Role of Oral Vitamin C Supplementation with Iron-Folic Acid in Treating Anemia among School-Going Adolescent Girls: A Non-Randomized Interventional Study from Central India

Background: Anemia affects 59.1% of Indian adolescent girls aged 15–19 years. Vitamin C may enhance non-heme iron absorption when added to iron-folic acid (IFA) supplementation. Objective: To evaluate whether adding oral Vitamin C to IFA supplementation improves hemoglobin levels in school-going adolescent girls with mild-to-moderate anemia. Methods: A non-randomized quasi-experimental study enrolled 211 adolescent girls (10-19 years) across four schools in central India. Two schools received IFA plus 500 mg Vitamin C daily (n=106); two received IFA alone (n=105) for 90 days. Results: Mean hemoglobin increased by 1.10 ± 0.62 g/dl in the intervention group versus 0.64 ± 0.58 g/dl in controls (adjusted mean difference: 0.45 g/dl; 95% CI: 0.29-0.61; p<0.001). Normal hemoglobin was achieved in 38.68% versus 19.05% of participants, respectively. Side effects were comparable between groups. Conclusions: Adding Vitamin C to IFA supplementation significantly improves hemoglobin levels in adolescent girls. Integration into national anemia programs warrants consideration, pending randomized controlled trial confirmation. Trial Registration: CTRI/2023/08/056557