Iron supplementation as a blood service policy

Donating whole blood regularly leads to the loss of about 250 mg of iron, which puts frequent donors at risk of developing iron deficiency. Iron supplements can help donors recover their hemoglobin and iron stores more quickly, and could serve as an alternative to lengthening the time between donations. This thesis explored how iron supplementation could be used as a policy in blood services, and identified donor groups at greater risk for iron deficiency.
We found that most non-anemic donors with low iron levels didn’t report symptoms like fatigue, poor concentration, or cravings for non-food items. However, men with very low ferritin did report more fatigue. Awareness of iron loss due to donation was limited among both donors and blood bank staff. While some staff were concerned iron supplements might be a burden, most donors said they’d be willing to take them if offered by the blood service.
Interestingly, young female donors in Finland, where iron supplements are routinely provided, had better iron levels than those in the Netherlands. In Dutch donors, heavy menstrual bleeding increased the risk of iron deficiency, while hormonal IUD use was linked to better iron status. Screening based on menstrual factors may help identify those who need it most.
Finally, a clinical trial (FORTE) showed that a low daily dose of 30 mg iron was just as effective as higher doses, with minimal side effects. In conclusion, daily low-dose iron supplements are an effective, well-tolerated way to protect donor health, especially in higher-risk groups like young women.