Effect of Saccharomyces boulardii probiotic supplementation on ferritin levels in children with iron deficiency

Abstract

Background and objectives. The mainstay therapy for iron deficiency is oral iron supplementation, which is often associated with various side effects. One emerging alternative is the use of probiotics. Saccharomyces boulardii (S. boulardii) has been shown to increase serum iron levels and total iron-binding capacity in experimental animals, but its effectiveness has not been demonstrated in children with iron deficiency anemia. This study aimed to determine the efficacy of S. boulardii probiotic supplementation on ferritin levels in children with iron deficiency. Materials and methods. This study was a double-blind, randomized controlled trial (RCT) comparing placebo with S. boulardii, conducted between January and February 2025 at the research laboratory of Hasanuddin University Hospital, Makassar, Indonesia. The sampling for the previous preliminary study was carried out by the research team at the Child Welfare Institution in Makassar between June and December 2024. Results. A total of 41 children in the treatment group and 40 children in the control group completed the study. Both groups experienced significant increases in ferritin levels (p = 0.001). Between-group comparison did not show a significant difference in post-treatment ferritin levels (p = 0.164) or in the magnitude of change before and after treatment (p = 0.148), although the treatment group had higher post-treatment ferritin values (51.52 ± 40.07 vs. 39.82 ± 29.88), as well as a greater increase in ferritin (34.81 ± 38.92 vs. 23.01 ± 28.02). Although ferritin levels after treatment were higher in the probiotic group than in the placebo group, the difference was not statistically significant (p > 0.05). Conclusions. Supplementation with S. boulardii, when used as an adjuvant to standard iron therapy, did not provide a statistically significant additional benefit in increasing ferritin levels compared with placebo in children with iron deficiency.

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