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From: B. Harris)
Subject: Re: Donating blood can reduce heart attack risk (was Re: 
Date: Wed, 10 Sep 1997

In <> (Robert
R. Fenichel) writes:

> (George Conklin) wrote:
>>In article <>,
>>Robert R. Fenichel <> wrote:
>>> If one looks
>>>around the world at the safety and availability of banked blood, the
>>>dominant pattern is that the more donors get for giving (money, time
>>>off work, whatever), the more likely the blood is to be contaminated.
>>>  For more on the relation between motivation and blood quality, the
>>>seminal work was a book by Titmuss called The Gift Relationship.  It
>>>was around in paperback a few years ago.
>>>            Robert R. Fenichel, M.D.

  And that is why, in the case of hemochromatosis, we should be careful
to continue to charge hemochromatosis people for phlebotomy (since they
are being treated for a disease, and are getting something more than
the regular donor), but AFTER the blood is out, then get them to
privately sign a little card, just like any donor, okaying the blood
for either transfusion or not.  And receive NO consideration for that,
either way.  This would continue to preserve the altruistic purity of
the act, and make this blood at least as safe as that gotten from
employees who are paid in "off time" to donate.

   U.S. News had an article on this a week ago.  The Red Cross won't
take hemochromatosis blood because the donation of the blood is not
altuistic.  But that's wrong.  The phlebotomy isn't altruistic, but the
decision to donate the blood that has already been taken, still can be.
Duh.  Some idiot who spoke for the Red Cross suggested that if they
ever do take this blood for transfusion, they'll have to stop charging
for it, because they don't with other donors.  But of course, this
would be exactly the wrong thing to do, because then you WOULD have a
problem.   Sheesh.

                                            Steve Harris, M.D.

From: B. Harris)
Subject: Re: Donating Blood to thin and lower iron
Date: 29 Dec 1998 19:52:36 GMT

In <> (Steven Belknap) writes:

>If blood donation is seen as offering benefits to the donor, then some
>people may donate blood despite having risk factors for infectious
>diseases. The screening tests are good, but not perfect. Blood donation
>should be regarded as an altruistic act. If and when convincing evidence
>accumulates that blood donation provides benefits to the donor, then the
>donor or his insurer should be charged for this benefit.


    Yep.  And if so, he should be charged the same whether that blood
is used for transfusion or not.  And then, after he's paid (and
provided he hasn't confessed to any risk factors) be gently presented
with exactly the same altruistic opportunity that everybody else who
donates is, when they decide to anonymously and privately drop that
card in the slot saying, finally, "USE IT!" or "DON'T USE IT!" in
regard to the blood they just gave.  And get nothing tangible in return
or reward either way.

    The fact that it possible that both things can be done at the same
time (charge the donor for a service, AND present him later ALSO with
the possibility for an altruistic act) seems to have escaped the best
biomedical ethical studies minds of our time.  While meanwhile
hemachromatosis phlebotomy blood, now wasted, would solve the county's
blood problem if only a fraction of these people decided to be
altruistic.  Duh.

    This doesn't make you especially admiring of our univsersity
medical ethics board's combined brain power.  This is the kind of idea
12 year-olds come up with for science fair projects.  Who would choose
to donate, if they were getting therapeutically phlebotomized?  How
would their blood test out compared with the rest of the population who
donates for other reasons?  Available studies I've seen suggest no
particular difference.  Nor do I see a reason why there should be much
of a difference.

   At some point, you have to trust people.  You do it when you go out
on the snowy roads on Dec 23 to try to get those last few Christmas
presents.  If you can routinely put your life in the hands of strangers
for that, why can you not in a far more controlled and contemplative
situation like this?  For a far better cause (saving a life).  Eh?

                                        Steve Harris, M.D.

From: (Steve Harris
Subject: Re: recovery from blood loss
Date: 10 Oct 2003 09:50:12 -0700
Message-ID: <>

"Keith F. Lynch" <> wrote in message

> "Robert A. Fink, M. D." <> wrote:
> > Replacement of two pints of blood, in an otherwise healthy person,
> > should not require more than a couple of days.
> Why does the Red Cross require you to wait eight weeks between
> donations of one pint?
> Could I really donate a pint every day or two, for decades?

Obviously not. It's takes a day or two to replace the salt and water
from donation of 20% of your blood, but it takes a week or two to
replace the proteins, and a month or two to replace the red cells.

Now, the last figure is obviously extremely variable. A young healthy
vitamin and iron replete person with a very low red cell count (giving
them maximum drive for replacement) can make 3% of total red cell mass
a day or more. So in theory you could replace 2 pints (20% of total)
in a week. In practice that doesn't happen because rate goes down as
you get close to being back to normal (it's inverse exponential
because replacement rate is proportional to relative lack), and most
people who lose blood are not maximally healthy and optimally
youthful. So that week stretches quite a lot. The eight weeks of the
red cross gives time for all contingencies.

Beyond that, even an iron replete person (average young man, say) has
only has enough iron stores to replace about half their blood volume,
so if you keep taking blood faster than they can eat iron, they begin
to slow way down in red cell production after they've replaced about
the fifth pint or so. Only iron overloaded folks can keep donating
blood every couple of weeks, after the second or third month.


From: Steve Harris <>
Subject: Re: Why do many vitamin supplements not include iron?
Date: 5 Sep 2005 22:28:08 -0700
Message-ID: <>

lars wrote:

> i am a blood donor,  i donate a  0.5 litre  every 3 months,we get
> erco-fer 60mg  for free,
> but i olnly use it 3 first days after donating.,  and i have no  problem
> with with low hemoglobin,  if hemoglobin drops fast then you are going
> to be tired,   but longterm loss  isnt that evident


What's the point in taking the iron at all, if you only take it for 3

That half liter of blood has 250 mg of iron in it, or so. You MIGHT
absorb as much as 60 mg from your three pills, but probably not that

The reason they make you wait 90 days, is so that know-it-alls like you
who toss their pills, can still absorb the standard 3 mg of iron a day
from the 10 mg in their diet, and not get anemic from their donations.


From: Steve Harris <>
Subject: Re: whole blood or plasma?
Date: 11 Aug 2005 11:48:26 -0700
Message-ID: <> wrote:

> ># why can I donate plasma every six days, rather than every 56 days for
> >whole blood?
> It takes your body only a few hours to replace the plasma.  It takes
> much longer to replace red blood cells.


A few hours to replace the water and salts in the plasma (from the
intersitial fluid and the gut), but they want the plasma for the
proteins in it, and it takes a week at least for the liver to
synthesize those.  Regular plasma donors get a simple pre-test for
protein content before they allow them to donate again. This is
especially important since some some plasma is still bought, and people
with a need for money for drugs or something else pressing, may not
tell the truth about when they last donated. And such people, who can
be malnurished or ill or both, can't always replace plasma proteins as
quickly as a healthy donor.


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