Haemoglobin and your blood donation

Haemoglobin and iron
Every time you come to give blood or platelets a Blood Bank Officer checks your haemoglobin level. THIS IS MANDATORY along with filling your Medical Questionnaire before Blood Bank checks for your HB.

 

What is Haemoglobin?

Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs.
Haemoglobin levels vary from person to person. Men usually have higher levels than women.

A low hemoglobin count is generally defined as less than 12.5 grams of hemoglobin per deciliter (125 grams per liter) of blood. For both men and women, this is the current measurement. Previously, it was 13.5 g/dL. (deciliter)

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Copyright: A. Purmanund Blood Bank Officer doing a Haemoglobin test

We set a fairly high ‘cut-off’ level because we want to be sure that your haemoglobin will not drop below normal after you have donated.

If you donate platelets you lose a certain number of red cells each time, and after a number of donations your iron stores and Hb can drop. To ensure your safety we need your Hb to be at least 125g/l for both men and women.

What is a normal haemoglobin level?

Each testing laboratory provides a reference range. This is generally considered to be the normal range for healthy adults.

Blood Service haemoglobin reference range
Females                                                        Males
125-165 g/L                                              125-185 g/L

Why is my haemoglobin measured before each donation?
The health of our blood donors and recipients is a priority. The haemoglobin screening test is performed to ensure that it is safe for you to donate and that there are sufficient red cells for the person receiving your blood.

Why haemoglobin levels might be too low to donate
There are a few reasons:

Variation between people – some of us just normally have a  low level.
• Iron – we all need iron to make haemoglobin. If your iron stores are low, the haemoglobin may fall below normal (or below the donation level).
• Testing procedure – while we take great care with our test on the session, occasionally it underestimates the amount of haemoglobin in the blood. It sounds quite “unquality like” because if we are not sure of our Hb value, we cant bleed the donors. The equipment is benign calibrated every day
• Lack of iron which is required to make new red cells
• A deficiency in vitamin B12 or folate
• Conditions causing blood loss, including blood donation. Its frequent and regular blood donation which can lower iron levels Not “a blood donation”
• Other health problems

At your next donation
You will have been asked to leave at least 3 months (4 months for women) before your next donation to allow your haemoglobin to reach a higher level. We hope that next time you come to give blood your haemoglobin will be above our ‘cut-off’ level and that you will not be disappointed again.

If you are unable to donate on 3 consecutive occasions then on your next visit, please inform our Blood Bank Officer. You may also wish to speak to Dr Mrs Sonoo, Head in Charge, NBTS – Candos by calling on 424 0650. Else, we advise you to go to an Area Health Centre (AHC) or Community Health Centre (CHC) and tell the Doctor that you  were deferred (not able to give blood) due to low HB. The Doctor will do the needful.

More about iron
Iron is very important because it helps your body to make haemoglobin and you give away a lot of iron when you donate blood.

As iron is found in a variety of foods, you can usually get enough from a balanced diet. The major sources of iron are meat and meat-based foods, cereals and vegetables.

Boosting iron levels
You can boost iron levels by trying to eat a well-balanced diet.

Although iron from non-meat sources is more difficult for the body to absorb, people following a well-balanced vegetarian or vegan diet should get enough iron in their diet.

Vegetarians and Irons
Vegetarians who eat a varied and well balanced diet are not at any greater risk of iron deficiency anaemia than non-vegetarians. A diet rich in wholegrains, legumes, nuts, seeds, dried fruits, iron-fortified cereals and green leafy vegetables provides an adequate iron intake.

21 Vegetarian Foods That Are Loaded With Iron

Are Vegetarians getting enough irons?

Every day, try to eat three portions of food below that are good sources of iron:

Non-Veg sources of iron

  • lean red meat, turkey and chicken
  • fish – including mackerel, sardines, salmon, pilchards and shellfish eggs

Vegetarian Sources

  • breakfast cereals – some cereals are fortified with iron
  • pulses and beans – in particular baked beans, chickpeas and lentils
    nuts (including peanut butter)
  • brown rice
  • tofu
  • bread – especially wholemeal or brown breads
  • leafy green vegetables – especially curly kale, watercress, broccoli and spinach
    dried fruit – in particular apricots, raisins and prunes

Vitamin C
Vitamin C helps you to absorb more iron. So to get the most from the food you eat, have vitamin C rich foods with meals: for example fresh fruits and vegetables, or drinks such as fresh orange juice.

