Effect of oral vitamin E with intravenous vitamin C in the treatment of anemia of chronic disease
Rivera-Rodríguez, K.M.; Morales-Borges, R.H.; Román-Juliá, R.; Duconge, J.; Miranda-Massari, J.; Gonzales, M.J.; Morales-Borges, R.H.
Boletin de la Asociacion Medica de Puerto Rico 110(1): 49-54
2018
ISSN/ISBN: 0004-4849 Document Number: 703083
Background: Vitamin C has been useful in the treatment of anemia due to chronic illness but not utilized frequently in clinical practice. Regarding Vitamin E, small human and animal studies have shown benefits. The available evidence with regards to the benefits of high dose Intravenous Vitamin C (IVC) and oral vitamin E in anemia in chronic disease is scarce. We conducted a small randomized, controlled pilot study to examine if high IVC with oral vitamin E will raise hemoglo-bin and improve the quality of life of patients with chronic diseases. Method: Nine patients (5 male and four female) qualified with the eligibility criteria. The age range was from 41 to 82 years-old. The majority of the subjects suffered from systemic arterial hyperten-sion, chronic kidney disease, and Diabetes mellitus type 2. They were randomized in two groups: group 1 received a combination of high dose IVC (25 gm intravenously once a week × 4 weeks) plus oral vitamin E (mixed tocopherols and tocotrienols 800 mg) and group 2 received IVC only. The duration of the study was one month. The quality of life of life was assessed by using a simple quality of life scale name SF36 modified by the company MAX International. Results: The general (total) score in quality of life scale, in was 14 for group 1 and 8 for group 2. It was 8.2 for the combination group versus 9.8 for vitamin C only. The increased difference in he-moglobin was 1.52 gm/dL versus 0.85 gm/dL, and the reticulocyte count increased in both groups but higher in the combination group. The change in ESR also was noticeable in the combination group (4.6 mm/hr vs. 9.25 mm/hr), but the CRP level had a 41.6% effective reduction in the vita-min C only group compared to the combination therapy. The ferritin had a negative difference for group 1 (61.7%), but group 2 had a positive difference of 44.92% showing that the combination therapy decreased ferritin level as an inflammatory marker. Conclusion: The results of this small pilot study suggest a clinical benefit of the combination of high-dose IVC plus oral vitamin E in anemia in chronic disease. A randomized controlled study with a larger sample is necessary to determine the validity and implication of these findings.
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