blood donation

byron27

This morning i read a report in my local paper about the local blood supply being quite low and would like to help out. I used to give blood about 10 years on a regular basis but i seemed to always get cold sores and feel weak for a couple of days after giving blood. My diet has improved since those days though now i am training twice a day and would really like to get some information, factual or circumstantial, about the effect on training after giving blood.

patch70

This is from Velonews:
http://www.velonews.com/train/articles/5265.0.html

When you give blood, about 450cc of whole blood is taken. As points of reference, a typical bike water bottle holds 600cc and a can of Coke contains 355 cc. Your 450cc donation represents about 10 percent of all the blood in you at any one time, so it's not a lot but it's not a little either. I've had riders worry about giving even two or three small blood tubes for UCI testing!

You can expect this donation to lower your hematocrit by about three percentage points. As you probably know, hematocrit is the measurement of the volume of your blood taken up by the red blood cells. The rest of the space is taken up by plasma, white blood cells, platelets, clotting factors and other miscellaneous molecules.

In the best study I found on this topic, a group of researchers took 10 male "amateur competitive cyclists" and measured heart rate (HR), VO2max, power output (in watts), and ventilatory threshold (VTh) during a standardized incremental exercise study. They tested each cyclist at four time points relating to a blood donation: One week before; two hours after; two days after, and seven days after. These researchers found that at maximal efforts all performance measurements were adversely affected at all three post-donation time points. For example, at the two hours and the two days testing, VO2max was down about eight percent. Even at seven days post-donation, the average VO2max was only improved to about seven percent down from pre-donation baseline testing. It's too bad they didn't test at subsequent 1-week intervals, but it's reasonable to speculate that a complete return to baseline might take as much as three to four weeks, or even a bit longer.

This research also demonstrated another important by showing that all submaximal measurements we not affected by the blood donation. Performance was only hurt at maximal effort. That's interesting because most of us, and even pros for that matter, spend the vast majority of our training time in submaximal zones.

So here's what I'd advise to different groups of cyclists:

Elite amateur and professional: Do not give blood. The detriment to performance is too great. Even during the off-season, you don't need this. As well an out-of-competition blood test would certainly turn up suspicious results due to alterations of serum EPO levels and reticulocyte counts. You really don't need this.
Competitive amateur: Off-season blood donations would be fine. I've long had a somewhat New Age theory that it would be good to donate blood because it would create sort of a cleansing turnover effect. I've seen nothing scientific written to support this idea.
Serious recreational: There is no reason that I can see not to donate blood on a regular basis. Blood centers advise every eight weeks maximum. Giving blood every 12 weeks might be more reasonable for this group.
Casual: Get out there and give every eight weeks to help make up for the fanatic riders described above!
General advice about the actual blood donation:


On the day before, do whatever you want. I usually time a donation to fall the day after a fairly hard series of workouts.
Don't do any workout the day of the donation.
An easy spin the day after should be fine and perhaps beneficial.
Hydrate well the day before, the day of and days following your donation.
Regular blood donors (more than two to three times a year) need regular ron supplementation. I recommend a daily multivitamin with iron plus an iron supplement. I use iron sulfate 140mg (28mg of elemental iron) three days a week. Also consider a nice steak dinner the day of or after the donation.
I found nothing that relates practically or theoretically to your question about a "super-compensation" effect. I can't think how or why that would occur and I'm fairly certain that it doesn't.

Finally, apheresis (aka, pheresis) refers to the taking of only certain parts out of the whole blood and returning the rest to the donor. The big three "pheresises" are plasmapheresis (only the plasma is kept), pateletpheresis (plateletes), and leukophoresis (white blood cells). Since athletic performance is all about the red blood cells, this is a great option for you and any athlete. The most common seems to be plateletpharesis as their is a great need for platelets to be transfused to cancer patients on chemotherapy. While there are medications to stimulate red and white blood cell production in these patients, there is nothing to replace the platelets which are needed to prevent serious bleeding episodes such as a brain hemhorrhage. Plateletpheresis takes about two hours compared to the hour or so for a traditional blood donation. My local blood center here in San Francisco has special "e-chairs" (yes, internet connection and DVDs) for platelet donors.

So thanks a million for you question. I hope I've answered your questions and that you and many others will pursue this very important option. They don't call blood donation "the gift of life" for nothing.

