Grewia tenax fruits as a traditional remedy for iron deficiency anemia: A comparative clinical study with ferrous salt

Abstract

Background: Iron deficiency anemia (IDA) remains a significant global public health concern, particularly among vulnerable populations such as children and menstruating women. Although standard oral iron supplements are effective in replenishing iron stores, their use is often limited by gastrointestinal side effects that negatively impact adherence. Grewia tenax fruits, a traditional Sudanese remedy, are widely used for managing IDA; however, their clinical efficacy has not been rigorously evaluated. Method: This open-label study compared G. tenax chewable tablets with ferrous gluconate in 34 adult females (18-50 years) with confirmed IDA (hemoglobin <12 g/dL). Participants received either G. tenax (five tablets twice daily) or ferrous gluconate (one tablet twice daily) for a period of 4 weeks. Hematological parameters were monitored weekly, and iron profile markers were assessed at baseline and at week 4. Results: Ferrous gluconate produced significantly greater increases in hemoglobin and serum iron levels. Although G. tenax showed more modest hemoglobin improvements, it yielded higher post-treatment ferritin levels (7.82 vs. 7.43 μg/L) and greater reductions in total iron-binding capacity, suggesting enhanced iron storage and regulation. A transient rise in reticulocyte counts observed in the G. tenax group indicates early erythropoietic stimulation. Variability in individual response to G. tenax may be attributed to differences in absorption or metabolism, underscoring the need for personalized approaches. Conclusion: These findings challenge the usual iron dose, highlighting the unique pharmacological effects of G. tenax. Further research is warranted to explore its mechanisms, long-term benefits, and role as a culturally acceptable adjunct or alternative in the management of IDA. Relevance for patients: The study population reflects women who are disproportionately affected by IDA in Sudan, making the findings highly relevant to communities that traditionally rely on G. tenax as a culturally rooted remedy.

Keywords

Iron deficiency anemia / Grewia tenax / Iron bioavailability / Iron supplementation / Traditional practice in Sudan

Funding

None.

Conflict of interest

The authors declare that they have no competing interests.

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