Background: Metabolic syndrome is a collection of dyslipidemia, central obesity, hypertension, and diabetes. Pathogenesis is influenced by psychological and oxidative stress. RBCs can also be damaged by oxidative stress. [Crenated cells with Heinz bodies]. 
The Aim of The Work: To analyze the red blood cell morphological changes as oxidative stress markers and to investigate the efficacy of vitamins C and E as supplements to standard metabolic syndrome treatment.
Patients and Methods: For eight weeks, 60 patients with diabetes, hypertension, and dyslipidemia who had been on medication for 1-2 years were randomly assigned to one of two groups: standard treatment alone or vitamin C capsule 500mg once daily [OD] and vitamin E 400 mg OD in addition to standard treatment. Standard treatment includes Enalapril 5 mg twice daily [BD] and/or tablet Amlodipine 5 mg OD, Metformin 500 mg BD, and Atorvastatin 10 mg at bedtime [HS]. Both groups were monitored for four weeks after treatment. At 0, 4, and 8 weeks, parameters such as red blood cell [RBC] morphological changes, fasting blood sugar, blood pressure, and lipid profile were examined.
Results: Both groups had similar baseline characteristics. When compared to the control group, the study group had a significant reduction in fasting blood sugar [p = 0.023], an increase in high density lipoprotein [HDL] [p = 0.03], low density lipoprotein [LDL] [p = 0.001], systolic blood pressure [p = 0.024], diastolic blood pressure [p = 0.005], percentage of crenated RBCs with Heinz bodies [p<0.001], and total cholesterol [p<0.001].
Conclusion: Vitamin C and E as add-on therapy to the standard treatment is effective in reducing insulin resistance, blood pressure, and improving the lipid profile.