Clinical Research

Clinical research shows the Lucky Iron Fish is effective at improving iron status in different groups of people across the world. 
Numerous studies have been conducted over the years in different parts of the world. These studies have been carried out by both the company and independent third-party researchers.

Overview of clinical findings

The Lucky Iron Fish and the Lucky Iron Leaf are simple health innovations designed to help treat and prevent iron deficiency and iron deficiency anemia.

The efficacy of the Fish/Leaf has been tested in numerous randomized control trials, clinical trials, and laboratory/hospital trials. The original work was carried out by graduate students who formed Lucky Iron Fish Enterprise but since that time, the trials have been carried out by independent research teams from different universities and NGOs from different countries around the world and the majority are randomized, controlled trials.

Studies have been carried out on infants (aged 1-5 years); school-aged children (aged 5-7 years); women of reproductive age (aged 18-55 years); and HIV-positive patients [men and women] (aged 15-35 years).

Regular use of the Fish or Leaf results in an improvement in iron status compared to controls. Hemoglobin is a protein in your red blood cells that carries oxygen to your body's organs and tissues and transports carbon dioxide from your organs and tissues back to your lungs. If a hemoglobin test reveals that your hemoglobin level is lower than normal, it means you have a low red blood cell count and may be iron deficient or anemic. The biomarker for iron levels in the body is the hemoglobin content in your blood. The improvement in iron status results in a decrease in iron deficiency and iron deficiency anemia. Adults also report fewer headaches, have more energy, fewer periods of dizziness and fainting; improved hair and nail quality and less yellow skin. Children perform better in cognitive tests and their parents and teachers report that they are more attentive and have the ability to concentrate on tasks for longer.

There are no negative side-effects reported when using the Fish or Leaf and they are compatible with antiretroviral or parasite treatments.

Because the level of iron released from Fish/Leaf is similar to the levels seen in fortification of food staples like flour or rice, the product is safe to use alone or in combination with other iron-enriching products.

It is important to remember that the Fish/Leaf is only helpful if it is used according to the manufacturer’s instructions.

The Fish or Leaf only reduces anemia if users are suffering from iron deficiency and iron deficiency anemia. This is why one trial in Cambodia did not work because it transpired that the vast majority of the participants were not suffering from iron deficiency anemia, but anemia caused by a genetic condition. 


Research Report Summary, 2019

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Impact of a Collaborative Childhood Anemia Intervention Program in Peru
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Dietary Factors Modulate Iron Uptake in Caco-2 Cells from an Iron Ingot Used as a Home Fortificant to Prevent Iron Deficiency.

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Commercializing the Lucky Iron Fish™ Using Social Enterprise: A Novel Health Innovation for Iron Deficiency and Anemia in Cambodia and Beyond.
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Iron release from the Lucky Iron Fish™: safety considerations.

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A Randomized Control Trial Using a Fish-Shaped Iron Ingot for the Amelioration of Iron Deficiency Anemia in Rural Cambodian Women.

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Happy Fish: A Novel Supplementation Technique to Prevent Iron Deficiency Anemia in Women in Rural Cambodia.

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The Etiology, Treatment and Effective Prevention of Iron Deficiency and Iron Deficiency Anemia in Women and Young Children Worldwide: A Review.
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Randomized controlled trial assessing the efficacy of a reusable fish-shaped iron ingot to increase hemoglobin concentration in anemic, rural Cambodian women.
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Iron content of Cambodian foods when prepared in cooking pots containing an iron ingot.

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Testing the efficacy of the Lucky Iron Fish® in reversing iron deficiency anemia in rural, impoverished regions of Guatemala.

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Recently, a commentary was published suggesting that there may be potentially harmful contaminants in the Lucky Iron Fish/ Leaf.

Lucky Iron Fish Enterprise maintains that its products are safe. We are concerned about the safety and the impact of our products, so to be transparent about safety, the company has decided to publish the safety protocols and specific tests done in addition to the normal procedure to make sure that the Fish and Leaf are safe to use.
The Food Chemical Codex is a compendium of internationally recognized standards for determining the purity and the quality of food ingredients. There are many chemicals present in minute quantities in food. Normally, these are considered safe but, in sufficient concentrations, some of these may be harmful. The Codex provides a set of standards to make sure food and food additives are safe for human consumption.

Work has been published on the safety of the Lucky Iron Fish. In addition, over the past several years, three independent, commercial laboratories have confirmed that the Fish/Leaf are safe. However, to be certain that every batch of Fish or Leaf  produced meets the Codex standards, a protocol for safety assurance is in place.  


The safety protocol for each batch of Fish or Leaf involves three tests: (1) the manufacturer tests the raw material used to produce the Fish/Leaf; (2) once molded into shape, the Fish/Leaf are tested again by the manufacturer to confirm that no contaminants have been added to the ingots during production; and (3) finally, the Fish/Leaf are tested again once they have been shipped and ready for distribution. This last test is important because they are carried out by independent, commercial testing laboratories accredited to perform such tests. For the final stage, a statistically recognized sampling process is used known as a ‘lot sampling method’. Effectively a sample of product is selected at random from each batch. Water is prepared with each Fish/Leaf and the presence of twenty elements are tested using inductively coupled plasma optical emission spectroscopy (ICP-OES). This is a sensitive probe that determines the levels of particular elements in the water.

Each test is repeated three times and each sample of water is tested three times i.e., nine data points are collected for each Fish/Leaf and for each element.

The inductively-coupled plasma optical emission spectroscopy measures the following elements: 

  • Aluminum
  • Antimony
  • Arsenic
  • Boron
  • Barium
  • Bismuth
  • Cadmium
  • Calcium
  • Chromium
  • Copper
  • Lead
  • Lithium
  • Magnesium
  • Manganese
  • Mercury
  • Molybdenum
  • Nickel
  • Phosphorus
  • Selenium
  • Silver
  • Strontium
  • Sulphur
  • Thallium
  • Tin
  • Titanium
  • Vanadium
  • Zinc


Following the publication of the commentary suggesting that the Fish may contain contaminants and notwithstanding the comments above, the company sent an additional randomly chosen set of eight Fish for testing at an independent, commercial laboratory. The data were analyzed as described above. For each trial the Fish was boiled in 1 litre of water with 2-3 drops of commercially available lemon juice (final pH 4.5) for 10 minutes.

With the exception of Iron (Fe) all remaining 19 elements showed levels that were below the standard set in the Food Chemical Codex. 

For any further information, please feel free to reach out to us via


USAID The Future of Food Assistance for Nutrition: Evidence Summit II, OCTOBER 2020


To note:

Lucky Iron Fish is only effective when used regularly (at least 3 times a week) and the outlined instructions are followed. 

It takes 3-6 months to see a clinical increase in iron status.

Used properly, the Fish does not cause side-effects because it is gentle on your digestive system. Clinical tests have also shown that the Lucky Iron Fish only alleviates iron deficiency and iron deficiency anemia; it does not improve anemia caused by other conditions (e.g. Thalassemia).

All the batches of Fish are tested to ensure that the iron released from the Fish is consistent and safe and that no other compounds are released that might be deleterious to health. The Lucky Iron Fish is approved for sale in countries around the world.

This product is not intended to diagnose, treat, cure or prevent any disease. Carefully read all product documentation, and ask your healthcare provider if this product is right for you.
If you suspect that you have a medical problem, promptly contact your regular health care provider. Iron taken in excess can be harmful to both adults and children.


To get the most out of your Lucky Iron Fish, please visit our Use & Care page.

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