A friendly warning to frequent blood donors: the blood test at the donation center

[pnwmom]

may not reveal iron depletion, and you could be very low on iron stores without knowing it. You need to keep track of your ferritin levels for that. (Not just your hemoglobin and hematocrit.)

My son has been donating every two months, motivated by altruism as all frequent donors are. I'm betting there are lots of you among Duers. He is also a vegetarian, and there are plenty of them around here, too. He's been having some serious symptoms that made me wonder about anemia, but he was convinced that he couldn't be low on iron because the blood center kept pricking his finger and telling him he was fine.

It turns out that those pricks don't measure ferritin levels, and ferritin levels are what show your iron stores. The prick only measures the iron currently in your blood stream -- but you might be only one donation away from complete depletion -- as the young man in this account was.

I'm not saying not to donate -- but to protect your own health by making sure your iron stores are at a healthy level. This might mean donating less frequently or taking iron supplements. And it means checking your ferritin levels, not just your hemoglobin and hematocrit (as the blood centers do.) Ask your doctor!

(And if you are NOT a donor, you still should get your blood checked, especially if you're a male. Adult men often have too much in iron stores and could benefit from being a blood donor. Watch your ferritin levels to make sure they're not getting too high. Ask your doctor!)

http://chrishibbard.hubpages.com/hub/Donating-Blood-Caution

Let me begin by saying, giving blood--and helping strangers in general--is both noble and honorable. I would recommend you donate blood and support your local blood center,if your doctor says you are able to do so. I have found you cannot trust a blood center to treat your health as important as the number of pints they collect.

snip



http://bloodjournal.hematologylibrary.org/content/50/3/441

Serum ferritin was measured in 2982 blood donors. First-time male donors had a geometric mean of 127 microgram/liter and female donors 46 microgram/liter. While values were essentially constant in the women between the ages of 18 and 45, there was a rapid increase in the men between 18 and 30 years of age consistent with the establishment of iron stores during that time. Blood donation was associated with a decrease in serum ferritin. One unit per year, equivalent to an increased requirement of 0.65 mg/day, halved the serum ferritin level in the male. More frequent donations were associated with further decreases. From the data obtained it would appear that male donors, while depleting their iron stores, were able to donate 2–3 U/yr without an appreciable incidence of iron deficiency. Women could donate only about half that amount, and more frequent donations were associated with a high incidence of iron deficiency and donor dropout. These data have provided information on the effect of graded amounts of iron loss through bleeding on iron balance.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096860/

Conclusion.
The results of this study show that an increase in the number of donations results in an increase in the frequency of depleted iron stores and subsequently in erythropoiesis with iron deficiency, although the level of haemoglobin remained acceptable for blood donation. This result may indicate the need to review the guidelines on acceptance of donors.
Introduction
Iron deficiency is the most common nutritional deficiency in both developing and developed countries. Regular blood donation may be an important cause of iron loss. Each 1.0 mL of blood contains approximately 0.5 mg of iron. A unit of donated blood therefore contains approximately 250 mg of iron and a single donation of one unit of blood can lead to the loss of 236 mg iron in men and 213 mg in women. Iron stores are approximately 30% lower in female donors than in male donors who give one unit of blood yearly. Iron deficiency has been observed in long-term blood donors1–3.
In the majority of blood banks, haemoglobin has generally been used as a screening test for the suitability to give blood. However, the use of this parameter has been reported to have poor sensitivity in the detection of early stages of iron deficiency2,4. Indeed, an accurate diagnosis of a state of iron deficiency requires several laboratory tests.

[hedgehog]

1. If you have kids, and you can take them along, you should.

I can't donate anymore due to health issues, but a couple of my kids are now regular donors. The best way to teach your kids altruistic behavior is to model it for them!

[brewens]

2. I'm have a hard time believing the FDA wouldn't be all over that one if it

was really a serious risk. They control the guidelines the blood centers use.

I've been in the business for seven years and have yet to hear of a donor experiencing that particular problem. I know a few hundred that donate every eight weeks. We see many, mostly women,that struggle meeting our hemoglobin level standard.

[pnwmom]

3. As I said, many adult men have too much ferritin and BENEFIT from frequent donations.

However, this is not the case with all men, particularly young men -- who haven't had so many years to develop their stores -- and vegetarians like my son.

There is plenty of research out there about how low ferritin levels can occur with blood donation. I don't know why the FDA isn't concerned about this.

For example:


http://bloodjournal.hematologylibrary.org/content/50/3/441

Serum ferritin was measured in 2982 blood donors. First-time male donors had a geometric mean of 127 microgram/liter and female donors 46 microgram/liter. While values were essentially constant in the women between the ages of 18 and 45, there was a rapid increase in the men between 18 and 30 years of age consistent with the establishment of iron stores during that time. Blood donation was associated with a decrease in serum ferritin. One unit per year, equivalent to an increased requirement of 0.65 mg/day, halved the serum ferritin level in the male. More frequent donations were associated with further decreases. From the data obtained it would appear that male donors, while depleting their iron stores, were able to donate 2–3 U/yr without an appreciable incidence of iron deficiency. Women could donate only about half that amount, and more frequent donations were associated with a high incidence of iron deficiency and donor dropout. These data have provided information on the effect of graded amounts of iron loss through bleeding on iron balance.


