Dear valued Blood donor,

Your health and wellbeing is important to us. The South African National Blood Service checks your haemoglobin before each blood donation. Haemoglobin is a protein in your body that contains iron and carries oxygen to different tissues in your body. A haemoglobin test is conducted prior to each blood donation to determine if it is safe for you to donate. If your haemoglobin is too low we will advise you to not donate until the haemoglobin has improved.

When you donate blood, you give away iron.  Iron is a major constituent of haemoglobin. Your body needs iron for various metabolic processes, including production of new blood cells.

We encourage all blood donors to learn how to maintain healthy iron levels.

Frequently Asked Questions about Iron, Ferritin test and Blood Donation

• How does blood donation affect my iron? – Donating a unit of whole blood leads to loss of 200 – 250 mg of iron.

• Can giving blood cause iron deficiency or anaemia? – If you lose iron faster than you replace it, you can develop iron deficiency. Uncorrected, iron deficiency can lead to anaemia. Many donors have sufficient iron to donate blood safely, however, pre-existing low iron status and frequent blood donation can lead to low iron.

• How might low iron levels affect me? – Many individuals with low iron do not have symptoms. Symptoms can vary from mild to severe and include tiredness, weakness, dizziness, sores on tongue, poor concentration.

• How can I maintain healthy iron levels? – Ensure that you eat a well-balanced, nutritious diet rich in iron and vitamin C. However, diet alone may not be sufficient to replenish iron you routinely lose through whole blood donation. The SANBS recommends that individuals aged 16 – 45 years who donate whole blood take iron supplements offered after donation.

• I am above the age of 45 years can I take iron tablets? – The SANBS recommends that individuals above the age of 45 years consult their Medical Practitioner to find out if taking iron supplements is right for them.  The reason is that taking iron tablets can often mask conditions that would present through low iron, examples include colon cancer. Therefore, a Medical Practitioner can exclude these conditions prior to issuing iron tablets.

• Why should I take iron tablets? – The time it takes to replace iron through diet varies. For some donors it may take longer than 12 weeks between donations. Iron tablets assist to speed up recovery of iron lost through blood donation.

• My haemoglobin is normal do I still need to take iron tablets? – Your body uses haemoglobin to make new red blood cells.  You can have normal haemoglobin even though your  iron stores (ferritin levels) have dropped. Taking iron supplements assists your body to recover the iron you lose when you donate a unit of whole blood and to maintain good health. However, if your ferritin levels are above 100 mcg/L you do not need to take iron tablets.

• Can I give blood while taking iron tablets? – You can donate blood while taking iron tablets for supplementation purposes. However, you cannot donate blood while taking iron tablets to treat low iron i.e. you cannot donate blood if you are taking iron tablets prescribed by a Doctor to treat iron deficiency or anaemia.

• How do I take my iron tablets?
• If you are receiving iron tablets offered by SANBS post donation, we advise that you take one tablet every second day, preferably at bedtime.
• Taking the tablets on alternate days has been found to improve iron absorption. While taking the tablets at bedtime has been proven to reduce side effects.
• Alternatively, you can take one tablet daily.
• Avoid taking iron tablets with black tea, coffee, breakfast cereals or calcium rich foods as these interfere with iron absorption.

• How can I assist my body to absorb iron tablets? – Eating fruits and vegetables rich in vitamin C enhances iron absorption by as much as 20 times. Examples include oranges, kiwi fruit, melons and lemons.

• Can iron tablets cause side effects? – Iron supplements can cause side effects described on the package insert. The side effects can include constipation, diarrhoea or an upset stomach. However, iron tablets offered by SANBS post donation contain low dosage iron and have been found to cause minimal side effects, when taken as recommended.

• Are there any contraindications to iron tablets?
• Individuals diagnosed with high iron, for example, haemochromatosis, hemosiderosis should not take iron tablets.
• Individuals with disturbances in iron metabolism for example thalassaemia, sideroblastic anaemia should not take iron tablets.
• Individuals with hypersensitivity to iron should not take iron tablets.
• Individuals with history of bleeding stomach ulcers or family history of colon cancer should consult their Medical Practitioner before taking iron tablets as iron tablets can mask an underlying condition that could otherwise be diagnosed through low haemoglobin.

• Can iron tablets be harmful? – Iron tablets are not usually harmful to adults when taken as directed. Accidental ingestion by children can be dangerous. You should keep all iron containing products out of reach of children.

• What is a ferritin test? – Ferritin is a test for iron. It is used to measure the amount of iron stored in the body.  When a person comes to donate blood, they normally get tested for haemoglobin.  Haemoglobin measures the amount of red blood cells circulating in the blood. The red blood cells contain iron.

• What is the difference between a haemoglobin and ferritin test? – Haemoglobin provides an indication of the amount of iron circulating in the blood, while ferritin provides an indication of the amount of iron stored in the body. Ferritin provides a more accurate indication of the amount of iron in your body, because it is used to measure iron which is stored in the body. Ferritin is used to check whether a person has normal iron stores, low iron stores (Iron deficiency) or abnormally high iron stores (Iron overload). Blood services across the world are starting to introduce routine ferritin testing in addition to haemoglobin testing and SANBS is doing the same.
• Ferritin testing for blood donors – The SANBS has introduced a ferritin test for whole blood donors. The test is conducted following donation of a unit of whole blood to determine your iron stores. The test is conducted at different times depending on your last ferritin test results.
• How can I know my ferritin test results? – You will be notified of abnormal ferritin test results via a WRAP message which is a message sent to your cell phone via an SMS link. Abnormal results are results which are either below the normal ferritin test cut-off level or above the cut-off level. You will also be advised on action to take with regard to these abnormal results.
• My haemoglobin was normal, does this mean that I have normal ferritin as well? – A normal haemoglobin does not always imply that the ferritin (iron stores) is normal. It is possible to have normal haemoglobin even though your iron stores (ferritin) are low or high. This is the reason that SANBS has introduced a ferritin test, to assist us to more accurately determine if your iron stores are adequate, low or high. This information helps us to advise you accordingly, so that you can maintain healthy iron levels.
• If you have any questions on the above, please contact our Customer service department on 0800 119 031.

We look forward to assisting you improve your iron levels!