{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:00:38Z","timestamp":1785128438631,"version":"3.55.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Iron deficiency anemia (IDA) is common among women of reproductive age and is frequently associated with abnormal uterine bleeding (AUB). Although oral iron is first-line therapy, the optimal dosing schedule remains uncertain. This study compared daily and alternate-day oral iron in real-world practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational cohort study of women aged 18\u201370\u202fyears with confirmed IDA treated with oral ferrous sulfate at a tertiary referral center between January 2023 and June 2024. Patients received oral iron every 24\u202fh or every 48\u202fh according to physician prescription. AUB etiology was classified using the PALM\u2013COEIN system. Outcomes included hemoglobin change, World Health Organization anemia severity, hemoglobin normalization (\u226512\u202fg\/dL), adherence, adverse-event-related discontinuation, and intravenous iron escalation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 171 women were included. Leiomyomas were the most frequent PALM\u2013COEIN category (106 patients, 62.0%). Mean baseline hemoglobin was 9.02\u202f\u00b1\u202f1.45\u202fg\/dL. At 6\u202fweeks, mean hemoglobin was 10.91\u202f\u00b1\u202f1.76\u202fg\/dL in the 24-h group and 11.26\u202f\u00b1\u202f1.86\u202fg\/dL in the 48-h group (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.255). At 3\u202fmonths, final hemoglobin was available in 147 patients; mean values were 12.79\u202f\u00b1\u202f1.68\u202fg\/dL and 12.68\u202f\u00b1\u202f1.62\u202fg\/dL, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.692). Hemoglobin normalization occurred in 75.2 and 71.7% of patients, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.687). Adherence was high, and discontinuation due to adverse events was uncommon. Intravenous iron escalation was numerically more frequent with alternate-day therapy (26.8% vs. 13.9%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.056), although escalation decisions were based on clinical judgment without standardized criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both regimens were associated with hematologic improvement. However, because allocation was non-randomized, baseline differences were present, and intravenous iron escalation was not based on standardized criteria, equivalence cannot be inferred. Oral iron dosing should be individualized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1893130","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:26:02Z","timestamp":1785126362000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Daily versus alternate-day oral iron in women with iron deficiency anemia: impact of dosing schedule and adherence on hemoglobin recovery"],"prefix":"10.3389","volume":"13","author":[{"given":"Christian Omar","family":"Ramos Pe\u00f1afiel","sequence":"first","affiliation":[{"name":"Hematology Department, Hospital General de M\u00e9xico \u201cDr. Eduardo Liceaga\u201d","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Mart\u00ednez Moreno","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital General de M\u00e9xico \u201cDr. Eduardo Liceaga\u201d","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Mart\u00ednez Tovar","sequence":"additional","affiliation":[{"name":"Molecular Biology Department, Hospital General de M\u00e9xico \u201cDr. Eduardo Liceaga\u201d","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Vero Sosa","sequence":"additional","affiliation":[{"name":"Social Service in Health Research Program, Research in Medicine, Universidad Aut\u00f3noma Metropolitana (UAM)","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Mart\u00ednez Murillo","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital General de M\u00e9xico \u201cDr. Eduardo Liceaga\u201d","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ad\u00e1n Germ\u00e1n","family":"Gallardo Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"School of Sport Sciences, Universidad An\u00e1huac M\u00e9xico","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s40360-025-00984-2","article-title":"Efficacy of daily versus alternate day oral iron supplementation for management of anaemia among general population: a systematic review and meta-analysis","volume":"26","author":"Dhanvijay","year":"2025","journal-title":"BMC Pharmacol Toxicol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1023046","DOI":"10.3389\/fnut.2022.1023046","article-title":"Poor adherence to iron-folic acid supplementation and associated factors among pregnant women who had at least four antenatal care in Ethiopia. A community-based cross-sectional study","volume":"9","author":"Asmamaw","year":"2022","journal-title":"Front Nutr"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1038\/s41598-023-29034-9","article-title":"Alternate day versus daily oral iron for treatment of iron deficiency anemia: a randomized controlled trial","volume":"13","author":"Pasupathy","year":"2023","journal-title":"Sci Rep"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"436","DOI":"10.46747\/cfp.6706436","article-title":"Iron dosing frequency","volume":"67","author":"Lee","year":"2021","journal-title":"Can Fam Physician"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.21203\/rs.3.rs-3933791\/v1","article-title":"Treatment of Iron deficiency anaemmia in pregnancy study. The clinical impact of treatment for Iron deficiency anaemia using an optimized care pathway in accordance with national guidelines","author":"Churchill","year":"2024","journal-title":"Research Square"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"e2414305","DOI":"10.1001\/jamanetworkopen.2024.14305","article-title":"Optimal oral iron therapy for iron deficiency anemia among US veterans","volume":"7","author":"Patel","year":"2024","journal-title":"JAMA Netw Open"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1136\/flgastro-2020-101506","article-title":"Management of iron deficiency anaemia in secondary care across England between 2012 and 2018: a real-world analysis of hospital episode statistics","volume":"12","author":"Brookes","year":"2020","journal-title":"Frontline Gastroenterol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e000530","DOI":"10.1136\/bmjgast-2020-000530","article-title":"Ferric maltol real-world effectiveness 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