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096860/

Conclusion.
The results of this study show that an increase in the number of donations results in an increase in the frequency of depleted iron stores and subsequently in erythropoiesis with iron deficiency, although the level of haemoglobin remained acceptable for blood donation. This result may indicate the need to review the guidelines on acceptance of donors.
Introduction
Iron deficiency is the most common nutritional deficiency in both developing and developed countries. Regular blood donation may be an important cause of iron loss. Each 1.0 mL of blood contains approximately 0.5 mg of iron. A unit of donated blood therefore contains approximately 250 mg of iron and a single donation of one unit of blood can lead to the loss of 236 mg iron in men and 213 mg in women. Iron stores are approximately 30% lower in female donors than in male donors who give one unit of blood yearly. Iron deficiency has been observed in long-term blood donors1–3.
In the majority of blood banks, haemoglobin has generally been used as a screening test for the suitability to give blood. However, the use of this parameter has been reported to have poor sensitivity in the detection of early stages of iron deficiency2,4. Indeed, an accurate diagnosis of a state of iron deficiency requires several laboratory tests. Measurements of serum iron and serum ferritin concentrations and red cell indices such as mean cell volume (MCV) and mean corpuscular haemoglobin (MCH) can be used with a high degree of accuracy and prec

[randome]

4. Giving blood -or platelets- is also good for your health. It revs up your immune system.

I didn't know that about the ferritin levels but getting your iron levels checked is still a good indicator, whether for good or ill. You can always, as you say, get a more expansive test from your doctor.

Although perhaps less frequent donations are called for from the information you provided.
[hr][font color="blue"][center]Stop looking for heroes. BE one.[/center][/font][hr]

[pnwmom]

5. My husband knows someone whose health benefits by MONTHLY donations.

He has a condition that stores too much iron in his body.

So everybody should understand that a test for hematocrit isn't enough to know your iron status. Men, especially, can have too much iron stored and can benefit by donating blood. But others, like my son, have too little stored and don't know it. A test for ferritin levels is what will show this.

[Bluenorthwest]

6. So for people in similar situations who are not allowed to donate, would you recommend

a sort of straight up bleeding? If there is a benefit, can that benefit be denied? Are there doctors who would take the blood and dispose of it, to make sure the patient got these benefits? Or is the discrimination actually doing active harm to some who are not allowed to donate?

[pnwmom]

7. Now that I'm thinking about it, my husband said that his friend

had to "give blood" -- meaning, get some drained -- every month, but they had to throw it away because it was so high in iron! But his was an extreme case. My husband tends to store too much iron so he donates regularly, and his blood is just fine.

Years ago I read about this condition, and it was standard medical procedure to treat it with "bleedings." I don't know what basis an insurance company would have for denying this form of treatment.

[kestrel91316]

8. Normal people should not be bled for no reason. There is no inherent health benefit, lol.

The patients who need to be bled are the ones with a rare condition called polycythemia vera (I had a feline patient with this years ago) or those with iron levels way too high due to some genetic thing (I have a friend with this).

[pnwmom]

10. Of course they shouldn't. But many men have excess iron stores that will

be revealed by their ferritin levels, and their doctors may tell them that donating blood a couple times a year is good for them.

And others, like my husband's friend, have a disease that causes extremely high iron levels, and they also benefit from "bleeding" -- even if their blood is too high in iron to be useful to anyone else.

[kestrel91316]

15. Which is why I mentioned the excess iron condition right there in my post........

[hfojvt]

14. I just put some laundry on the line

and I think the mosquitoes took about a quart.

So there's that option.

[pnwmom]

16. I think I would rather donate blood the new modern way.

With clean needles.

[NutmegYankee]

9. Given the normal meat intake of American men...

Iron deficiency is the last of their concerns. If anything, we have too much.

[pnwmom]

11. Younger men like my son haven't had as long to build up excess iron stores,

and young men who are vegetarians may have even less of a supply -- so donating every two months, as my son was encouraged to do, could be too much for them.

But you're right that most adult men in this country are more likely to have a problem with iron over-load than with iron depletion.

[pansypoo53219]

12. cook w/ cast iron.

i guess i will never need any iron supplement. hmmm, bacon fried in cast iron. I LOVES my cast iron chicken pot. may be why mosquitos don't like me.

[pnwmom]

13. That is useful advice, but doesn't work for people who eat in college cafeterias.

Other tips I've learned are not to combine iron-rich foods with calcium foods or tea or coffee. But Vitamin C, taken along with iron foods, increases the absorption of the iron.

[nadinbrzezinski]

17. I used to be a freqent donor

and nether the Mexican or American Blood Blanks allowed donations more often than three months, and that was the precise reason. They must have changed that a while ago.

Yup, I was a member of the 10 gallon club in San Diego... and I donated at the Red Cross once a year. So I did time my donations and was careful about that.

These days, even if I wanted to...