Synergism of iron, vitamin C, and probiotic components in maintaining intestinal microflora and immunity

Mubarakshina O.A., Somova M.N., Batishcheva G.A., Dronova Yu.M., Zhdanova O.A., Stepkin D.I., Shcherbova Z.R.

1) Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; 2) Voronezh City Polyclinic No. 10, Voronezh, Russia

This review examines the relationship between iron, vitamin C, intestinal microflora, and the immune system, as well as the rationale for including iron and vitamin C in probiotic complexes. Iron is a key micronutrient involved in respiratory processes, hemoglobin and DNA synthesis, cell cycle regulation, and immune cell function. Iron deficiency is prevalent worldwide and can disrupt both systemic processes and intestinal microbial balance, reducing microbiota diversity and short-chain fatty acid production. Antibiotics used to treat infectious diseases further exacerbate dysbiotic changes by affecting intestinal barrier function and reducing the synthesis of metabolites important for immunity and micronutrient absorption.
Probiotic strains can improve non-heme iron absorption by lowering intestinal pH, stimulating prebiotic fermentation, and influencing the function of transport proteins. Prebiotics such as inulin and galactooligosaccharides also increase mineral bioavailability and support the growth of beneficial microflora. Vitamin C acts as a cofactor, enhancing iron absorption and providing antioxidant protection, while B vitamins influence metabolism and are essential for dysbiotic changes in the microbiota. The combination of iron, vitamin C, and B vitamins with pro- and prebiotic components is characterized by a synergistic effect: it improves the absorption of micronutrients, supports the restoration of microbiota, strengthens barrier mechanisms, and promotes increased immune reactivity. The summarized data emphasize the relevance and effectiveness of this approach for the prevention and correction of deficiency conditions and microbial imbalances.

For citations: Mubarakshina O.A., Somova M.N., Batishcheva G.A., Dronova Yu.M., Zhdanova O.A., Stepkin D.I., Shcherbova Z.R. Synergism of iron, vitamin C, and probiotic components in maintaining intestinal microflora and immunity. Pharmateca. 2025;32(9):8-14. (In Russ.). DOI: https://dx.doi.org/10.18565/pharmateca.2025.9.8-14

Authors’ contribution: Article concept and design – O.A. Mubarakshina, M.N. Somov. Data collection and processing – O.A. Zhdanova, Yu.M. Dronova, D.I. Stepkin, Z.R. Shcherbova. Text writing – O.A. Mubarakshina, M.N. Somov. Scientific editing – G.A. Batishcheva, Yu.M. Dronova, O.A. Zhdanova.
Conflicts of interest: The authors confirm that they have no conflicts of interest to declare.
Funding: The study was conducted without any sponsorship.

Keywords

About the Authors

Olga A. Mubarakshina, Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; mubarakshina@mail.ru, ORCID: https://orcid.org/0000-0001-6799-6322 (corresponding author)
Marina N. Somova, Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; ORCID: 0000-0002-6511-4098
Galina A. Batishcheva, Dr. Sci. (Med.), Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; bat13@mail.ru, ORCID: https://orcid.org/0000-0003-4771-7466
Yulia M. Dronova, Cand. Sci. (Med.), Associate Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; y.dronova@yandex.ru, ORCID: https://orcid.org/0000-0003-4513-091X
Olga A. Zhdanova, Dr. Sci. (Med.), Associate Professor, Professor, Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; olga.vr9@yandex.ru, ORCID: https://orcid.org/0000-0002-3917-0395
Daniil I. Stepkin, Student, Voronezh State Medical University named after N.N. Burdenko, Voronezh, Russia; danya.stepkin.00@bk.ru, ORCID: https://orcid.org/0000-0002-2187-7093
Zalina R. Shcherbova, Cand. Sci. (Med.), Gastroenterologist, Voronezh City Polyclinic No. 10, Voronezh, Russia; fallen777angel@mail.ru

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