories, iron and food folate.

Anemia, Macrocytic↗

PubMed1966

The effect of intramuscular iron therapy on hematological values in normal men and women.

It has been claimed repeatedly that iron stimulates hemoglobin formation in normal men and women. Because of the inconclusive evidence in the literature, the possible stimulatory action of iron on normal hemoglobin synthesis was reinvestigated by evaluating the effect of 1000 mg. of intramuscular iron on hematological parameters in six normal men and six normal women over a six-month period. Determinations of red cell and hemoglobin mass after three and six months and monthly determinations of hemoglobin concentration, packed cell volume, red cell count, reticulocyte count, mean corpuscular volume and mean corpuscular hemoglobin concentration showed no significant rise in either the men or the women. It is concluded that there is no demonstrable proof that the administration of iron stimulates erythropoiesis or hemoglobin synthesis in iron-sufficient normal men and women.

Adult↗

PubMed1966

Nutritional anemia and megaloblastosis in pregnancy.

Macrogranulocytic and/or erythroid megaloblastic bone marrow changes which could not be accurately predicted from the hematologic findings in the blood were present in 25% of 305 mildly to moderately anemic pregnant women attending a public antepartum clinic in Montreal. Iron deficiency was the primary cause of anemia in most instances. Serum folate activity of less than 4.1 ng./ml. and/or serum vitamin B(12) levels of less than 100 pg./ml. were present in 90% of the 77 patients having these bone marrow changes, whereas approximately one-third of 228 patients with normoblastic marrow had these low values. Red cell folate did not correlate as well as serum folate activity with bone marrow changes. After treatment with oral folic acid in the range of 0.2 mg. to 0.8 mg., daily, for seven to 14 days, the megaloblastic and macrogranulocytic changes in patients with low serum folate activity and normal serum vitamin B(12) values disappeared in 15 of 21 patients. Of five women having both low folate and vitamin B(12) values, three failed to respond and two showed only partial improvement after 0.4 mg. of folic acid daily, per os, for 10 days. The average diet of these anemic women was suboptimal in folate and in iron.

Anemia, Hypochromic↗

PubMed1966