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The doctor is concerned about possible masking of anemia from donations vs occult GI bleeding.
Thanks so much for the detailed reply!
Quote:
Originally Posted by Travelassie
Not to mentioned trying to force you to eat liver while you're sleeping would make you choke on it.
Hard to say if the iron ( especially low dose iron?) itself was able to raise your hemoglobin by two grams within a month, as Medical Lab Guy alluded to it's a multivariable system with lots of players in the mix.
Hope that helps.
Well I'm not sure if it was low dose, I don't know why I typed that. I've been taking over the counter iron 65 mg (325 mg Ferrous Sulfate).
Thanks to you and Medical Lab Guy for the detailed answers!!
I have been donating blood every 6 to 8 weeks for years now, maybe this was the first time I've had blood tests within a week of donating?
Well I'm not sure if it was low dose, I don't know why I typed that. I've been taking over the counter iron 65 mg (325 mg Ferrous Sulfate).
Thanks to you and Medical Lab Guy for the detailed answers!!
I have been donating blood every 6 to 8 weeks for years now, maybe this was the first time I've had blood tests within a week of donating?
I think that's the standard iron tablet dosage- don't think it's all that low, but it can be a trick getting it absorbed in the GI tract, depending on the person, when the iron is taken, with/without food. I've been taking a combination vitamin C/iron tablet- same 65 mg iron as yours, with vitamin C to enhance absorption of the iron. This has been at the instruction of my oncologist, my hemoglobin isn't currently too bad, though they check iron studies too and I am still somewhat iron deficient it seems.
You know, I guess it wouldn't be a surprise to find you're at least somewhat anemic if your hemoglobin is checked soon after a blood donation. They say you replace the liquid volume of your blood first, followed
by the cellular portion ( including the red cells). I'd guess if you're donating blood every 8 weeks, maybe your red blood cell making apparatus is struggling to keep up with the blood loss during the donations for some reason, and maybe it wouldn't be a bad idea to dial the frequency back a bit? Though I know they check the hemoglobin or hematocrit each time before you donate and if your hemoglobin/'crit levels aren't high enough they will defer the donation. Used to happen to me quite often back in the day when I donated blood, then it got to where my hemoglobin/'crit levels were never high enough so I stopped trying.
Maybe taking that iron for a month was enough to raise your hemoglobin by 2 grams, if you're not actively bleeding and it's between your blood donations. You'd know for sure, I think, with a repeat CBC. I can tell you from sad experience that if you're actively bleeding, your hemoglobin/hematocrit probably wouldn't rise that much in such a short time. In any case, if there's any question at all about your possibly bleeding from a source you can't identify, doing an occult blood test would be a good idea, IMO. You can go from there.
...I'd guess if you're donating blood every 8 weeks, maybe your red blood cell making apparatus is struggling to keep up with the blood loss during the donations for some reason, and maybe it wouldn't be a bad idea to dial the frequency back a bit? Though I know they check the hemoglobin or hematocrit each time before you donate and if your hemoglobin/'crit levels aren't high enough they will defer the donation. Used to happen to me quite often back in the day when I donated blood, then it got to where my hemoglobin/'crit levels were never high enough so I stopped trying.
That's what the PCP said to me also.
Another thing that happened when I donated blood on 1/15 was it took forever to finish donating the pint. They even said they could not use the plasma since it took over a certain time frame, maybe 15 minutes? This has never happened to me before, usually I fill the pint bag up quickly. But I am getting old (68 ) so maybe my blood donating days are sadly coming to an end?
A qtr lb of liver has only 5.5mg of Fe-- There is no GOOD dietary source of Fe once you become Fe-deficient... and if your Fe levels are normal, then just eating meat on a regular basis is enough to keep you normal until you have some unusual blood loss.
Donating blood every 6 weeks is a real tax on your bone marrow, particularly as you age....An occasional blood donation shouldn't deplete total Fe stores in your marrow enough that you need to take an Fe supplement. Repeated donations may have depleted your stores....
..but we can't be sure that your low Fe is not also due to occult GI bleeding. Theoretically, a colonoscopy within the last five years should exclude colon ca as a source of blood loss-- but not new diverticulosis, or benign polyps...and we still know nothing about the upper GI-- peptic or cancerous ulcers or new esophageal problems...How sure do we need to be?
A qtr lb of liver has only 5.5mg of Fe-- There is no GOOD dietary source of Fe once you become Fe-deficient... and if your Fe levels are normal, then just eating meat on a regular basis is enough to keep you normal until you have some unusual blood loss.
Donating blood every 6 weeks is a real tax on your bone marrow, particularly as you age....An occasional blood donation shouldn't deplete total Fe stores in your marrow enough that you need to take an Fe supplement. Repeated donations may have depleted your stores....
