To think that more women may be happy to give blood if the NHS treated any resulting anaemia properly?

[Herriet]

I realise this may just be me, and if it is then I am definitely unreasonable!

I gave blood every three months for years and during those years I slowly became more and more anaemic. I was in my twenties, healthy and eating well, and my periods were not heavy.

We know that heavy periods (over 80ml per month) can cause anaemia. This equates to 240ml every three months. But for some reason the NHS doesn't mention that giving away 470ml in a donation might cause anaemia too.

I've since had babies and ended up with an iron infusion. These are expensive. But now I have a lovely iron store, likely to last me years and years. I see the NHS is desperate for donors (link below) - should I restart donating and give it all away again? If I get anaemic again they will say 'take iron pills', but I've tried a variety of these before and they do not agree with me. So I can choose to give blood and eventually need iron pills and be permanently constipated, or I can choose not to, and be happy and healthy. I would donate if they would give me an iron infusion at a reasonable 'ideal' level of ferritin, rather than only doing it once ferritin is 5 or whatever and I can barely function.

I'm O negative. The NHS really really wants my blood, according to the article below. But not enough to offer me another iron infusion in future if I become anaemic again due to donating.

https://www.bbc.co.uk/news/articles/c98p0pj7dypo

I agree with @minipie
I donated blood for a couple of years but my veins are so small it always took ages for them to get blood out of me. The last couple of times I tried they sent me home because it was just taking too long.
I’ve tried to persuade DH and my adult sons (with their lovely big veins) to do it, but they’re all squeamish. I’ve told them that they wouldn’t be squeamish if they needed the blood themselves!

Yes with iron at 12 and tablets not working, I’d ask for iron transfusion.

Totally agree. I hit 40, and they suddenly took it seriously and said "We are going to do a colonoscopy because you might have bowel cancer causing your anaemia." I said that was unlikely as I had been taking iron tablets and tranexamic acid for a decade. Tons of GP apps, blood tests and exploration then...nothing. "Sorry you are just anaemic. Keep taking the tablets and test every three months." Absolutely infuriating, given that my hair falls out in clumps, I get heart palpitations frequently, and I haven't been rested since Gordon Brown was aprime Minister. They cared in pregnancy and they cared when I hit 40, but outside that I am just told to manage with an ineffective treatment.

". I just don’t think I absorb it properly."
This is it. When I was a skinny, pregnant vegetarian I still wasn't anaemic. My blood grips onto iron.
I do feel tired for 36hrs after giving blood now I'm older so I eat lots and avoid the gym but I'm not wiped out by it.

i donated last night and was pleasantly surprised at how many men there were at that time

Are ferritin supplements different to iron supplements? As with my low ferritin of 10 I was put on ferritin supplements, I’ve no idea how different they are though (pp says they take iron supplements). Also I was put on a high dose, with high strength supplements twice a day.

This is still only haemoglobin, NOT iron. I’m another one who has been giving blood, passing the test barely (every time I’ve had to have the more accurate test and just passed) and then by this spring I was fully anaemic.

Shockingly, my ferritin levels across the last 15 years show iron deficiency and it’s taken having a middle aged woman GP to identify this as the cause of being knackered.

I had a male GP prescribe antidepressants and a month of iron tablets at the same time as a ferritin was 8 and Hb was 119.

Ten years later I’m finally getting things sorted - Iron tablets, high dose vitamin C, and vitamin B complex all together finally bringing my levels up.

I don’t think I’ll be going back to giving blood. Both the NHS and the blood service have shown little regard to the issue of iron deficiency, it’s symptoms and the disproportionate effect on women.

Sorry, I meant ferrous sulphate (just checked the box!).

Just spoke to the GP and she said to just buy any old iron tablets in the chemist.
She didn't have any advice on what type.
She didn't suggest a transfusion and she was surprised when I asked if I could have a follow up test in a few months to see if tablets are working.

Does anyone have any suggestions of palatable iron supplements for autistic teenage DD who is funny with taste and can't swallow pills?
She's vegetarian and has a very limited diet and she also has heavy periods. She's often tired and she's white as a sheet so I'm wondering if she might be a bit iron deficient too.

If your DD is restricting her diet, often tired and unusually pale then I think she needs to see a GP asap, as supplements wont help her quickly enough.

The apple flavour spa tone aren't too bad, they usually have them in boots. Or you can mix the unflavoured one with orange juice. She really should get a blood test done though, spatone may not be strong enough

They were always pretty hot on on my iron levels years ago when I was a teenager and I often went for blood tests and prescribed iron. I am guessing that it’s become a bit a lottery now and people are told to just buy them over the counter and not followed up with any further tests and not checked out? Which doesn’t surprise me really !

Quite a lot of stuff has serious side effects. Doesn’t pregnancy itself carry a risk of death?! The risk is so incredibly low.

Is this accurate? My GP said an iron infusion will take a few days to boost numbers where as tablets can take weeks! And that’s if you can stomach them in the first place..

Interesting - I've been donating blood regularly for 2 years but have recently been diagnosed with anaemia. I'm gutted not to be able to donate any more, however I do wonder if this has perhaps contributed.

iron infusions are an increasing cause of complaints/litigation. They do come with some risks, the most irritating/common being semi-/permanent skin staining along the course of the cannula. However, they can also cause severe allergic reactions, and although these are rare and are less common with newer formulations than older ones, they cannot be ignored. The consent process for an iron infusion should refer to the side effects as well as the proposed benefits. People with autoimmune disease seem to be at higher risk of severe allergic reactions (and given that women are disproportionately represented amongst patients with autoimmune disease, it isn't a huge leap to wonder if women might be at higher risk of adverse reactions to IV iron). Like everything else in medicine the proposed benefits have to be weighed up against the proposed risks, and those are often a little bit more complex than most of the discussion you see MN might suggest. I would absolutely not have an IV iron infusion in any private clinic (particularly if it seems surprisingly cheap) unless I knew they had the skillset and equipment to treat anaphylaxis quickly.

