My last two blood tests flagged ferritin as low, and total iron as high. I don’t have anemia, and related markers like hemoglobin are all fine.
This is likely due to regular blood donations (after having done none for several years). Everything I had read indicated that 4-6 weeks should be plenty to recover, and while this may be true for red blood cell counts and hemoglobin, maybe not for ferritin.
Low ferritin in itself doesn’t appear to be harmful, but rather than risk developing anemia, I’ll reduce the donation frequency from 3 to 6 months, and retest iron-related biomarkers prior to the next donation.
Vertical lines mark blood donations (500ml whole blood). The grayish areas are the “reference” ranges.
Looks like “total” iron has come back down to earth, and ferritin is slowly creeping up again. Serum iron levels are known to vary a lot, so I don’t know if I can blame the blood donations for upsetting the total iron values, or maybe I just ate more red meat in the days prior to the last test…
I’ll hold off a couple more months before doing another donation, and then stick with one donation every 6 months.
Although ferritin is an acute phase reactant (meaning it rises during acute illness or inflammation), when not ill, it is a better measure of total body iron stores.
If you want to donate more, pick up over the counter ferrous sulfate 324 mg (65 mg iron) and take one pill 3 times per week. The two side effects are darker stools and constipation which is why I recommend 3 times per week. When people are iron deficient due to chronic blood loss, we recommend taking it daily with a stool softener. However, for your purposes, three times per week should do. You can titrate the dose according to your donation schedule.
Looks like my ferritin levels are back in the normal range. Planning to donate blood later this week, and will stick with twice-a-year (rather than quarterly) donations from here on.
Thought it would be interesting to use this app to see if a blood donation resulted in a measurable reduction in hemoglobin, and how many days it would take to get back to normal. Unfortunately the readings fluctuate ±1 g/dL – and the expected reduction after donating is only 1 g/dL.
Interestingly, there was also a discrepancy between the hemoglobin reported in a recent lab test (15.1 g/dL) and the fingerstick test they do prior to donating (16.4 g/dL). Turns out this is a known issue.
In any case the “collection specialists” somehow managed to miss-tap my immaculate veins twice in a row, so this experiment will have to wait for another time
Hadn’t noticed this myself, but then again I wasn’t doing controlled stress tests, so I’m not sure I would have noticed a 10% reduction in maximal aerobic capacity…
Eric, I experienced this first hand about 10-12 years ago. I donated blood and found I could not keep up my Wednesday night running group. The coach, who had a PhD in Immunology, just laughed at me and said: “Don’t you know the literature on this topic? “. It’s basically the reverse of blood doping. I slowly regained my performance over 4 to 6 weeks.
Even in amateur sports, many of us suspect all different types of doping is going on. Not much testing even in world champ races. Most if not all the Doping methods carry risks that are not worth it besides the fact it is cheating.
It’s been almost a year since my last donation, and my ferritin levels are still on the lower end, despite there being no shortage of iron…
Apparently exercise can affect these values, but I did avoid strenuous exercise for 24h leading up to the blood draw. Perhaps next time I’ll try to give it at least 3 days?
Following this with close interest. How are you tracking levels - blood tests with doctor?
I am healthy and have ‘normal’ iron levels, however I have dealth with restless leg syndrome and so I have taken an Iron supplement.
Are your blood donations regular whole blood donations, and how often? I did a double (“Power Red”) donation a few times you can only do half as often (3 times a year instead of 6) and had terrible RLS and extrememly low Iron levels after due to the higher impact, so I have stopped doing those and now only occasionally do regular donations (and stack up on Iron before).
My graphs were similar to yours - low Transferretin saturation levels (which have slowly recovered and increased year over year) but normal iron store/ferretin and other levels. I did find that taking Iron for 30-60 days prior and/or after made a noticeable difference, however I did have to find a good kind that worked well and had good absorption (ferrous fumerate, iron protein supplement, or iron bisglycinate worked the best for me; ferrous sulfate, gluconate, citrate all gave me unhelpful side effects). Taking with Vitamin C helped a lot too.
The dashed vertical lines in the charts above are 500mL whole-blood donations.
Since my transferrin saturation levels are normal and my iron levels too high, taking iron supplements doesn’t seem like a good idea? But it’s also possible that the values are all a bit off because I didn’t allow for enough post-exercise recovery time before testing – we’ll find out next time!
Did the blood donations affect your hemoglobin levels, or just other iron-related biomarkers?
If your Transferretin levels are low, but Total Iron levels are normal, that to me does indicate either early-stage iron deficiency or chronic low iron intake. If your Iron intake (ferretin levels) are low, it puts your body your body in a state of stress causing it to store (protect) iron for preservation. Basically, full blown deficiency anemia (late stage) takes a long time to get to and a long time to fix because you need to keep your ferretin levels high for an extended period of time before your stores can recover (stores increase slowly, ferretin increases quickly). I had a similar experience - by taking my Iron regularly (a single 325mg daily), my ferretin levels quickly recovered from 57 to 120 in , while meanwhile my iron total levels have stayed relatively steady over the past 3-4 years.
To put it another way, the fact that your total Iron levels are all across the board is very concerning, because those levels should not be varying significantly unless your body is really under crisis (which from a ferretin perspective, it is). Meanwhile, high ferretin levels aren’t necesarily going to translate to high Iron levels - those should be pretty stable.
After I donated blood, my Ferretin did take a pretty noticeable drop. However my other markers did not and were pretty stable.
I’m SO glad you posted this, thank you so much! It caused me to go back and dig into this, and I discovered that during the times I was having extremely bad restless legs and other problems, I had actually donated far more often than I was supposed to.
Here’s the Ferretin graph with my donation dates (Red is regular whole blood donation, Black is a double (“power red”) donation)
The minimum for regular donations (according to Red Cross) is 56 days, which is approximately how far apart the three donations on the left are. However, the minimum for double/power red donations is every four months (according to the Red Cross) or even 6 months (according to some other blood donation providers). So, I had actually donated twice as often as I should have (I also donated another regular prior to the double donation at the far left)
I should not have been donating that often (part of the reason is that there are two major Blood Banks where I live, both running donation drives frequently, and keeping the two coordinated is not always the easiest).
Just did another (comprehensive) blood panel, and, like last year, my ferritin levels remain low 6 months after the last donation, and will likely take another 6 months to get back into the normal range.
But this time, all the other iron-related biomarkers are normal (e.g. no elevated free iron). I avoided strenuous exercise for almost a week before the blood draw, perhaps that made a difference?
In any case, I now have fewer reservations about supplementing with iron: I’ll try 25mg iron bisglycinate, and see where that gets me in 6 months…
(I also donated another regular prior to the double donation at the far left)