Dennis Gastineau started giving blood regularly when he was in medical school in the 1970s. The $25 he received bought almost enough groceries for a week. Now, it just seems like the right thing to do.
It may also be bad for his health. Gastineau, who happens to be a hematologist, is among the 2.4 million donors who risk silent damage as a result of frequent giving. U.S. government research published last year found this group iron-deficient, which can lead to fatigue, compromised mental function and eventually anemia. Now, iron levels are being examined as part of an $87.2 million study the U.S. is funding on blood donation and transfusion safety.
Seventy percent of the blood supply comes from repeat donors. Limiting their giving may hamper a system that already suffers shortages. The Mayo Clinic predicts a 10 percent drop in its supply from its restrictions on donors after finding that one-third had iron deficiency.
"We want to make sure we don't have a group of people walking around being iron-deficient," said Manish Gandhi, the medical director of the Mayo Clinic's blood donation center. "Blood donation in the U.S. is an altruistic thing. We need to focus on what we should be doing to protect these wonderful donors."
Almost 10 million Americans annually give blood. Still, that's only 5 percent of those eligible, according to a national survey conducted by the U.S. Department of Health and Human Services. The agency's REDS-III study, underway since 2011, is examining donors' iron levels as part of an effort to improve blood banking and transfusion practices. Boosting the number of donors may be key to a healthier blood-banking system.
Whole blood, which is divided into four components to treat everything from hemophilia to ulcers and accident victims, can now be given every two months, under rules set by the Food and Drug Administration.
The question is whether that's too often. The FDA, National Heart, Lung and Blood Institute and the AABB, a nonprofit that represents the transfusion medicine industry, are struggling to find a way to minimize iron loss in donors without reducing the total blood supply. Researchers are working on a test to identify donors susceptible to iron deficiency that can be done during blood drives.
Using iron supplements can carry troublesome side effects such as an upset stomach and constipation. And while the American Red Cross generally encourages its donors to eat healthy meals to restore iron levels after giving blood, the metal is hard to absorb from food.
"Right now no one knows what the right answer is," Gandhi said in a telephone interview.