by Dr. Leo Galland
Iron deficiency is the most common cause of anemia in the world and is a frequent complication of pregnancy. Supplements of iron may help to correct anemia but frequently produce gastrointestinal side effects.
The dietary supplement lactoferrin, a protein derived from milk, binds to iron and increases its absorption. Research done at the Department of Gynecology and Obstetrics, University of Naples in Italy, found that taking lactoferrin capsules was as effective as iron supplements in correcting anemia among healthy pregnant women.
The researchers conclude: “The results show that bovine lactoferrin has the same efficacy as ferrous sulfate in restoring iron deposits with significantly fewer gastrointestinal side effects.”
Reference and Abstract:
Acta Obstet Gynecol Scand. 2009;88(9):1031-5. Efficacy and tolerability of oral bovine lactoferrin compared to ferrous sulfate in pregnant women with iron deficiency anemia: a prospective controlled randomized study. Nappi C, Tommaselli GA, Morra I, Massaro M, Formisano C, Di Carlo C. Department of Gynecology and Obstetrics, University of Naples Federico II, Via S. Pansini 5, Naples, Italy. nappi@unina.it
OBJECTIVE: To compare the effects of bovine lactoferrin with ferrous sulfate on iron nutritional status and to evaluate their tolerability in 100 pregnant women with iron deficiency anemia.
DESIGN: Prospective, randomized, controlled, double blind trial.
SETTING: Obstetrics clinic of a University Department of Obstetrics and Gynecology.
POPULATION: One-hundred pregnant, healthy women to be treated either with one capsule of 100 mg bovine lactoferrin twice a day (Group A; n=49) and 520 mg ferrous sulfate once a day (Group B; n=48).
METHODS: After 30 days, we evaluated hemoglobin (Hb), serum ferritin, serum iron and total iron- binding capacity (TIBC) values. All women were asked to keep a diary of five potential gastrointestinal side effects (abdominal pain, nausea, vomiting, diarrhea and constipation). For each symptom, patients had to rate its severity according to a scale ranging from 0 (absent) to 3 (severe).
MAIN OUTCOME MEASURES: Hb level before and after treatment. Secondary outcomes were serum ferritin, serum iron and TIBC levels and the difference in symptom scores between groups.
RESULTS: In Groups A and B, Hb, serum ferritin and iron were significantly increased while TIBC was significantly reduced in comparison with basal values. No significant differences were observed between Groups A and B. The median scores of abdominal pain and constipation were significantly higher in patients treated with ferrous sulfate in comparison with those treated with bovine lactoferrin.
CONCLUSIONS: The results show that bovine lactoferrin has the same efficacy as ferrous sulfate in restoring iron deposits with significantly fewer gastrointestinal side effects.
Based on literature and calls I’ve made to supplemental Lactoferrin manufacturers, it appears that virtually all Lactoferrin sold in the US is of the low-iron or iron-depleted (apolactoferrin) variety.
While I don’t have access to the full study abstracted above, my guess is that the researchers did NOT use this more-commonly-available iron-depleted version. This is an important distinction to make to those who might be considering substituting a Lactoferrin supplement for Ferrous Sulfate or other iron source. Indeed, one manufacturer, Life Extension, warns that its Lactoferrin product should be avoided by those with Iron Deficiency.
Rick, another mechanism by which anemia is corrected is by lowering inflammation in the body. I speak of ID anemia that is also prevalent in anemia of inflammation or as some call it: anemia of chronic disease. In this scenario, the iron is prevented from being absorbed by a peptide produced in the liver called hepcidin. The literature mentions hepcidin as a regulator of iron homeostasis in the body. Lactoferrin, reduces inflammation so that the iron is absorbed better and used by the body.
High levels of iron sulfate actually increase levels of hepcidin (by increasing toxicity and inflammation) thus, lowering the amount of iron that can be used and causing your body to store it in its organs i.e. the liver. So now you have a situation where you have anemia with high ferritin levels. So whether the lactoferrin contains iron or not – it is still quite effective by means of reducing hepcidin. So if you look a bit further you will see that that has implications not just in pregnancy but in cancer and other inflammatory ID states.
I have read the full study and have also read the clinical trial goals/methods. Researchers used a german-made Bovine lactoferrin supplement available in Italy commercialized by Grunenthal, as Lattoglobina® (capsules with 100 mg of bLf)
I would recommend a standard dose of iron at about 24mg, but I would add 3 gms of buffered vitamin C daily and lactoferrin in a slightly higher dose than used for pregnancy in this study for cancer or infection/sepsis. And in sepsis, it may help cut your chances of developing DIC (but that is just my theory). I would love to see a study in cancer and anemia of inflammation with lactoferrin. By the way, one of the benefits of lactoferrin is that it helps your immune system work better and helps heal ulcers (bleeding is another cause of anemia and low iron).
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VRJ-4SRW171-1&_user=10&_coverDate=01/31/2009&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_searchStrId=1648046209&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=ba7d0892012b3edb39a4221ec5d69371&searchtype=a
http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01221844