♦ Avoid drinking tea or coffee just before, after or with meals as this may reduce the absorption of iron from foods.

Are there foods that reduce iron absorption? ¹
Substances which reduce iron absorption if consumed with or within an hour following a meal, include:
• calcium found in dairy and soy products
• polyphenols found in tea, coffee, cocoa and red wine (inhibit absorption of non-haem iron only)
• oxalic acid found in spinach, rhubarb and sweet potato
• phytates found in cereals and legumes

Further Reading : Encouraging Women and young girls to donate blood regularly

References:
1. Australian Red Cross – Iron and Haemoglobin
2. Medicine.net
3. http://www.blood.co.uk (Haemoglobin and Iron)

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Encouraging young girls and women to donate blood in Mauritius

From information collected during the workshop hosted by the Ministry of Health & QL/National Blood Transfusion Service on June 13 at Gold Crest on “Blood Sustainability – Present and Future”, according to blood bank’s statistics, on gender distribution of blood donors,there is a great gap between male and female donors. Men comprised of 85.5%, while female donors only 14.5%.

42.7% was deferred due to low Hemoglobin among female donors
🔴 YOUNG GIRLS AND WOMEN ARE ALSO ENCOURAGED TO DONATE BLOOD.🔴 
Being not able to give once, does not mean you cannot donate blood. Your HB (Level of Hemoglobin) was perhaps not adequate BUT that does not mean, you are anemic.
The myths that because you “supposedly” lose iron during menstruation does not mean you cannot donate blood. After your menstruation, you can come and donate blood. There is ZERO risks, provided your Hemoglobin level meets the criteria of 12.5g/dL.

Women seem more willing to donate blood than men despite the limitations that affect their donation rate. However in Mauritius, there are less female donors than men and we believe there is a need to remove those “factors” that women are less incline to donate blood.

Generally, women are more altruistically inclined than men to give blood, the motherly instinct for example BUT fear and lack of information especially among high income level female gender groups, there are less donors. However and as mentioned above, there are restrictions to women giving blood, especially low haemoglobin concentration, which reduce the number of female blood donations. Women also have more difficulty when blood is withdrawn and are more susceptible to vasovagal reactions, which negatively affect their experience as donors (fear of fainting etc).

NBTS will work on action plan to see the best means to reduce these barriers to encourage women to continue to offer to donate blood, thereby ensuring that they become regular donors, which is a key factor in guaranteeing an adequate supply of blood and to find means for that. Media including Social Media, could be used. BUT, we do sensitization at Schools and though less at Universities and almost impossible at Textiles Factories, we need perhaps be aggressive and have the support of Radio and TV.

In a study done (abroad) by Newman et al.5, 1,000 randomly selected donors were questioned about their experience 3 weeks after donating. Among women 9% reported vasovagal reactions, 11.1% fatigue and 12.5% arm discomfort after the procedure as opposed to 4.5%, 4% and 6.9%, respectively, in men. Women are typically lighter than men, and vasovagal reactions and post-donation fatigue appear inversely related to weight.

Still, the percentage of women giving blood in Mauritius is too low. We encourage our women folks to come forward and donate blood at least once or twice a year.

Donors Deferred for Low Haemoglobin

As mentioned in this article, although you were not able to donate on your recent attempt, you may be able to donate in the future. A haemoglobin and hematocrit reading, which is lower than the required level does not indicate that the donor has any serious health issues. Also, some donors naturally have lower levels, which causes them no harm. However, it may prevent them from being eligible blood donors.

According to Dr Vishwas Madhav Thakur, General Physician on Lybrate, those donors who are slightly anaemic due to iron deficiency can increase their iron intake and thereby boost their haemoglobin and hematocrit level. Men whose haemoglobin levels are below 12.5 g/dL and women who have levels below 12g/dL are not allowed to donate blood.

The most common cause of low haemoglobin, especially in women, is low levels of iron because iron is needed to make hemoglobin. Blood donation further leads to removal of iron from the body, which may cause or contribute to low iron levels and possibly anemia. For someone who has haemoglobin or blood count problem, it is important to take a multivitamin with iron or an iron-only supplement to replace the iron lost through blood and platelet donations after consultation with your doctor or practitioner.

Even though anyone with low haemoglobin is not allowed to donate blood, in rare cases if they do, they may experience symptoms like weakness, tiredness, and fatigue due to the low blood count. Patients are often encouraged to eat a well-balanced diet that is high in Vitamin C and iron rich. If a low haemoglobin patient is not allowed to donate blood today, it does not mean that the patient can never donate blood.

