Prevention of Iron Deficiency and Iron Deficiency Anemia in Various Patient Categories in the Russian Federation. Expert Council Resolution
https://doi.org/10.15829/3034-4123-2025-74
EDN: WZJVAX
Abstract
At the Expert Council meeting, key issues related to the prevention of latent iron deficiency (LID) and iron deficiency anemia (IDA) in at-risk populations were discussed, including women of reproductive age, pregnant women, blood donors, and patients with chronic diseases. Participants reviewed international and national guidelines, acceptable levels of iron intake, as well as barriers limiting the implementation of standard preventive approaches in clinical practice. Particular attention was given to chelated forms of iron, especially iron bisglycinate, noted for its high bioavailability and favorable tolerability profile. The experts emphasized the importance of using formulations containing components that enhance iron absorption and metabolism. Following the discussion, a resolution was adopted reflecting the consolidated interdisciplinary position of specialists on the prevention of LID and IDA, including patient management algorithms, care pathways, risk group identification, and recommendations for improving the regulatory framework.
About the Authors
O. M. DrapkinaRussian Federation
Oksana M. Drapkina
Petroverigsky Lane, 10, bld. 3, Moscow, 101990,
Dolgorukovskaya str., 4, Moscow, 127006
O. N. Tkacheva
Russian Federation
Olga N. Tkacheva
Ostrovityanova str., 1, Moscow, 117513
E. V. Shikh
Russian Federation
Evgenia V. Shikh
Trubetskaya St., 8, bld. 2, Moscow, 119048
L. Yu. Drozdova
Russian Federation
Liubov Yu. Drozdova
Petroverigsky Lane, 10, bld. 3, Moscow, 101990
I. I. Baranov
Russian Federation
Igor I. Baranov
Academician Oparin str., 4, Moscow, 117997
I. G. Bakulin
Russian Federation
Igor G. Bakulin
Kirochnaya str., 41, St. Petersburg, 191015
B. A. Bakirov
Russian Federation
Bulat A. Bakirov
Lenin str., 3, Ufa, Republic of Bashkortostan, 450008
R. V. Ponomarev
Russian Federation
Rodion V. Ponomarev
Novy Zykovsky Proezd, 4, Moscow, 125167
A. V. Starodubova
Russian Federation
Antonina V. Starodubova
Ostrovityanova str., 1, Moscow, 117513
T. A. Fedorova
Russian Federation
Tatiana A. Fedorova
Academician Oparin str., 4, Moscow, 117997
N. O. Khovasova
Russian Federation
Natalia O. Khovasova
Dolgorukovskaya str., 4, Moscow, 127006
References
1. GBD 2021 Anaemia Collaborators. Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990-2021: findings from the Global Burden of Disease Study 2021. Lancet Haematol. 2023;10(9):e713-e734. doi:10.1016/S2352-3026(23)00160-6.
2. Kassebaum NJ, Jasrasaria R, Naghavi M, et al. A systematic analysis of global anemia burden from 1990 to 2010. Blood J Am Soc Hematol. 2014;123:615-24.
3. Collaborators G: Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858. doi:10.1016/S0140-6736(18)32279-7. Erratum in: Lancet. 2019;393(10190):e44. doi:10.1016/S0140-6736(19)31047-5.
4. Sifakis S, Pharmakides G. Anemia in pregnancy. Ann N Y Acad Sci. 2000;900:125- 36. doi:10.1111/j.1749-6632.2000.tb06223.x.
5. Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood. 2004;104(8):2263-8. doi:10.1182/blood-2004-05-1812.
6. Gómez-Ramirez S, Jericó C, Muñoz M. Perioperative anemia: Prevalence, consequences and pathophysiology. TransfusApher Sci. 2019;58(4):369-74. doi:10.1016/j.transci.2019.06.011.
7. Freeman HJ. Iron deficiency anemia in celiac disease. World J Gastroenterol. 2015;21(31):9233-8. doi:10.3748/wjg.v21.i31.9233.
8. Safiri S, Kolahi AA, Noori M, et al. Burden of anemia and its underlying causes in 204 countries and territories, 1990-2019: results from the Global Burden of Disease Study 2019. J Hematol Oncol. 2021;14(1):185. doi:10.1186/s13045-021-01202-2.
