title: Oral iron supplementation after blood donation: a randomized clinical trial.
abstract: OBJECTIVE
  Although blood donation is allowed every 8 weeks in the United States, recovery of hemoglobin to the currently accepted standard (12.5 g/dL) is frequently delayed, and some donors become anemic.
  
  
  OBJECTIVE
  To determine the effect of oral iron supplementation on hemoglobin recovery time (days to recovery of 80% of hemoglobin removed) and recovery of iron stores in iron-depleted ("low ferritin," ≤26 ng/mL) and iron-replete ("higher ferritin," >26 ng/mL) blood donors.
  
  
  METHODS
  Randomized, nonblinded clinical trial of blood donors stratified by ferritin level, sex, and age conducted in 4 regional blood centers in the United States in 2012. Included were 215 eligible participants aged 18 to 79 years who had not donated whole blood or red blood cells within 4 months.
  
  
  METHODS
  One tablet of ferrous gluconate (37.5 mg of elemental iron) daily or no iron for 24 weeks (168 days) after donating a unit of whole blood (500 mL).
  
  
  METHODS
  Time to recovery of 80% of the postdonation decrease in hemoglobin and recovery of ferritin level to baseline as a measure of iron stores.
  
  
  RESULTS
  The mean baseline hemoglobin levels were comparable in the iron and no-iron groups and declined from a mean (SD) of 13.4 (1.1) g/dL to 12.0 (1.2) g/dL after donation in the low-ferritin group and from 14.2 (1.1) g/dL to 12.9 (1.2) g/dL in the higher-ferritin group. Compared with participants who did not receive iron supplementation, those who received iron supplementation had shortened time to 80% hemoglobin recovery in both the low-ferritin (mean, 32 days, interquartile range [IQR], 30-34, vs 158 days, IQR, 126->168) and higher-ferritin groups (31 days, IQR, 29-33, vs 78 days, IQR, 66-95). Median time to recovery to baseline ferritin levels in the low-ferritin group taking iron was 21 days (IQR, 12-84). For participants not taking iron, recovery to baseline was longer than 168 days (IQR, 128->168). Median time to recovery to baseline in the higher-ferritin group taking iron was 107 days (IQR, 75-141), and for participants not taking iron, recovery to baseline was longer than 168 days (IQR, >168->168). Recovery of iron stores in all participants who received supplements took a median of 76 days (IQR, 20-126); for participants not taking iron, median recovery time was longer than 168 days (IQR, 147->168 days; P < .001). Without iron supplements, 67% of participants did not recover iron stores by 168 days.
  
  
  CONCLUSIONS
  Among blood donors with normal hemoglobin levels, low-dose iron supplementation, compared with no supplementation, reduced time to 80% recovery of the postdonation decrease in hemoglobin concentration in donors with low ferritin (≤26 ng/mL) or higher ferritin (>26 ng/mL).
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT01555060.
authors: Institute for Transfusion Medicine, Pittsburgh, Pennsylvania.
authors: Joseph E
authors: JE
authors: Kiss
authors: RTI, Rockville, Maryland.
authors: Donald
authors: D
authors: Brambilla
authors: National Heart, Lung, and Blood Institute, Bethesda, Maryland.
authors: Simone A
authors: SA
authors: Glynn
authors: BloodCenter of Wisconsin, Milwaukee.
authors: Alan E
authors: AE
authors: Mast
authors: American Red Cross, Dedham, Massachusetts.
authors: Bryan R
authors: BR
authors: Spencer
authors: Blood Systems Research Institute, San Francisco, California.
authors: Mars
authors: M
authors: Stone
authors: University of British Columbia, Victoria, Canada.
authors: Steven H
authors: SH
authors: Kleinman
authors: American Red Cross, Farmington, Connecticut.
authors: Ritchard G
authors: RG
authors: Cable
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001772:Blood Cell Count; D001782:Blood Donors; D019587:Dietary Supplements; D005260:Female; D005293:Ferritins / Q000097:blood*; D005296:Ferrous Compounds / Q000627:therapeutic use*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D007501:Iron; D008297:Male; D008875:Middle Aged
chemical_list: D005296:Ferrous Compounds; D006454:Hemoglobins; D005293:Ferritins; D007501:Iron; C011819:ferrous gluconate