For more information and to find your local blood center, go to www.bloodcenters.org or www.americasblood.org/.
Prentice

Dear Doctor;
I was recently diagnosed with oral herpes and am now dealing with my first bout of the virus. From what I've read, it seems like stress and sun can trigger recurrences. As a road cyclist living and training at high altitude (in a state where it's almost always sunny), will the physical stress of long rides and the overbearing sun doom me for frequent cold sores?

Do you have any suggestions to repress future outbreaks for someone in this kind of situation?
Thanks,
EH
Summit County, Colorado

Dear EH;
Thanks for your question. It's a really good one as it both affects and confuses many people. Oral herpes (aka, herpes labialis, cold sores, fever blisters) is a skin infection of the mouth and lips caused by the herpes simplex virus. This is quite similar to but a little different from genital herpes (aka, herpes genitalis), which is a skin infection of the genitals caused by the herpes simplex virus.

Most of the confusion about the two is because of the similarity of the terminology, plus the fact that the two viruses, while happiest in their body region of choice, can in fact infect their cousin's usual domain.

Once exposed to the oral herpes virus, there may be no symptoms at the time of exposure or ever. Most people in fact are exposed by the age of 20 and never show symptoms. The virus simply lies dormant in the nerves of the face. If symptoms do occur, they do so usually within one to two weeks of the initial exposure. The characteristic blister lasts usually a week or so.

Prevention is important because oral herpes is contagious. Kissing and oral sex are bad ideas during an outbreak. Also sharing of eating utensils, towels and other personal items is discouraged. Realize also that, like with genital herpes, there is a phase when the virus can be spread even when there are no blisters apparent. This is early in the course of the outbreak when the virus has migrated from the nerve to the skin surface but before the blister forms.

Treatment includes oral anti-viral medicines to shorten the duration and severity of the outbreak. This is usually not necessary due to expense and possibility of side effects and is probably only a good idea for severe or frequent cases. Acyclovir ointment is an option that may be worth a try.

There are only two critical oral herpes related issues that I should mention for completeness. This first is that if the virus gets into or around the eye, an extremely serious infection possibly ending in blindness can result. See an ophthalmologist or emergency physician immediately if you think this may be occurring. The second is that people who have weakened immune systems (e.g., HIV, cancer, infants) are susceptible to having the virus spread into their blood and/or nervous system. This can be deadly.

Triggers for a recurrence of oral herpes include sun exposure, stress, menstruation, illnesses with fever, and other unknown causes. So while it's true that you are at risk of recurrences because of your geographic and lifestyle choices, it's way to early to say that you're "doomed" to a life of hideous disfigurement and social isolation. With time you may find that you have no or very infrequent recurrences. There's no way to predict at this point. In the meantime I'd recommend a high SPF lip balm. If you do find that this turns out to be troublesome, see a dermatologist for specialized care.

byron27

thanks alot, you have answered all my concerns!

__________________
A turn of the crank,
is all that it takes to start,
a revolution

Duckwah

I'd say give blood every 12 weeks or so if you want but make sure you drink plenty of fluids before and after and eat plenty of protein in the week after your donation.

There wasa theory that blood donation could help reduce the buildup of certain metals in the blood that are not excreted but i never saw any conclusive studies on that.

In Australia you can only give blood every 13 weeks. I donate regularly and just take it easy for a couple of days after.

__________________
Don Stevenson

Strength and Conditioning Coach

Octogen Fitness

www.octogen.com.au

fitness@octogen.com.au

matt s

That's very useful and interesting, but I would find it helpful to know if anyone has any information on what is the full recovery period from a blood donation. If one was back to normal, give or take a couple of percentage points, after two weeks, then I'd have no hesitation. If it took more like 12 weeks for one's blood count to return to normal, then I might think twice - depending on racing schedule.
Thanks, Matt

Shabby

I donate blood, on a semi-regular basis, and here's my two cents:

1. Scull few glasses of water as you're about to start donating. The water in your stomach will be getting absorbed as you're donating, which means you don't feel dehydrated. The drink some OJ with a steak for dinner (vitamin C helps the absorption of heme iron).

2. Take it easy the day after, not doing hard sessions.

3. Two or three days after, you'll feel "flat" and wonder why it's all so hard, but a week later you'll be fine.

Over the off season, donate prior to the easy week in a four week cycle, when you're in recovery mode anyway.

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