BEFORE DONATING BLOOD WHAT YOU MUST KNOW (Click on the link)

#1: The minimum time gap between two successive blood donations should be at least 3 months. This is because, in general, your blood cells can take around three months to regenerate post a donation episode. Going by the numbers, you can donate blood four times in a year.

#2: When it comes to the donor, ensure that your age is between 18 – 65 years and you weight is more than 45 kg, which is one of the key criteria for any person planning to donate blood. Also, you have to be in good health with your haemoglobin content more than 12.5 mg%.

#3: Blood donors are also asked questions related to their fitness before blood donation. Also, donor’s blood pressure, haemoglobin and weight are checked before the donor is deemed fit for blood donation.

#4: There are rare chances of a donor feeling dizzy, which is mainly due to anxiety. Apart from this, there are no other side-effects of donating blood. In fact, there are various health benefits of blood donation.

#5: Make sure you drink water or have fluids after donating blood as it will help you to stay hydrated as fluids get retrieved in 24 hours post blood donation. However, stay away from drinking aerated drinks or carbonated beverages.

#6: As far as diet is concerned, eat something light before donating blood. Also, avoid drinking alcohol the day prior to blood donation and do not smoke just before blood donation.

#7: Do not exercise or perform any strenuous physical activity after donating blood as there are high chances of suffering from dizziness. It is important to take rest that day to not strain yourself either physically or mentally.

LOW IRON
Some donors, especially women, struggle with a lack of iron – or low hemoglobin in their bodies.

What you should do? What to eat? How to increase your iron counts?

What if you ever feel fainting after donating blood ?  

1. Can you give blood on your menstruation?

“You may give blood during a menstruation, but if you are having a particularly heavy menstrual bleeding, it would be better for you not to. This is because any form of blood loss can reduce the iron levels in your body and potentially make you feel unwell for a short time. If you are having medical investigations please wait until these have been completed. You must also exclude pregnancy if a period has been missed before you give blood. If you have been prescribed medication by your doctor to help cope with menstrual pain or are having heavy or prolonged periods, talk to our Blood Bank Officer or a Doctor if present.

2. How much blood is actually taken?
“During a blood donation we take 450ml of blood, which is just under a pint.”

3. Can all blood types donate?
“All blood types can be taken and we always need different blood groups, but there are times when we may make an appeal for people with rare blood types, such as O negative and B negative, to donate. This is based on the demand for that blood type at a given time. If you don’t know your blood type, you will find out after your first donation.”

4. My haemoglobin was in the normal range, but I was told I couldn’t donate.
It is normal for haemoglobin levels to fluctuate. If you’ve not previously been deferred due to low haemoglobin levels and your level was in the normal range, we encourage you to eat a nutritious, well-balanced diet with foods rich in iron and high in vitamin C.

If you donate often, see your doctor who who can consider putting you a multivitamin with iron or an iron supplement. Multivitamins and supplements are available over-the-counter, but you should discuss with your health-care provider before taking them.

5. How might low iron levels affect me?
It is normal for iron levels to fluctuate, even in those individuals who don’t donate blood and platelets. Many people who have low iron feel fine and have no symptoms. Symptoms may change from mild to more serious and can include: anemia, tiredness and irritability, reduced endurance during physical activity, difficulty concentrating or a craving to chew things such as ice or chalk (pica).

6. Do any health conditions rule you out of giving blood?
“Although most people can give blood, there are some restrictions – depending on things like your health, medication, and whether you’ve been abroad recently. You are usually able to give blood provided you are:
• fit and healthy
• weigh at least 50 kgs
• are aged between 18 and 60, or over 65 (if after 60, you give at least once a year and this applies to men as well)

Note: 17 years old can also donate blood with Parent Consent.
♦If you are underweight, pregnant, receiving IVF treatment, are on certain types of medication or have previously received a blood transfusion, you are unable to give blood.
Breast Feeding: Wait one year
Tattoo and piercing (to all donors (men and women) temporary deferral for 6 months)

♦ Surgery: from 6 to 12 months

For more information contact:

National Blood Transfusion Service – Candos
Tel: 427 0711/427 7192/424 0650/424 4766
www.blooddonorsnetwork.org  
Sources:  1. WHO
2. Cosmopolitan- UK (cosmopolitan.com)
3. Healthsite.com
4. Low Iron – oneblood.org