Spirulina Increases Serum Iron and Improves Anemia Parameters in Ulcerative Colitis Subjects

by | Nov 21, 2023 | 2023, Digestive Health, Iron, Minerals, Spirulina

Written by Taylor Woosley, Staff Writer. 8-week twice daily supplementation of 500 mg spirulina powder significantly improved serum iron levels (p = 0.04), while preventing worsening of red blood cells and mean corpuscular volume in participants with ulcerative colitis. 

spirulinaUlcerative colitis (UC), a subtype of inflammatory bowel disease, is a chronic, idiopathic inflammatory disease affecting the colon that is characterized by relapsing and remitting mucosal inflammation1. The cause of the UC immune response remains largely unknown, but dietary and environmental risk factors have a role, as well as host factors such as genetic susceptibility and gut microbiota2. UC has been associated with numerous symptoms and complications, with the most common being iron deficiency anemia caused by inadequate intake, malabsorption, and chronic blood loss by mucosal ulcerations3.

Spirulina is a blue-green algae microalga and a popular dietary supplement due to its rich nutritional value and functional pharmacological active components, such as soluble dietary fiber, polyunsaturated fatty acids, proteins, vitamins, polysaccharides, and essential amino acids4. Its active ingredient C-phycocyanin has beneficial immunomodulatory functions and is a prebiotic source5. Previous research shows that oral administration of spirulina has shown antioxidative and anti-inflammatory effects, along with regulation of intestinal microbiota, which would be beneficial in the prevention and treatment of intestinal diseases6.

Moradi et al. conducted a randomized, double-blind, placebo-controlled trial to analyze the efficacy of spirulina powder administration on serum iron and ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with UC. Subject inclusion consisted of having a clinical diagnosis of UC, aged 18-65 years, experiencing active mild-to-moderate UC disease symptoms. 80 subjects (age: 38.64 ± 11.30 years and BMI: 25.81 ± 4.96 kg/m2) were randomly assigned to either the spirulina administration group (n = 40) or the placebo (n = 40) for 8 weeks. The spirulina group consumed a 500 mg spirula capsule twice daily, one at lunch and dinner, while the placebo group consumed two capsules of corn starch. Supplementation compliance was monitored via weekly phone calls. Participants were informed to maintain their usual dietary intake, medication regimen, and physical activity.

Fasting blood samples were collected, along with stool samples used to analyze FOBT pre- and post- intervention using the FOBT Cassette. Secondary study outcomes included cell blood count and other anemia parameters including hemoglobin, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) measured by a hematology analyzer. An independent t-test or Mann-Whitney U test for quantitative and Chi-square for qualitative variables were utilized to compare subjects’ demographic characteristics and micro- and macro-nutrient intakes between groups. Multiple linear regression was utilized to investigate post-intervention differences between the spirulina and placebo group.

73 subjects (n = 36 in the spirulina group, n = 37 in placebo) completed the 8-week intervention. No significant differences were noted between groups regarding baseline characteristics. Furthermore, dietary intake (p > 0.05) and physical activity (p = 0.36) were not significantly different between the two groups. Significant findings of the study are as follows:

  • 8-week supplementation with spirulina significantly increased serum iron (p = 0.04) compared to placebo after correcting for multiple comparisons.
  • A significant increase in MCV (p = 0.004) and a significant reduction in red blood cell count (RBC) (p = 0.01) and hematocrit (p = 0.03) were noted in the control group compared to the intervention group.

Results of the intervention show that twice daily 500 mg spirulina powder improved serum iron and aided in prevention of worsening RBC and MCV levels compared to placebo. Further human clinical research is necessary to comprehend the use of spirulina for irritable bowel-related diseases. Study limitations include the short study duration, small sample size, and the lack of evaluating the dose-response effect of spirulina administration.

Source: Moradi, Sajjad, Sahar Foshati, Fariborz Poorbaferani, Sepide Talebi, Reza Bagheri, Parsa Amirian, Fatemeh Parvizi, Michael Nordvall, Alexei Wong, and Mehdi Zobeiri. “The effects of spirulina supplementation on serum iron and ferritin, anemia parameters, and fecal occult blood in adults with ulcerative colitis: A randomized, double-blinded, placebo-controlled trial.” Clinical Nutrition ESPEN 57 (2023): 755-763.

© 2023 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism.

Click here to read the full text study.

Posted November 21, 2023.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Keshteli AH, Madsen KL, Dieleman LA. Diet in the Pathogenesis and Management of Ulcerative Colitis; A Review of Randomized Controlled Dietary Interventions. Nutrients. Jun 30 2019;11(7)doi:10.3390/nu11071498
  2. Burri E, Maillard MH, Schoepfer AM, et al. Treatment Algorithm for Mild and Moderate-to-Severe Ulcerative Colitis: An Update. Digestion. 2020;101 Suppl 1:2-15. doi:10.1159/000504092
  3. Mahadea D, Adamczewska E, Ratajczak AE, et al. Iron Deficiency Anemia in Inflammatory Bowel Diseases-A Narrative Review. Nutrients. Nov 10 2021;13(11)doi:10.3390/nu13114008
  4. Wang J, Su L, Zhang L, et al. Spirulina platensis aqueous extracts ameliorate colonic mucosal damage and modulate gut microbiota disorder in mice with ulcerative colitis by inhibiting inflammation and oxidative stress. J Zhejiang Univ Sci B. Jun 15 2022;23(6):481-501. doi:10.1631/jzus.B2100988
  5. Yu T, Wang Y, Chen X, Xiong W, Tang Y, Lin L. Spirulina platensis alleviates chronic inflammation with modulation of gut microbiota and intestinal permeability in rats fed a high-fat diet. J Cell Mol Med. Aug 2020;24(15):8603-8613. doi:10.1111/jcmm.15489
  6. Zhang D, Zhong D, Ouyang J, et al. Microalgae-based oral microcarriers for gut microbiota homeostasis and intestinal protection in cancer radiotherapy. Nat Commun. Mar 17 2022;13(1):1413. doi:10.1038/s41467-022-28744-4