9. Lukina EA, Dezhenkova AV. Iron metabolism in normal and pathological conditions. Clinical oncohematology. 2015;8(4):355-61. (In Russ.)
10. Moscheo C, Licciardello M, Samperi P, et al. New Insights into Iron Deficiency Anemia in Children: A Practical Review. Metabolites. 2022;12(4):289. doi:10.3390/metabo12040289.
11. Hurrell R, Ranum P, de Pee S, et al. Revised recommendations for iron fortification of wheat flour and an evaluation of the expected impact of current national wheat flour fortification programs. Food Nutr Bull. 2010;31(1 Suppl):S7-21. doi:10.1177/15648265100311S102.
12. World Health Organization. The urgent need to implement patient blood management: policy brief. Geneva: World Health Organization; 2021. ISBN: 978- 92-4-003574-4 (electronic), 978-92-4-003575-1 (print).
13. Milman N.Postpartum anemia I: definition, prevalence, causes, and consequences. Ann Hematol. 2011;90(2):124-9. doi:10.1007/s00277-010-1123-3.
14. Bergmann RL, Richter R, Bergmann KE, et al. Prevalence and risk factors for early postpartum anemia. Eur J Clin Nutr. 2010;64(5):627-33. doi:10.1038/ejcn.2010.48.
15. Breymann C., Auerbach M. Iron deficiency in gynecology and obstetrics: clinical implications and management. Hematology. 2017;22(3):152-9. doi:10.1080/10245332.2017.1347747.
16. Fraser IS, Mansour D, Breymann C, et al. Measuring the prevalence and burden of heavy menstrual bleeding. Int J Gynaecol Obstet. 2015;128(3):S1-S3. doi:10.1016/j.ijgo.2014.10.015.
17. Schoep ME, Adang EMM, Maas JWM, et al. Productivity losses due to menstruationrelated symptoms: a nationwide cross-sectional survey among 32,748 women. BMJ Open. 2019;9(6):e026186. doi:10.1136/bmjopen-2018-026186.
18. Henry L., Houston AM., Helman S. Barriers to seeking consultation for abnormal uterine bleeding: systematic review. BJOG. 2018;125(4):409-16. doi:10.1111/1471-0528.14884.
19. Munro MG, Critchley HOD, Fraser IS. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years. Fertil Steril. 2011;95(7):2204-8. doi:10.1016/j.fertnstert.2011.03.054.
20. The Lancet Global Health. Women's bleeding disorders are a global health issue. Lancet Glob Health. 2021;9(11):e1485. doi:10.1016/S2214-109X(21)00422-9.
21. Peuranpää P, Heliovaara-Peippo S, Fraser I, et al. Effects of anemia and iron deficiency in women with heavy menstrual bleeding. Acta ObstetGynecol Scand. 2014;93(5):522-8. doi:10.1111/aogs.12394.
22. Morrison J, Patel ST, Watson W, et al. Assessment of the prevalence and impact of anemia on women hospitalized for gynecologic conditions associated with heavy uterine bleeding. J Reprod Med. 2008;53(5):323-30.
23. Iolascon A, Andolfo I, Russo R, et al.; from EHA-SWG Red Cell and Iron. Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia. Hemasphere. 2024;8(7):e108. doi:10.1002/hem3.108.
24. Grishina GV, Krobinets II, Kasyanov AD, Sidorkevich SV. Detection and prevention of iron deficiency in blood donors (blood components). Medicine of extreme situations. 2023;25(4):168-73. (In Russ.)
25. Kavle JA, Stoltzfus RJ, Witter F, et al. Association between anaemia during pregnancy and blood loss at and after delivery among women with vaginal births in Pemba Island, Zanzibar, Tanzania. J Health Popul Nutr. 2008;26(2):232-40.
26. Juul SE, Derman RJ, Auerbach M. Perinatal Iron Deficiency: Implications for Mothers and Infants. Neonatology. 2019;115(3):269-74. doi:10.1159/000495978.