When it comes to oral iron replacement, less is often more, and there is increasing awareness that the old fashioned regimes of 3 high dose tablets (any salt) a day was responsible for excess side effects (essentially because there's a finite capacity for iron absorption from the bowel and once that's saturated the excess iron sits in the bowel causing side effects until it comes out the other end). One tablet a day/every other day is more commonly advised these days and better tolerated by a lot of people, and while it does take weeks/months to correct, that is usually an ok speed of correction (it will of course have taken months/years to become iron deficient for most people). Even one tablet every few days/ once a week may be better than nothing. There are some times though when quicker correction is needed (eg. pre-op/ pre-delivery where moderate blood loss may be anticipated) and then IV iron may be better (still takes a couple of weeks to start seeing measurable improvements in numbers), or of course if oral even at low dose can't be tolerated then the benefits may outweigh the risks. As well as supplementing iron, it's also important to stop excess iron loss (eg. by managing menstrual blood loss or not donating blood if you know it's going to put you at risk) or if there's ongoing loss that's not been defined then hunting for the cause may be important, particularly in older folk where cancers may become more of a concern.

The blood donation service is reliant on the good-will of volunteers to donate blood, but it's not a cost free endeavour - as well as all the logistic 'stuff', there are the disposables involved in blood collection and the processing costs for each unit of blood, etc to factor in. It is also a really barn-door obvious way by which people could become iron deficient or anaemic, just the same as having heavy periods or chronic GI bleeding, or having a PPH might be. For people in good health, with 'normal' diets and no other chronic/recurring causes of blood loss there should be time to recover and stay healthy between donations, but for other people that's just not so easy. If they have to start adding in the cost of supplementing iron to people who have donated then it probably becomes economically unviable in what is essentially an resource poor service (ie the NHS!) so it's better to not donate and to concentrate on remaining healthy. It also goes against the basic principles of 'doing no harm' if the service is putting people at higher risk when there's no benefit them (apart from the warm and fuzzy feeling of doing something good and perhaps getting a biscuit).

I think if you have an allergic reaction?

I am not sure.

Last time mine was checked it was preop and was 7. Apparently it’s supposed to be nearer 100.

I do feel tired/ lazy / depressed. I do think it is the iron and general lack of correct vitamins. Last pregnancy my folic got to near zero post partum after breastfeeding. Went to doc thinking I was dieing on cancer or something. Blanking out / losing seconds driving!

He thought I was being slightly dramatic but did the tests. Then called me up and had changed his tune. Said he had no idea how I was standing. That I urgently need this folic acid!

That;s a really helpful post, @Greybeardy. Thanks.

Unless someone has problems with absorption eg ileostomy etc then an infusion won't work any better.

I've had dozens & haemoglobin comes up over 6-8 weeks. Ferritin level will come up more quickly - a few weeks.

There are some very nasty problems with infusions from severe reactions which.can be fatal, infections and severe staining & permanent scarring. Iron tablets have none of those side effects & biggest issue is tummy pain & mild constipation for the majority of people.

Infusions are also very expensive compared with tablets. They are peddled on here as a miracle cure.

The scar I have covers about 1/3 of my lower arm & is permanent. It looks the colour of the infusion itself & is very noticeable on pale skin. It looks like I have a very dirty arm.

Teen DD with very low ferritin (2), very low haemoglobin and low free iron has been told by our friend who is a haematologist (Consultant, NHS) that iron supplements (high dose, daily) may well have to be taken for 6-12 months for her levels to improve. Any excess iron supplements will be diverted into making haemoglobin first, the iron stores will be built up right at the end, once haemoglobin reaches over 100. Hair loss will continue. Hair growth requires ferritin to be at reasonable levels first. So in situations like this the NHS should absolutely be doing an iron infusion, they just do not want to. Of course we also have to test for coeliac and autoimmune conditions, but in all likelihood ours will be a straight forward case of iron deficiency anemia, very common in teen girls and completely not managed properly by the NHS. Instead they prefer to diagnose mental health conditions and refer on ADHD pathways at great expense. But that is the system we operate in! It has taken us women decades to get adequate HRT in our 40s. We need to do better with teen girls too. Instead of diagnosing mental health conditions galore.

And quite frankly, if giving blood is likely to cause issues with women, then they should be given that advice and it is men that should be targeted for giving blood, not us women.

The way the French doctor explained iron infusion to me is that they do some sort of salt back test first so the staining is not possible and they can give a half dose first to monitor reaction, followed by another half dose 14-21 days later. At least that is what they do in France, it seems.

I know this might be controversial, but I'm not convinced a vegetarian or vegan diet is particularly healthy for women, especially young women because of the iron issues. It's not as easy to absorb some nutrients from plant sources for many people.

Yes I know a properly researched and balanced vegetarian diet might be ok, but in reality that's not what a lot of women, especially teenagers are eating. They eat a diet of convenience.

Does anyone know what the optimum dose of iron is? My Holland and Barrett tablets is 20mg. It says 1 tablet a day. Could I take more than that or are there risks to taking too much iron?