Guyana
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Blood is vital for life

WORLD Blood Donor Day will be celebrated on June 14, 2022, where voluntary blood donation to save lives is lauded and campaigns are activated to enhance public awareness on the importance of a steady supply of this vital commodity in health systems.

Although donors are not gender-specific, men can donate blood more frequently than women (every 12 weeks versus 16 weeks) due to the differences in their reproductive functions. Also, it was noted that there are less antibodies in men’s blood, making it easier to utilise the blood products such as plasma and platelets.

The composition of blood is 55 percent plasma, 45 percent red blood cells and less than1percent white blood cells and platelets. Red blood cells, white blood cells and platelets are generated by the bone marrow.
The red blood cells use iron to make a type of protein called hemoglobin, which binds to oxygen to form oxyhemoglobin. This is the transportation mechanism for supplying oxygen to individual cells in the body tissues for energy production. So when low levels of oxygen is detected in the body or there is some bleed (internal or external), new blood cells are generated by a mechanism regulated by the kidney.

A hormone called erythropoietin produced by the kidney then stimulates the bone marrow to either manufacture red blood cells or platelets, depending on if there is a reduction in oxygen levels or a hemorrhage.
There are certain categories of persons who may need to build up their Hb (hemoglobin) or “blood count” such as pregnant mothers, anemic persons, leukemia, kidney disease and cancer patients. Trauma cases such as accident victims and those undergoing surgical procedures are two of the established routine categories who will need blood.

Additional categories of persons who may require blood are those with bleeding because of heavy menstrual flow due to fibroids or GI (gastrointestinal) tract diseases such as ulcers, inflammatory bowel disease, melena or celiac disease or sometimes urinary tract bleeding also.

The body’s inability to absorb iron may also cause a deficiency in blood count such as a rare genetic disorder, endurance sports which cause iron loss through their GI tract, ulcerative colitis or Crohn’s disease, autoimmune diseases and hereditary blood disorders.

The normal range for Hb for women is 11.6 -15.0 grams per deciliter and for men is 13.2 to 16.6 grams per deciliter. Older adults may have a lower Hb due to improper nutrition or side effect from some medications but generally aging is not associated with a lower blood count.

The signs that indicate when your Hb is low are tiredness or fatigue, pale appearance, difficulty breathing, chest pain, fast heart rate, dizziness, headache, feeling cold especially in extremities (hands and feet), infections, craving for ice and restless legs.

It is recommended that oral iron supplements such as ferrous sulphate tablets or iron tonics be used to combat this problem. There are numerous brands comprising of varying strengths and rates of absorption. The price range varies depending on the quality of the product, country of origin and endorsement of the product.

The best times to take an iron supplement is one hour before a meal or two hours after a meal. It is best absorbed when taken with water and or juice. Tannins, a chemical present in tea and coffee would chelate or bind to the iron, thus not making you get the strength of the formulation.

Some transient side effects of iron are constipation and GI events such as nausea, vomiting and diarrhea.
For cases where there is severe blood loss and a need for a rapid response, parenteral forms of iron namely iron dextran, iron sucrose, sodium ferric gluconate and ferumoxytol would be prescribed by a doctor and administered in an in-patient setting, either intravenously or intramuscularly by a technically trained professional.

Also for patients with chronic kidney failure, synthetic erythropoietin (EPO) injectable may be administered, which is the precursor hormone to red blood cell production. Some of the parenteral formulations are used concurrently with the EPO injections since the increase red blood cell production demands more iron in the blood.

However for slower maintenance levels of iron in the blood, natural sources of iron rich foods are green leafy vegetables such as callaloo, kale, lean meat and poultry, salmon and sea foods, tofu, kidney beans, lentils and peas, nuts, dried fruits and baked potatoes. Some iron-fortified bread and cereals also provide a good source of the elemental iron.

For further pharmacological guidance, contact the pharmacist of Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.