Oral Iron Supplementation After Blood Donation

Kiss, Joseph E.; Brambilla, Donald; Glynn, Simone A.; Mast, Alan E.; Spencer, Bryan R.; Stone, Mars; Kleinman, Steven; Cable, Ritchard G.

doi:10.1001/jama.2015.119

Cited by 142 publications

(180 citation statements)

References 20 publications

(22 reference statements)

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“…5 An eligible participant was a volunteer, repeat blood donor ≥18 years who successfully donated a whole blood unit on the day of enrollment, but not in the prior 4 months. Participants agreed not to use iron supplements outside of the study.…”

Section: Methodsmentioning

confidence: 99%

“…3,4 Our group has recently documented that use of daily iron supplements is necessary for efficient recovery of donor hemoglobin and iron to support blood donation. 5 To date studies have separately assessed the effect of blood donation on iron stores, as assessed by serum or plasma ferritin, and hemoglobin, as assessed by venous hemoglobin concentrations. In order to more fully understand the dynamics of iron balance into and out of the body, however, it is necessary to assess these two major iron compartments together.…”

Section: Introductionmentioning

confidence: 99%

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Effect of iron supplementation on iron stores and total body iron after whole blood donation

Cable

Brambilla²,

Glynn

et al. 2016

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Background Understanding the effect of blood donation and iron supplementation on iron balance will inform strategies to manage donor iron status Study Design and Methods 215 donors were randomized to receive ferrous gluconate daily (37.5 mg iron) or no iron for 24 weeks after blood donation. Iron stores were assessed using ferritin and soluble Transferrin Receptor. Hemoglobin iron was calculated from total body hemoglobin. Total Body Iron (TBI) was estimated by summing iron stores and hemoglobin iron. Results At 24 weeks, TBI in donors taking iron increased by 281.0 mg (95% Confidence Interval [CI]: 223.4, 338.6) compared to pre-donation, while TBI in donors not on iron decreased by 74.1 mg (CI: −112.3, −35.9), p<0.0001, iron vs. no iron. TBI increased rapidly following blood donation with iron supplementation, especially in iron depleted donors. Supplementation increased TBI compared to controls during the first 8 weeks after donation: 367.8 mg (CI: 293.5, 442.1) versus −24.1 mg (CI: −82.5, 34.3) for donors with baseline ferritin ≤26 ng/mL; and 167.8 mg (95%CI: 116.5, 219.2) versus −68.1 mg (CI: −136.7, 0.5) for donors with baseline ferritin >26 ng/mL. 88% of the benefit of iron supplementation occurred during the first 8 weeks after blood donation. Conclusion Donors on iron supplementation replaced donated iron while donors not on iron did not. Eight weeks of iron supplementation provided nearly all of the measured improvement in TBI. Daily iron supplementation after blood donation allows blood donors to recover the iron loss from blood donation and prevents sustained iron deficiency.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of iron supplementation on iron stores and total body iron after whole blood donation

Cable

Brambilla²,

Glynn

et al. 2016

Transfusion

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“…35 Anemic patients with malabsorption, Helicobacter pylori infection, atrophic gastritis, previous gastric or duodenal surgery, genetic IRIDA, as well as patients with elevated hepcidin levels driven by inflammation, do not respond or only partially respond to oral iron treatment. The use of oral iron is controversial in active inflammatory bowel disease.…”

Section: Oral Iron Supplementationmentioning

confidence: 99%

Iron deficiency: new insights into diagnosis and treatment

2015

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Iron deficiency and iron deficiency anemia are common conditions worldwide affecting especially children and young women. In developing countries, iron deficiency is caused by poor iron intake and/or parasitic infection, whereas vegetarian dietary choices, poor iron absorption, and chronic blood loss are common causes in high-income countries. Erythropoiesis stimulating agents can result in functional iron deficiency for erythropoiesis even when stores are iron-replete. Diagnosis of iron deficiency is straightforward, except when it occurs in the context of inflammatory disorders. Oral iron salts correct absolute iron deficiency in most patients, because low hepcidin levels facilitate iron absorption. Unfortunately frequent side effects limit oral iron efficacy. Intravenous iron is increasingly utilized, because currently available preparations allow rapid normalization of total body iron even with a single infusion and are effective also in functional iron deficiency and in iron deficiency associated with inflammatory disorders. The evidence is accumulating that these preparations are safe and effective. However, long-term safety issues of high doses of iron need to be further explored. Learning Objectives• To diagnose absolute iron deficiency, iron deficiency anemia, and functional iron deficiency in the light of recent advances in iron metabolism • To evaluate advantages and disadvantages of oral and intravenous iron therapy

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“…But some contradictory studies are also documented as in one experiment; AgNPs were injected in group of mice for 28 days and any mutation on the cells of bone were investigated by hematological studies and no significant damage to the blood cells were documented (126). Similarly, nanoparticles were administered in mice by inhalation for twenty eight days and no significant change in blood chemistry was reported (127).…”

Section: Special Case: Ionization Of Silvermentioning

confidence: 99%

Nanotoxicity of Inert Materials: The Case of Gold, Silver and Iron

et al. 2016

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-Nanotechnology has opened a new horizon of research in various fields including applied physics, chemistry, electronics, optics, robotics, biotechnology and medicine. In the biomedical field, nanomaterials have shown remarkable potential as theranostic agents. Materials which are considered inert are often used in nanomedicine owning to their nontoxic profile. At nanoscale, these inert materials have shown unique properties that differ from bulk and dissolved counterparts. In the case of metals, this unique behavior not only imparts paramount advantages but also confers toxicity due to their unwanted interaction with different cellular processes. In the literature, the toxicity of nanoparticles made from inert materials has been investigated and many of these have revealed toxic potential under specific conditions. The surge to understand underlying mechanism of toxicity has increased and different means have been employed to overcome toxicity problems associated with these agents. In this review, we have focused nanoparticles of three inert metallic materials i.e. gold, silver and iron as these are regarded as biologically inert in the bulk and dissolved form. These materials have gained wider research interest and studies indicating the toxicity of these materials are also emerging. Oxidative stress, physical binding and interference with intracellular signaling are the major role player in nanotoxicity and their predominance is highly dependent upon size, surface coating and administered dose of nanoparticles. Current strategies to overcome toxicity have also been reviewed in the light of recent literature. The authors also suggested that uniform testing standards and well-designed studies are needed to evaluate nanotoxicity of these materials that are otherwise considered as inert.

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Oral Iron Supplementation After Blood Donation

Cited by 142 publications

References 20 publications

Effect of iron supplementation on iron stores and total body iron after whole blood donation

Effect of iron supplementation on iron stores and total body iron after whole blood donation

Iron deficiency: new insights into diagnosis and treatment

Nanotoxicity of Inert Materials: The Case of Gold, Silver and Iron

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