..but we can't be sure that your low Fe is not also due to occult GI bleeding. Theoretically, a colonoscopy within the last five years should exclude colon ca as a source of blood loss-- but not new diverticulosis, or benign polyps...and we still know nothing about the upper GI-- peptic or cancerous ulcers or new esophageal problems...How sure do we need to be?
True enough, though clear colonoscopies within the previous five years does not always exclude the presence of colon cancer...ask me how I know.. But I'm thinking that's where paying attention to possible symptoms ( ( though they tend to be very general, so it's hard) comes into play,,much easier to consider in hindsight ( oops, pardon the pun). If the blood loss is less dramatic or seems to stop, ( ie, the hemoglobin levels rise in response to iron therapy, for instance), I'd say the other conditions you mention might be considered based on the patient's symptoms, other physical findings or risks for those conditions.
Another thing that happened when I donated blood on 1/15 was it took forever to finish donating the pint. They even said they could not use the plasma since it took over a certain time frame, maybe 15 minutes? This has never happened to me before, usually I fill the pint bag up quickly. But I am getting old (68 ) so maybe my blood donating days are sadly coming to an end?
Yeah, I'm betting you've done your share of blood donations throughout the years, accumulated a number of those "Golden Gallon" certificates ( isn't that what they call them?) and it might be time to cut back the blood donations and let your hematopoeitic systems take care of you, with occasional donations as you can. I just looked it up, there's no maximum age for donation, as always, it's a matter of donor being healthy enough to donate, with any other reasons for deferral considered as they are in younger people.
As for the slow filling of the blood bag, perhaps your blood pressure could have been a bit low that day? Or it's also possible the placement of the needle in your arm wasn't optimum, ie, the bevel of the needle ( the end where the opening is) possibly not in the middle of the vein, but resting against the wall of the vein. This would likely partially occlude the needle opening and slow down the flow of the blood into the needle and tubing, and the blood unit. The turbulance caused by partial obstruction like that will activate the clotting factors in the plasma, could result in small clots or fibrin formation in the blood. Might even cause some of the red blood cells to rupture, releasing their contents into the plasma. Did you end up with a hematoma, or extensive bruising at the venipuncture site that day?
Yeah, I'm betting you've done your share of blood donations throughout the years, accumulated a number of those "Golden Gallon" certificates ( isn't that what they call them?) and it might be time to cut back the blood donations and let your hematopoeitic systems take care of you, with occasional donations as you can. I just looked it up, there's no maximum age for donation, as always, it's a matter of donor being healthy enough to donate, with any other reasons for deferral considered as they are in younger people.
As for the slow filling of the blood bag, perhaps your blood pressure could have been a bit low that day? Or it's also possible the placement of the needle in your arm wasn't optimum, ie, the bevel of the needle ( the end where the opening is) possibly not in the middle of the vein, but resting against the wall of the vein. This would likely partially occlude the needle opening and slow down the flow of the blood into the needle and tubing, and the blood unit. The turbulance caused by partial obstruction like that will activate the clotting factors in the plasma, could result in small clots or fibrin formation in the blood. Might even cause some of the red blood cells to rupture, releasing their contents into the plasma. Did you end up with a hematoma, or extensive bruising at the venipuncture site that day?
Now that I am thinking about it, the woman who originally placed the needle into my arm needed to get help from someone else because the blood did not immediately start flowing. The other woman there had to "jiggle" the needle before the blood came out. I don't know the proper terms. My blood pressure was 123/63 when they took it, that's a low reading for me. I usually get a bruise anytime I donate or get blood taken for a test and this bruise was no bigger than normal. The second nurse said I'd get a hematoma so I guess she knew that the needle wasn't placed correctly at first.
Sorry to Don in Austin for taking over your thread, in hindsight I should have started a new thread.
Now that I am thinking about it, the woman who originally placed the needle into my arm needed to get help from someone else because the blood did not immediately start flowing. The other woman there had to "jiggle" the needle before the blood came out. I don't know the proper terms. My blood pressure was 123/63 when they took it, that's a low reading for me. I usually get a bruise anytime I donate or get blood taken for a test and this bruise was no bigger than normal. The second nurse said I'd get a hematoma so I guess she knew that the needle wasn't placed correctly at first.
Sorry to Don in Austin for taking over your thread, in hindsight I should have started a new thread.
That's OK. I seem to be good and on the home stretch.
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) so maybe my blood donating days are sadly coming to an end?
But I'm thinking that's where paying attention to possible symptoms ( ( though they tend to be very general, so it's hard) comes into play,,much easier to consider in hindsight ( oops, pardon the pun). If the blood loss is less dramatic or seems to stop, ( ie, the hemoglobin levels rise in response to iron therapy, for instance), I'd say the other conditions you mention might be considered based on the patient's symptoms, other physical findings or risks for those conditions.
