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Evid Based Med doi:10.1136/eb-2012-101029
  • Therapeutics
  • Randomised controlled trial

One iron pill a day keeps fatigue away?

  1. Henriette Heinrich
  1. Division of Internal Medicine, University Hospital of Zurich, Zurich, Switzerland
  1. Correspondence to : Dr Pierre-Alexandre Krayenbuehl
    Division of Internal Medicine, University Hospital of Zurich, Zurich 8091 Switzerland; pierrea.krayenbuehl{at}usz.ch

Commentary on Vaucher P, Druais PL, Waldvogel S, et al. Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomised controlled trial. CMAJ 2012;184:1247–54.

Context

Could an apple a day keep the doctor away? The world's first multicentre trial addressed this question and found that a simple treatment lacked effect in common cold.1 Can an iron pill a day keep fatigue away? Iron is one of the cornerstones of cellular function being key in haemoglobin and DNA synthesis, and influencing enzymatic activity and especially mitochondrial function. The supposed association between iron deficiency and fatigue is long standing and has so far been difficult to prove. Although fatigue in the context of iron-deficiency ‘anaemia’ is self-evident for every doctor, and notably, pathophysiologically easy to comprehend, fatigue associated solely with low iron stores in ‘non-anaemic’ patients is unfamiliar and more difficult to understand. However, …

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