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. 2021 Jan;61(1):124-133.
doi: 10.1111/trf.16095. Epub 2020 Sep 24.

Iron status and self-reported fatigue in blood donors

Bryan R Spencer  1 , Matthew P Fox  2   3 , Lauren A Wise  2 , Ritchard G Cable  1 , Alan E Mast  4   5
Affiliations

Iron status and self-reported fatigue in blood donors

Bryan R Spencer et al. Transfusion. 2021 Jan.

Abstract

Fatigue is a reported symptom of iron depletion, but studies in blood donors show no conclusive link. We conducted an observational analysis of data from the STRIDE randomized trial to evaluate association of iron status with self-reported fatigue.

Study design and methods: Three blood centers randomly assigned 692 frequent donors to education or iron supplementation treatments. Biomarkers for iron status were measured during 20 to 24 months of follow-up. A fatigue score was derived from an 11-item questionnaire at baseline and final visits, and associations between iron status and fatigue were assessed.

Results: Final lab and questionnaire data were evaluable from 337 subjects. At baseline, female sex, older age, and anemia were associated with fatigue, but iron status was not. Mean (±SD) fatigue score change was 0.0 (±0.5). Mean (±SD) increase in iron stores was 1.0 (±3.5) mg/kg, but changes in body iron stores were not associated with fatigue score changes (0.01 per mg/kg; 95% CI, -0.01 to 0.02) or with fatigue (RR, 1.01; 95% CI, 0.99 to 1.04). The only factor associated with fatigue score changes was baseline fatigue (0.36; 95% CI, 0.25 to 0.48).

Conclusion: Among high-frequency donors, neither iron status at baseline nor changes in iron status predicted fatigue during follow-up, with improvements limited to those with higher levels of baseline fatigue. Assessment of the association between iron and fatigue in blood donors benefits from careful consideration of study design and the study population.

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Figures

FIGURE 1
FIGURE 1
Distribution of mean fatigue score at enrollment by sex. Fatigue score of less than 3.1 corresponds to approximately the lower quartile of the distribution for all subjects
FIGURE 2
FIGURE 2
Changes in mean fatigue score and in body iron stores between enrollment and final study visits
See this image and copyright information in PMC

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