The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron Deficient Blood Donors: A Secondary Analysis of the Ironwoman Rct

Macher, Susanne; Herster, Cornelia; Holter, Magdalena; Moritz, Martina; Matzhold, Eva Maria; Stojaković, Tatjana; Pieber, Thomas R.; Schlenke, Peter; Drexler, Camilla; Amrein, Karin

doi:10.20944/preprints202003.0462.v1

Cited by 6 publications

(3 citation statements)

References 52 publications

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“…There is mounting evidence that rates of donor deferral due to low-Hb are considerably less in those taking iron supplements, both at the first donation visit and at subsequent donations. [44][45][46][47][48] Only providing donors with information about their (low) ferritin level does not seem to increase their iron intake. 15 The beneficial effects of iron supplementation may be counteracted by more frequent adverse events in donors who receive iron supplementation, which is likely to limit acceptability and compliance.…”

Section: Discussionmentioning

confidence: 99%

Donation‐induced iron depletion is significantly associated with low hemoglobin at subsequent donations

et al. 2021

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Background: Blood donation is associated with a loss of hemoglobin (Hb)-bound iron. Hb levels recover relatively fast by using stored iron. However, it takes more time to replenish iron stores, potentially resulting in iron deficiency.Study design: Hb and ferritin levels were measured in 5056 new, first-time, and repeat whole blood donors. We investigated whether increasing numbers of donations are associated with lower ferritin levels. Furthermore, we tested whether low ferritin levels are associated with low-Hb deferral at the subsequent donation attempt by performing logistic regression adjusted for age and stratified by sex. Results: Whereas mean Hb levels are relatively stable, ferritin levels significantly decrease with increasing numbers of donations and were approximately 50% lower for donors with >50 donations compared with those with 2-10 donations. Despite the poor correlation of ferritin and Hb levels, cross-sectional, iron-deficient donors (ferritin <15 ng/ml) had 21.8 (8.5-55.6) higher odds in men, 10.1 (6.1-16.5) in premenopausal women, and 11.7 (5.2-26.4) in postmenopausal women for Hb deferral at a subsequent visit.Discussion: To conclude, repeated donations may induce iron deficiency, which corresponds with an over tenfold increased risk of having insufficiently restored Hb levels at a subsequent donation attempt. Longer donation intervals and/or higher dietary or supplemental iron intake are warranted to prevent accumulated iron depletion and subsequent low-Hb deferral in whole blood donors.

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Section: Discussionmentioning

confidence: 99%

Donation‐induced iron depletion is significantly associated with low hemoglobin at subsequent donations

et al. 2021

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“…Pica was present in 2.2% of a mostly representative United States donor population and associated with low ferritin as well as RLS [9]. In several donor studies, an association between iron and RLS was not found [6,7,48] but one recent study reported improvements in RLS, sleep, and fatigue following use of exogenous iron [49]. An association with proton pump inhibitor medications and RLS was recently reported, even after controlling for iron status, emphasizing its multifactorial etiology [50].…”

Section: Impact Of Iron Deficiency On Blood Donor Healthmentioning

confidence: 99%

Iron status of blood donors

Spencer

Mast

2022

Current Opinion in Hematology

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Purpose of reviewThis review examines recent research on the prevalence and importance of iron deficiency in blood donors, and on efforts to mitigate it. Recent findingsPremenopausal females, teenagers, and high-frequency donors are at the highest risk for donation-induced iron deficiency, in both high-resource and low-resource settings. The physiology relating iron stores to hemoglobin levels and low hemoglobin deferral is well elucidated in blood donor populations, yet the clinical effects attributable to iron loss in the absence of anemia are challenging to identify. Expanded adoption of ferritin testing is improving donor management but may cause decreases in the blood supply from temporary donor loss. The potential for personalized donor management is emerging with development of computational models that predict individual interdonation intervals that aim to optimize blood collected from each donor while minimizing low hemoglobin deferrals. SummaryMeasures to reduce iron deficiency are available that can be deployed on a standardized or, increasingly, personalized basis. Blood centers, regulators, and donors should continue to evaluate different tactics for addressing this problem, to obtain a balanced approach that is optimal for maintaining adequate collections while safeguarding donor health.

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“…However, iron deficiency without anaemia has not been found to be associated with reduced self‐perceived health‐related quality of life in blood donors [8, 9]. Recently, iron supplementation was found to reduce iron deficiency‐related symptoms in non‐anaemic Swiss blood donors [10]. Iron levels of Finnish blood donor population are mostly affected by blood donation activity [11].…”

Section: Introductionmentioning

confidence: 99%

Low ferritin levels appear to be associated with worsened health in male repeat blood donors

et al. 2021

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Background and objectives Frequent blood donation depletes iron stores of blood donors. Iron depletion may lead to anaemia, but the health effects of iron depletion without anaemia in healthy blood donors are not well understood. We studied in the FinDonor cohort whether worsening of self‐rated health of blood donors during the study period was associated with biomarkers for iron levels or other self‐reported changes in lifestyle. Materials and methods We included 1416 participants from the cohort who answered an 89‐item questionnaire on their health and lifestyle during their enrolment visit and again at the end of the study. We performed multivariate logistic regression to test if blood donation‐related factors affected the probability of reporting worsened health. To set these findings into a more holistic context of health, we subsequently analysed all other questionnaire items with a data‐driven exploratory analysis. Results We found that donation frequency in men and post‐menopausal women and ferritin level only in men was associated negatively with worsened health between questionnaires. In the exploratory analysis, stable physical condition was the only questionnaire item that was associated negatively with worsened health in both women and men. Conclusion Our results suggest that low ferritin level is associated with worsened health even in non‐anaemic repeat donors, although we find that when health is analysed more holistically, ferritin and other factors primarily related to blood donation lose their importance.

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The Effect of Parenteral or Oral Iron Supplementation on Fatigue, Sleep, Quality of Life and Restless Legs Syndrome in Iron Deficient Blood Donors: A Secondary Analysis of the Ironwoman Rct

Cited by 6 publications

References 52 publications

Donation‐induced iron depletion is significantly associated with low hemoglobin at subsequent donations

Donation‐induced iron depletion is significantly associated with low hemoglobin at subsequent donations

Iron status of blood donors

Low ferritin levels appear to be associated with worsened health in male repeat blood donors

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