Liposomal vs Conventional Oral Iron After Sleeve Gastrectomy

Comprehensive Hematological and Biochemical Comparison of Low-Dose Liposomal Iron Versus Standard-Dose Conventional Oral Iron in Iron Deficiency Anemia Following Sleeve Gastrectomy: A Prospective, Randomized Clinical Trial

Low-dose liposomal iron (17-34 mg elemental/day) was compared with standard conventional oral iron (100-200mg elemental/day) in the treatment of iron deficiency anemia following sleeve gastrectomy. Liposomal iron provided superior hematological improvement and gastrointestinal tolerance.

Inclusion Criteria

• Age between 18 and 65 years
• History of laparoscopic sleeve gastrectomy performed at least 6 months prior to enrollment
• Diagnosis of iron deficiency anemia, defined as:
• Hemoglobin <12 g/dL in women or <13 g/dL in men, and
• Serum ferritin <30 ng/mL or transferrin saturation (TSAT) <20%
• Mild to moderate anemia (hemoglobin ≥9 g/dL)
• Ability to take and swallow oral medications
• Willingness to participate and provide written informed consent Exclusion Criteria
• Active gastrointestinal disease (e.g., inflammatory bowel disease, peptic ulcer disease, or gastrointestinal bleeding)
• Chronic kidney disease with estimated GFR <30 mL/min/1.73 m²
• Use of oral or parenteral iron, vitamin B12, or folate supplementation within the previous 3 months
• Iron overload or hemochromatosis (serum ferritin >300 ng/mL)
• Known allergy or intolerance to iron preparations
• Active malignancy
• Pregnancy or breastfeeding
• Known hemoglobinopathies (e.g., thalassemia, sickle cell disease)
• Blood transfusion within the previous 1 month
• Cognitive or psychiatric disorder interfering with study participation or protocol adherence