Nutrients. 2021 May 17;13(5):1695. doi: 10.3390/nu13051695.

Valentina Talarico ¹, Laura Giancotti ², Giuseppe Antonio Mazza ³, Roberto Miniero ¹, Marco Bertini ⁴

Author information

• ¹Department of Pediatric, Pugliese-Ciaccio Hospital, 88100 Catanzaro, Italy.
• ²Unit of Pediatrics, University "Magna Graecia", 88100 Catanzaro, Italy.
• ³Department of Pediatric Cardiology, Regina Margherita Hospital, Città della Salute e della Scienza, 10126 Torino, Italy.
• ⁴R&D Department, Laboratori Baldacci SpA, 56121 Pisa, Italy.

Abstract

The iron absorption process developsmainly in the proximal duodenum. This portion of the intestine is typically destroyed in celiac disease (CD), resulting in a reduction in absorption of iron and subsequent iron deficiency anemia (IDA). In fact, the most frequent extra-intestinal manifestation (EIM) of CD is IDA, with a prevalence between 12 and 82% (in relation with the various reports) in patients with new CD diagnosis. The primary treatment of CD is the gluten-free diet (GFD), which is associated with adequate management of IDA, if present. Iron replacement treatment historically has been based on oral products containing ferrous sulphate (FS). However, the absorption of FS is limited in patients with active CD and unpredictable in patients on a GFD. Furthermore, a poor tolerability of this kind of ferrous is particularly frequent in patients with CD or with other inflammatory bowel diseases. Normalization from anemic state typically occurs after at least 6 months of GFD, but the process can take up to 2 years for iron stores to replenish.