Evaluating the effect of chicory on serum ferritin levels in transfusion-dependent Β-thalassemia patients: a randomized clinical trial

Ann Med Surg (Lond). 2025 Jul 14;87(9):5535-5541. doi: 10.1097/MS9.0000000000003565. eCollection 2025 Sep.

Abstract

Introduction: Several approved iron chelators exist, but they may cause significant adverse reactions in some patients. It is essential to explore complementary treatments that enhance compliance and minimize side effects.

Objectives: This study aims to evaluate the efficacy of chicory in reducing serum ferritin levels in transfusion-dependent β-thalassemia patients.

Methods: A randomized, double-blind, placebo-controlled trial was conducted at Ali-Asghar Children's Hospital in Tehran, Iran. Participants included individuals with transfusion-dependent β-thalassemia and serum ferritin levels exceeding 1000 nanograms per milliliter (ng/mL). A total of 110 patients were randomly assigned to receive either chicory syrup or a placebo for 8 weeks. Primary and secondary outcomes were compared between the intervention and control groups.

Results: All 110 enrolled patients had their ferritin levels measured at baseline and 2 months after initiating either chicory extract or placebo. Mean ferritin levels decreased in both the treatment group (918.28 ± 151.42 ng/ml) and the placebo group (799.145 ± 145.07 ng/ml), with a statistically significant difference (P = 0.04). Additionally, alanine transaminase (ALT) levels showed a significant decline in the treatment group (8.12 ± 13.49 U/L) compared to the placebo group (2.8 ± 6.65 U/L) (P = 0.019).

Conclusion: Our findings suggest that chicory extract may effectively reduce ferritin levels in patients with β-thalassemia. However, further research with larger sample sizes is warranted to validate these results and strengthen the evidence for the therapeutic potential of chicory.

Keywords: alanine transaminase; chicory; ferritin; β-thalassemia.