Antioxidant Therapeutics as a Dual Strategy Against Anaemia and Oxidative Stress in Metabolic Disorders
Anaemia and oxidative stress are frequently comorbid in metabolic disorders such as type 2 diabetes mellitus, obesity, metabolic syndrome, and chronic kidney disease. The two processes are bi-directionally linked: oxidative stress perturbs iron handling, erythropoiesis, and red blood cell (RBC) lifespan, while anaemia exacerbates tissue hypoxia and generates further reactive oxygen and nitrogen species (ROS/RNS). This interplay contributes to inflammation, organ dysfunction, reduced exercise capacity, and worsened clinical outcomes. Antioxidant therapeutics-ranging from endogenous pathway activators and mitochondria-targeted compounds to nutraceuticals and adjunctive agents used with iron or erythropoiesis-stimulating therapies-offer a promising dual strategy to simultaneously mitigate oxidative damage and improve hematologic status. This review synthesizes current mechanistic understanding of the anaemia-oxidative stress axis in metabolic disease, evaluates classes of antioxidant interventions with preclinical and clinical evidence, discusses biomarker-guided use and safety considerations, and outlines research priorities to translate antioxidant strategies into improved patient outcomes.