Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Clinical Trial
. 2013 Aug;53(8):1637-44.
doi: 10.1111/trf.12061. Epub 2013 Jan 10.

Ascertainment of iron deficiency and depletion in blood donors through screening questions for pica and restless legs syndrome

Affiliations
Clinical Trial

Ascertainment of iron deficiency and depletion in blood donors through screening questions for pica and restless legs syndrome

Barbara J Bryant et al. Transfusion. 2013 Aug.

Abstract

Background: Pica and restless legs syndrome (RLS) are associated with iron depletion and deficiency. The presence of pica and RLS was prospectively assessed in blood donors.

Study design and methods: During a 39-month period, 1236 donors deferred for fingerstick hemoglobin (Hb) level of less than 12.5 g/dL and 400 nondeferred "control" donors underwent health screening and laboratory testing (complete blood count, ferritin, iron, transferrin). Pica and RLS were assessed by direct questioning. Deferred donors and iron-deficient control donors were given 325 mg of ferrous sulfate daily for 60 days. Reassessments were performed and additional iron tablets dispensed at subsequent visits.

Results: Pica was reported in 11% of donors with iron depletion or deficiency, compared with 4% of iron-replete donors (p < 0.0001). Pagophagia (ice pica) was most common and often of extraordinary intensity. Female sex, younger age, and lower mean cell volume and transferrin saturation values were strongly associated with pica. Donors with pica given iron reported a marked reduction in the desire to consume the nonnutritive substance by Days 5 to 8 of therapy, with disappearance of symptoms by Days 10 to 14. RLS was reported in 16% of subjects with iron depletion or deficiency compared with 11% of iron-replete donors (p = 0.012). Iron replacement generally resulted in improvement of RLS symptoms; however, at least 4 to 6 weeks of iron therapy was necessary.

Conclusion: The presence of pica is associated with a high probability of iron depletion or deficiency in blood donors; however, RLS lacks a strong correlation in this population. Screening questions for pagophagia may be useful in the ascertainment of iron deficiency in donors and may identify those who would benefit from oral iron.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None

Comment in

  • Iron and ice.
    Davey RJ. Davey RJ. Transfusion. 2013 Aug;53(8):1623-5. doi: 10.1111/trf.12319. Transfusion. 2013. PMID: 23927636 No abstract available.

References

    1. Parry-Jones B. Pagophagia, or compulsive ice consumption: a historical perspective. Psychol Med. 1992;22:561–571. - PubMed
    1. Andrews N. Iron deficiency and related disorders. In: Greer JP, Foerster J, Rodgers GM, Paraskevos F, Glader B, Archer DA, editors. Wintrobe’s Clinical Hematology. 12. Vol. 1. Lippincott Williams; 2008.
    1. Ferguson JV. Pica: a clue to iron deficiency anemia. J Tenn Med Assoc. 1989;82:187–188. - PubMed
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4. Washington, DC: American Psychiatric Association; 2000. Text Revision.
    1. Hening WA. Subjective and objective criteria in the diagnosis of the restless legs syndrome. Sleep Med. 2004;5:285–292. - PubMed

Publication types

MeSH terms