27. Daru J, Zamora J, Fernández-Félix BM, et al. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. Lancet Glob Health. 2018;6(5):e548-e554. doi:10.1016/S2214-109X(18)30078-0.
28. Shand AW, Bell JC, McElduff A, et al. Outcomes of pregnancies in women with pre-gestational diabetes mellitus and gestational diabetes mellitus; a population-based study in New South Wales, Australia, 1998-2002. DiabetMed. 2008;25(6):708-15. doi:10.1111/j.1464-5491.2008.02431.x.
29. Vorobyova NM, Tkacheva ON, Kotovskaya YuV, et al. on behalf of the EUCALYPTUS researchers. Russian epidemiological study of EUCALYPTUS: protocol and basic characteristics of participants. Russian Journal of Geriatric Medicine. 2021;1(5):35- 43. (In Russ.) doi:10.37586/2686-8636-1-2021-35-43.
30. Khovasova NO, Vorobyova NM, Tkacheva ON, et al. The prevalence of anemia and its associations with other geriatric syndromes in people over 65 years of age: data from the Russian epidemiological study EUCALYPTUS. Therapeutic Archive. 2022;94(1):24-31. (In Russ.) doi:10.26442/00403660.2022.01.201316.
31. Zeidan RS, Martenson M, Tamargo JA, et al. Iron homeostasis in older adults: balancing nutritional requirements and health risks. J Nutr Health Aging. 2024;28(5):100212. doi:10.1016/j.jnha.2024.100212.
32. Filmann N, Rey J, Schneeweiss S, et al. Prevalence of anemia in inflammatory bowel diseases in european countries: a systematic review and individual patient data meta-analysis. Inflamm Bowel Dis. 2014;20(5):936-45. doi:10.1097/01.MIB.0000442728.74340.fd.
33. Parfenov AI, Bykova SV, Sabel'nikova EA, et al. All-Russian Consensus on Diagnosis and Treatment of Celiac Disease in Children and Adults. Therapeutic Archive. 2017; 89(3):94107. (In Russ.) doi:10.17116/terarkh201789394-107.
34. Ivenskaya TA, Klimov LYa, Kuryaninova VA, et al. Characteristics of iron deficiency conditions in children with celiac disease. Medical Bulletin of the North Caucasus. 2023; 18(2):135-9. (In Russ.) doi:10.14300/mnnc.2023.18029.
35. Zamani F, Mohamadnejad M, Shakeri R, et al. Gluten sensitive enteropathy in patients with iron deficiency anemia of unknown origin. World J Gastroenterol. 2008;14:7381-5. doi:10.3748/wjg.14.7381.
36. Orgler E, Dabsch S, Malfertheiner P, et al. Autoimmune Gastritis: Update and New Perspectives in Therapeutic Management. Curr Treat Options Gastro. 2023;21:64- 77. doi:10.1007/s11938-023-00406-4.
37. Betesh AL, Santa Ana CA, Cole JA, Fordtran JS. Is achlorhydria a cause of iron deficiency anemia? Am J Clin Nutr. 2015;102(1):9-19. doi:10.3945/ajcn.114.097394.
38. Malfertheiner P, Megraud F, Rokkas T, et al. Management of Helicobacter pylori infection: The Maastricht VI/Florence consensus report. Gut. 2022;71:1724-62.
39. Cardenas VM, Mulla ZD, Ortiz M, Graham DY. Iron deficiency and Helicobacter pylori infection in the United States. Am J Epidemiol. 2006;163:127-34. doi:10.1093/aje/kwj018.
40. Turck D, Bohn T, Castenmiller J, et al. Scientific opinion on the tolerable upper intake level for iron. EFSA J. 2024;22(6):e8819. doi:10.2903/j.efsa.2024.8819.
41. Abbas AM, Abdelbadee SA, Alanwar A, Mostafa S. Efficacy of ferrous bisglycinate versus ferrous glycine sulfate in the treatment of iron deficiency anemia with pregnancy: a randomized double-blind clinical trial. J Matern Fetal Neonatal Med. 2019;32(24):4139-45. doi:10.1080/14767058.2018.1482871.
