Ron Marinucci: January, 2015 Column: National Blood Donor Month

Ron Marinucci: January, 2015 Column: National Blood Donor Month

January is National Blood Donor Month. Traditionally, the winter months find vital blood in short supply. Snow and cold weather, illnesses brought on by them, and the holidays all contribute to reduced donations. To increase awareness of the dearth of needed blood, the American Red Cross has designated January as NBDM to encourage more people to give.

I know I’ve written about this before, four or five years ago, but supplies remain low. And the need has not diminished.

With that in mind, should runners donate blood, be it in January or at any time during the year? Of course runners should donate. Dr. Barry Siegfried is the Medical Director for the Great Lakes and Southeastern Michigan Blood Services Regions of the American Red Cross. He urged, “Runners are encouraged to donate blood for the same reason as nonrunners: blood products are medical treatments that can only be obtained from healthy people.” And runners are “healthy people.”

Giving blood is an easy and relatively painless way to help others. Runners, though, considering their physical activity, have legitimate questions. How does donation affect running performance, especially harder training and racing? What precautions should runners take, before and after?

For the most part, anyone can donate. The few restrictions include weight and age. Donors must weigh 110 pounds or more and be 17 or older. They must be in general good health. A simple hemoglobin test checks that blood iron (ferritin) levels are satisfactory.

It’s important to heed these requirements. West Michigan runner Peggy Zeeb is slight. She admitted, “I lied about my weight once and donated blood. My blood pressure dropped dangerously low.” After recovery, she was “told to never donate again!” If she wanted to help, she added, “I should bake cookies to feed the people who do donate.”

There are different types of donations. Whole blood donations are most common and are found at most donations sites away from Red Cross centers. Such donations are usually completed in about an hour, depending on the number of donors in line.

Apheresis, both for plasma and platelets, requires a bit more time, from an hour and a half to two and a half hours. Both types of apheresis involve extracting plasma and/or platelets while returning most or all of the red blood cells to the donor. This donation is typically done at a hospital or Red Cross center.

Blood, of course, is crucial to running. Blood carries the oxygen that powers the body. The more oxygen that is delivered, the faster, longer, and harder runners can go. Obversely, less oxygen leads to less power. Again, it’s blood that provides that oxygen.

Typically, donations involve removing a pint of blood. That pint depletes about 10% of an average person’s total blood volume. While at rest or just doing every day activities, nothing strenuous, the lower blood volume can still usually provide enough oxygen to function normally. Once the heart rate is increased, as running does, the body’s demand for oxygen outpaces what the depleted blood can supply.

Therefore, blood donation, particularly of whole blood, has a negative impact on running, most specifically on hard training and racing. For easy running, nothing hard, donating blood is not much of an issue. A little caution and common sense should prevail. Dr. Seigfried noted, “One study found no effect on measures of submaximal performance a week after donating.” The key word is “sub maximal.”

Some runners may experience light-headedness and much greater fatigue for a few days after giving blood. They are wiped out. These feelings of fatigue can last for several days. That’s because it normally takes up to 72 hours to replace the volume of liquid taken in donation. Taking a day or two of rest won’t hurt fitness and will allow some recovery.

“The donor should avoid heavy exercise for the rest of the day,” Dr. Seigfried recommended. “Consider ‘the rest of the day’ to be 12 to 24 hours. Because responses to blood donation vary, donors should be prepared to adjust their activities in accordance with how they feel.”

Dr. Seigfried emphasized drinking fluids. “Runners are familiar with staying hydrated,” he said. “This is important before donation.” And to this he added “the importance of staying hydrated after the fluid loss associated with blood donation.”

Restoring the red blood cells is a different matter. Replacing them to normal levels can take three to five weeks, sometimes longer, depending on the individual. That’s why donations are limited to once every eight weeks.

Over that period, several weeks, training for competition and competition itself is certainly affected. Anything that requires maximal effort, such as racing, is not recommended. “Donors should also be aware that their athletic performance could be slightly reduced for several weeks after donating,” Dr. Seigfried said. It’s important to remember that “responses to blood donation vary.”

He added, “Data on athletic performance after blood donation are conflicting. Most studies have found 6 to 10% decreases in measures of maximal exercise performance, such as maximal oxygen consumption, immediately after donating a unit of blood. One study found that maximal oxygen consumption returned to its predonation value by 20 days after donation.” But studies aren’t conclusive for all runners and exercisers. “However,” he continued, “in a small study of runners, a direct measure of performance, the time to run three miles, was not affected for up to eight weeks after donation.” It’s important to remember, though, that individual runners may well have different results.

Apheresis donations have much less impact on running performance. Recovery time is considerably shorter since most, if not all, of the red cells are returned right away to the donor. Training, even hard training, can be resumed within a few days, if not sooner.

Flint-area runner Stu Allen regularly donates plasma and platelets through apheresis. “I usually donate on Sundays after my weekly long runs,” he said. “The benefits of being a platelet donor versus a red blood donor is that platelets replenish in about 24 hours. That means you don’t see a dip in performance.” Whole blood donations typically affected his running for about a week. Because apheresis returns his red cells to him, he “can train hard again in about 24 hours.”

Bob Drapal echoes those thoughts. “I’ve been doing apheresis for almost 20 years,” he noted. “It has never caused me to alter my training or my running routine.” He added that he can donate “a few times a month without any real negative effect on running.”

I’ve been donating, whole blood, since 1967 and running for about 40 of those years. Improbably, in the past I’ve even run on donations days, after giving, with no real problems. But I’ve always gone shorter and easier on those runs. Now, at my advanced age, I always run before donating and then take 24 hours before running again, still shorter and easier. And I won’t plan any racing or hard or long workouts for a few weeks if I donate. I learned my lesson the hard way, from experience.

I’d had no difficulties with racing 5Ks and even 10Ks a short while, maybe within a week, after donating. That, as I’ve noted before, changed about 10 or 12 years ago. I ran the Crim 10 Mile as a guide runner for my blind buddy, Michael Holmes. We had trained pretty hard that summer and Holmes had a time goal, a reasonable one. We were well on pace to meet or even beat it. Then, about seven miles into the race, I crashed. I’ve hit “the wall,” hard, in marathons and that’s exactly what this Crim felt like to me. I had to walk, with Holmes, a lot over the last three miles. I just couldn’t go, not fast, not slow, but had to walk. I felt bad about missing Holmes’ goal, my fault, but it took a couple of days before I made the connection between donating a week or so before and my lousy racing performance. After all, I’d never had problems before. But again, I’d only raced shorter distances.

So, in the end, of course runners should donate blood. Dr. Siegfried encourages it, with the cautions he has provided. For most runners, it is safe and rewarding. Most recreational runners can donate throughout the year. More competitive runners should think ahead. A perfect time for them to give is following a goal race, while recovering from the race and its hard training schedule. Be sure to hydrate and take a rest day or two, followed by shorter and easier running efforts. And if you ever have any questions or concerns, talk to your doctor or the Red Cross.