Supplementation with which of the following nutrients is routinely restricted during the early stages of hematopoietic stem cell transplantation (HSCT)?

• A. Sodium
• B. Iron
• C. Folate
• D. Vitamin B12

Answer: (B)

Iron supplementation is restricted in the early stages of hematopoietic stem cell transplantation because the transfusions given during this period can lead to iron overload, and the body has limited ability to excrete excess iron. Excess iron not only harms organs like the liver and heart but also fuels the growth of microbes, including opportunistic fungi, in a highly immunocompromised host. By withholding iron, clinicians aim to reduce iron overload and the associated infection and oxidative risks during the neutropenic, transplant-critical phase. Sodium, folate, and vitamin B12 are not routinely restricted; their management depends on fluid balance and individual nutritional needs, and they are not universally withheld like iron is during this stage.