Each country has an established blood donation system. The system provides the structure and foundation to support a nation’s lifeline. Despite the importance these initiatives hold, people around the world still refuse to donate. A lack of donors has been observed over time for American citizens, demanding an urgent call for donors that have been issued. Approximately 38% of the American population is eligible to donate, although less than 10% of eligible participants actually do (1) (Figure 1). There is an exhaustive list of reasons behind this lack of donors, but it is important to note that advocacy is key. What if more information about donor benefits was emphasized? Would this spark interest in potential donors? Advocating for these benefits could ultimately lead to better patient outcomes (2). One donor can save up to three lives. One benefit they get in return? A decrease in their risk of developing hemochromatosis.

Hemochromatosis is a condition in which the body has too much iron. It can be hereditary or acquired (3). This illness derives from increased iron levels in the liver. It affects critical organs including the liver, pancreas, and heart, as well as the skin and joints (3). Hemochromatosis worsens over time without treatment or therapy, causing the onset of numerous comorbidities such as diabetes, liver cancer, and liver scarring (4). There is no conventional medical therapy to cure hemochromatosis, yet ongoing research suggests that routine blood donations are a promising preventative measure that lowers the chances of getting the illness (5). Regular blood donations help reduce the extra iron in the body, enhancing the long-term health of hemochromatosis patients.

The iron content in the human body is very small, accounting for only 0.008% of our body weight (6). Despite this, iron plays a critical role in our growth and development (7). It is a key ingredient to make the blood that flows through our body, providing oxygen to our organs (7). Unfortunately, iron is not a mineral produced by the human body. It must be obtained from the foods and supplements we consume. The body regulates iron through the use of an in-house protein called ferritin. Ferritin has the ability to store and release iron based on the body’s needs (8). It has a spherical shape with a hollow center. This hollow center is where iron is stored. To release this iron, we have to look into chemical reactions.

Chemical reactions rely on the transfer of electrons between one element to another. Imagine a ball in a cup. The ball is the electron and the cup represents the element that the electron is held by. When the ball is taken from its cup and put into another, a chemical reaction called oxidation takes place. This means that the element loses an electron.

Now ferritin stores iron as a ferric ion with an oxidation state of Fe3+. This oxidation state describes how many electrons have been lost by the element iron (represented by the chemical symbol Fe). Electrons have a negative charge, so removing them makes the ion more positive, thus the “+” sign. The number 3 indicates how many electrons were lost.

The oxidation state comes from the separation of the iron atom from the compound it was in when we consumed it. For example, some iron supplements come in the form of ferric sulfate (Fe2(SO4)3). When processed, the body separates the sulfate through a chemical reaction taking 3 electrons away from the element iron, leaving Fe3+. Keep in mind that iron losing electrons is not the only way it can undergo a chemical reaction. A reaction occurs when it gains electrons as well. So instead of removing the ball from the cup, you add another one. This process is called reduction. Adding one electron makes the ion more negative, so a Fe3+ ion would turn into Fe2+.

In ferritin, Fe3+ is woven within the sphere, while another compound known as mineral ferrihydrite (Fe3+)2O3•12H2O is attached to the exterior of the sphere to assist with chemical neutralization (9). Neutralization is known as a reaction that occurs between an acid and base which results in a non-toxic by-product and water. Now when the body requires iron, it must be reduced from Fe3+ to Fe2+ (10). Once this reduction is completed, the iron is now ready for use in the body.

Patients with hemochromatosis experience this chemical reaction where too much iron is released at excessive rates. This is where donating blood comes to the rescue. With an increase in advocacy for blood donations and the promotion of blood donor benefits, we can come closer to resolving the imbalance of blood supply and demand. Blood donors are vital to achieving this goal. Not only can they save the lives of many, but they can also drastically lower their risk of hemochromatosis or alleviate the symptoms. For more information, including finding local clinics please visit americasblood.org.

This is based on a piece first published on WordPress, February 2021, titled ‘The Benefits of Donating Blood’.

References 

1. STANFORD BLOOD CENTER. Blood Donation Facts & Statistics – Become a Blood Donor [Internet]. STANFORD BLOOD CENTER. no date [cited 2021 Aug 23]. Available from: https://stanfordbloodcenter.org/donate-blood/blood-donation-facts/
2. Colley A. Health benefits of donating blood [Internet]. St. Mary’s Medical Center. 2017 [cited 2021 Feb 21]. Available from: https://www.stmaryskc.com/news/2017/january/health-benefits-of-donating-blood/
3. Fix OK, Kowdley KV. Hereditary hemochromatosis. Minerva Med. 2008 Dec;99(6):605–17.
4. Strohmeyer G, Niederau C, Stremmel W. Survival and causes of death in hemochromatosis. Observations in 163 patients. Ann N Y Acad Sci. 1988;526:245–57.
5. Adams PC, Barton JC. How I treat hemochromatosis. Blood. 2010 Jul 22;116(3):317–25.
6. Sami R, Al-Katib S, Physiology P, Maisem M, Al-Kaabi M, Aseel J, et al. Effect of the relationship between vitamin C and serum ferritin on fertility. 2019 Dec 24; Available from: https://www.researchgate.net/publication/338149484_Effect_of_the_relationship_between_vitamin_C_and_serum_ferritin_on_fertility
7. Abbaspour N, Hurrell R, Kelishadi R. Review on iron and its importance for human health. J Res Med Sci Off J Isfahan Univ Med Sci. 2014 Feb;19(2):164–74.
8. Dunaief D, Cwanger A, Dunaief JL. Chapter 63 – Iron-Induced Retinal Damage. In: Preedy VR, editor. Handbook of Nutrition, Diet and the Eye [Internet]. San Diego: Academic Press; 2014 [cited 2021 Aug 23]. p. 619–26. Available from: https://www.sciencedirect.com/science/article/pii/B9780124017177000630
9. Chemistry LibreTexts. Iron Storage: Ferritin [Internet]. Chemistry LibreTexts. 2018 [cited 2021 Jan 27]. Available from: https://chem.libretexts.org/Courses/Saint_Marys_College_Notre_Dame_IN/CHEM_342%3A_Bio-inorganic_Chemistry/Readings/Metals_in_Biological_Systems_(Saint_Mary’s_College)/Iron_Storage%3A_Ferritin
10. Knovich MA, Storey JA, Coffman LG, Torti SV. Ferritin for the Clinician. Blood Rev. 2009 May;23(3):95–104.