why can’t people with anemia (not enough iron in blood) get blood transfers from donors who have hemochromatosis (too much iron in blood)?
In: Biology
Because anemia is not only ‘not enough iron’, it is a category of conditions that prevent you from getting oxygen where you need it. Oxygen is transported by blood, which requires hemoglobin which involves iron, but there are other types of anemia than just ones that deal with hemoglobin. For example, megaloblastic anemia is where your cells are abnormally large due to a deficiency in B12 or Folic Acid, while Non-Megaloblastic anemia are those that involve impaired DNA synthesis of one or more important substances in the body. If the body is not making what it needs, sometimes it’s not enough to just put good stuff in and hope for the best. Bone marrow transplants are sometimes the treatment of choice for serious Anemia because it aims to fix the root of the problem, because bone marrow is a major source for all cells. Blood transfusion is a temporary solution that doesn’t always work.
TL;DR: Anemia is not as simple as ‘low iron: Put more iron in’, there are a myriad of other factors involved. You can put iron in, but the actual problem that caused the issue needs to be resolved.
Source: Medical Lab Technologist/Biology B.S.
Saw your post earlier and literally just got a real life answer for you.
A friend has hemochromatosis and does “therapeutic blood donation” to manage her levels, so you may be getting it if you require blood transfusions.
Paradoxically, most of us with hemochromatosis can’t donate the blood we need to get pumped out of us every few months to keep our iron in check. My doc explained, even though our blood is very needed and particularly beneficial, there’s really bureaucratic rules that govern donations, so technically hemochromatosis is considered a blood disorder and a disqualifying condition just because it fits under that umbrella. My doc did mention as an aside that if I happen to not mention it, my blood would definitely help people.
Eli why couldn’t the person who has low iron problem eat more food with iron? I mean your body can only absorb nutrients one way
I was diagnosed with hereditary hemochromatosis (HH) at the beginning of the year and have had 12 phlebotomies since then. I’m finding it to be one of the most confusing ailments I’ve come across.
The Red Cross fact is interesting and there must be some difference between them and the blood bank that does my phlebotomies. I was told by an experienced worker that they do them for free with the understanding that they get to use the blood of it meets their other criteria. That must mean there are enough situations where that happens to make it with while. It also must mean that having HH doesn’t automatically exclusive my blood. This is backed by the fact that the release I sign changes after they find out my hemoglobin is too low.
This leads me to the realization that iron in the blood isn’t the same as hemoglobin levels since mine have never been high enough to donate even though my ferritin levels started literally off the chart. How does this work? Apparently there’s something besides those iron levels that cause my hemoglobin to be low, even though my ferritin levels are high.
Important thing others have left out – anemia isn’t only caused by low iron. Sometimes, a B12 deficiency causes low iron absorption (called pernicious anemia) and in that case adding iron will not help. In other cases, it is caused by your body not producing enough red blood cells to carry the iron, which is sickle cell anemia and also cannot be fixed by adding iron. Hemolytic anemia is also an issue with red blood cells, where they are deformed and die quickly. This solution will not help those people
Because the Red Cross doens’t accept blood from people with hemochromatosis, even though it’s mutually beneficial for both the hemochromatic patient (because they need to lose blood) and for the average blood loss patient (because iron rich blood is better for blood loss), because the Red Cross considers certain people icky and having tainted blood, like gay people and convicts, and of course people with hemochromatosis.
I have hemochromatosis, and am type O-. I have no other diseases and am in good health. I am a dream donor. The Red Cross is obsessed with blood purity to a fault and will not allow me to give blood.
Two issues with hemochromatosis:
-Theoretical risk for iron overload in the recipient, especially in those with childhood anemias (ex: sickle cell, PKD, etc).
-Theoretical risk for anaphylaxis.
Both risks are minuscule and you’d be hard pressed to find a hematologist who agrees with this logic, but the counterargument is “why bother risking it unless there’s a major shortage” so that’s where it stands in the US.
Another thing to understand from the iron-deficient patient side is that we avoid giving blood products to these patients because their body will eventually develop antibodies to the donor blood (alloantibodies), making it so they “reject it” with time. So say later on they get in a car accident and need blood more urgently, they now have to wait ~24 hours to find a suitable donor since they have alloantibodies to the majority of donor blood (ex: anti-Duffy). Just a rough example.
People who need a transfusion can get red blood cells from ordinary donors; it is easier to find and doesn’t require match ups. People with an excess do sometimes have supervised blood lettings that may involve donation if they don’t have other problems.
I know my red blood cell count went down very low during chemo, and I wasn’t given a transfusion. Blood transfusions have risks. Before they tested for HIV, hemophiliacs who receive concentrated blood products died in great numbers.
Anemia is not necessarily “not enough iron in the blood.” That can cause anemia, but a better definition would be any condition that causes your blood to not be able to carry oxygen as efficiently. This could be due to not enough iron (as iron is an essential part of hemoglobin, the protein in red blood cells that carries oxygen), but it could also be due to not enough vitamin B12 or folate (which your body uses to help make blood cells), or the red blood cells being the wrong shape (as in sickle-cell disease), or not enough RBCs being produced, or from RBCs being broken down too quickly… basically there are a number of things that can cause anemia, but infusing blood with more iron than normal isn’t going to fix all of them, and in any case the effect would be temporary.
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