Many people donate blood regularly, but it drastically depletes their iron stores, which can take months to fully replenish, raising concerns that donors are living “on the brink of anemia”, writes Brittany Trang for STAT.
How donating blood can impact iron levels
According to Trang, one question that “has plagued the field of blood donation ever since there were transfusions” is whether blood donation can actually harm people.
In general, body iron levels are self-preserved since iron from old red blood cells is used to make new red blood cells. Unless a person loses blood, either through menstruation, injury, or donation, iron does not leave the body.
Although a person’s body replaces the volume of blood donated within 24 hours, the same is not true for the volume of red blood cells, which can take months to replenish. For low-iron donors, the process of replacing iron lost through donation can take longer than four months, even though donors are technically eligible to donate blood every 56 days.
To reach the donation limit, many regular blood donors will take iron supplements to build up their red blood cells just enough to reach the threshold in time for their next donation.
These donors are “living on the brink of anemia to be able to donate blood,” said Eldad Hod, associate professor of pathology and cell biology and vice president of laboratory medicine at Columbia University Irving Medical Center.
How donating blood affects donors
To determine how donors are affected by donating blood, Hod and a team of researchers conducted a study to follow frequent donors who had low iron but no anemia.
In the study, participants donated blood, which was then screened for its transfusion quality and whether the donors had low iron. A total of 79 participants who donated blood had low iron levels and were blindly randomized into two groups.
In one group, participants received intravenous iron to correct their iron deficiency, and in the other group, participants received a saline placebo. Then, four to six months later, participants were asked to donate blood again and complete quality-of-life surveys, as well as cognitive function assessments.
Overall, Hod and his team found that there were no significant differences in transfusion quality, cognitive performance, or quality of life between participants who had their iron replenished and those who did not. had none.
“The answer doesn’t match our preconceptions, but it’s actually better for public health because it suggests that what we’re doing isn’t harming our donors,” said Steven Spitalnik, executive vice president of medicine at laboratory in the Department of Pathology and Cells at Columbia. biology and one of the authors of the study.
Although the researchers found that the quality of transfusion improved after iron repletion in women under 50, they said it was unclear whether this difference was clinically significant and studies additional ones were needed. Notably, women under 50 are the group most likely to be turned down for blood donation due to lack of iron, as they tend to lose iron during menstruation.
The study researchers noted that future studies should examine whether adolescents, who need higher amounts of iron for their development, are also affected by blood donation or whether it is harmful to them due to their increased iron needs.
Additionally, health experts have said that potential donors identified as iron deficient should not simply be told to take iron supplements. Instead, donation center workers might take the opportunity to encourage them to find a potential underlying cause for their deficiency.
Overall, the study results suggest that blood donation is not harmful to donors and that there is no need to add additional iron level requirements to donor screenings to ensure the security.
“We do no harm to people who donate blood,” said Gary Brittenham, a Columbia medicine professor and another study author, “but we do a great benefit to people who need it.” (Trang, STAT9/20)