Iron supplementation in healthy blood donors to reduce donor deferral, iron deficiency and/or anaemia is a matter of debate. Blood donation inevitably results in the loss of about 250 mg of iron. If this iron is not replaced, blood donors may become iron deficient or develop iron-deficiency anaemia potentially resulting in donor deferral at the next blood donation. Therefore, compensation of iron deficiency is of utmost importance for blood donation services.

The authors of this Cochrane review conducted a web-based search and identified 30 randomised controlled trials including 19 comparisons of iron supplementation and placebo or control, one comparison of oral and parenteral iron supplementation, four comparisons of different doses of iron supplementation, one comparison of different treatment durations of iron supplementation, and 12 comparisons of different iron supplementation preparations.

There was moderate-quality evidence that iron supplementation had a substantial effect on reducing the risk of low-haemoglobin deferral, but a significant proportion of donors taking iron experienced side effects. Possible courses for future action by blood donation services would be the targeted use of iron supplementation at individuals at greater risk of iron deficiency, stratified or personalised donation intervals and/or dietary advice.

– Rainer Moog

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