42. Bries AE, Wang C, Agbemafle I, et al. Assessment of Acute Serum Iron, NonTransferrin-Bound Iron, and Gastrointestinal Symptoms with 3-Week Consumption of Iron-Enriched Aspergillus oryzae Compared with Ferrous Sulfate. Curr Dev Nutr. 2019;3(12):nzz127. doi:10.1093/cdn/nzz127.
43. Friling M, García-Muñoz AM, Perrinjaquet-Moccetti T, et al. Tolerability of Oral Supplementation with Microencapsulated Ferric Saccharate Compared to Ferrous Sulphate in Healthy Premenopausal Woman: A Crossover, Randomized, DoubleBlind Clinical Trial. Int J Mol Sci. 2022;23(20):12282. doi:10.3390/ijms232012282.
44. Frykman E, Bystrom M, Jansson U, et al. Side effects of iron supplements in blood donors: superior tolerance of heme iron. J Lab Clin Med. 1994;123(4):561-4.
45. Tiekou Lorinczova H, Begum G, Temouri L, et al. Co-Administration of Iron and Bioavailable Curcumin Reduces Levels of Systemic Markers of Inflammation and Oxidative Stress in a Placebo-Controlled Randomised Study. Nutrients. 2022;14(3):712. doi:10.3390/nu14030712.
46. Yu X, Chen L, Ding H, et al. Iron Transport from Ferrous Bisglycinate and Ferrous Sulfate in DMT1-Knockout Human Intestinal Caco-2 Cells. Nutrients. 2019;11(3):485. doi:10.3390/nu11030485.
47. Bumrungpert A, Pavadhgul P, Piromsawasdi T, Mozafari MR. Efficacy and Safety of Ferrous Bisglycinate and Folinic Acid in the Control of Iron Deficiency in Pregnant Women: A Randomized, Controlled Trial. Nutrients. 2022;14(3):452. doi:10.3390/nu14030452.
48. Milman N, Jønsson L, Dyre P, et al. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. J Perinat Med. 2014;42(2):197-206. doi:10.1515/jpm-2013-0153.
49. Szarfarc SC, de Cassana LM, Fujimori E, et al. Relative effectiveness of iron bisglycinate chelate (Ferrochel) and ferrous sulfate in the control of iron deficiency in pregnant women. ArchLatinoamNutr. 2001;51(1 Suppl1):42-7.
50. Ferrari P, Nicolini A, Manca ML, et al. Treatment of mild non-chemotherapyinduced iron deficiency anemia in cancer patients: comparison between oral ferrous bisglycinate chelate and ferrous sulfate. Biomed PharmacotherBiomedecinePharmacother. 2012;66(6):414-8. doi:10.1016/j.biopha.2012.06.003.
51. Fischer JAJ, Cherian AM, Bone JN, Karakochuk CD. The effects of oral ferrous bisglycinate supplementation on hemoglobin and ferritin concentrations in adults and children: a systematic review and meta-analysis of randomized controlled trials. Nutr Rev. 2023;81(8):904-20. doi:10.1093/nutrit/nuac106.
52. Bakirov BA, Nagaev IR, Donskov SV. Nutritional correction of iron metabolism status in women of reproductive age: results of an open prospective post-marketing study with active control in parallel groups. Cardiosomatics. 2025;16(1):62-75. (In Russ.) doi:10.17816/CS677071.
53. Drapkina OM, Avalueva EB, Bakulin IG, et al. Management of patients with iron deficiency anemia at the stage of primary health care. Practical guide. M.: ROPNIZ, LLC "Silicea-Polygraph", 2022, 88 p. (In Russ.) doi:10.15829/ROPNIZ-zda-2022. EDN: TKORUS.
Supplementary files
Review
For citations:
Drapkina OM, Tkacheva ON, Shikh EV, Drozdova LY, Baranov II, Bakulin IG, Bakirov BA, Ponomarev RV, Starodubova AV, Fedorova TA, Khovasova NO. Prevention of Iron Deficiency and Iron Deficiency Anemia in Various Patient Categories in the Russian Federation. Expert Council Resolution. Primary Health Care (Russian Federation). 2025;2(3):21-34. (In Russ.) https://doi.org/10.15829/3034-4123-2025-74. EDN: WZJVAX