Ron Marinucci April Column: "To Give or Not to Give?"
by Ron Marinucci, Apr. 6, 2022
“To give or not to give?” For many runners deciding whether or not to donate blood, that is the question.
Almost constantly we hear reports of “dangerously low” blood supplies, of “serious shortages” of blood. I receive fairly frequent reminders from the American Red Cross. It’s clear that more blood donations are needed, but how are runners affected if they choose to give?
Practically anyone can donate. There are a few restrictions such as age (at least 17 years old, but 16 years old in some states with parent permission) and weight (110 or more pounds). Potential donors should be feeling well, no cold, flu, fever, etc., and must pass a simple hemoglobin test (No studying required!). There must be 56 days or more between whole blood donations. At most drives, donors can be in and out in an hour or so, especially if they fill out the pre-donation Rapid Pass at home.
But as noble as it is, making a blood donation raises special concerns for runners and other athletes who train intensely. Most questions revolve around performance, both in training and in competition, and recovery.
Bryan Spencer, PhD, is a research scientist with the American Red Cross. He said, “A unit of whole blood contains approximately a pint of blood.” That pint is about 10% of a person’s total blood volume. He continued, “About 40-50% of that is red blood cells. Plasma makes up most of the rest.” It takes most people 24 to 48 hours to replenish the volume of fluid lost in a donation. But Dr. Spencer added, “Red blood cells take longer to recover. The conventional understanding is four to six weeks, but some donors, those with low iron or iron-poor diets, may take longer.”
It’s the red blood cells that contain hemoglobin. Hemoglobin delivers oxygen to muscles, essential of course to physical activities like running. After 24 hours or so, normal daily activities usually are not affected much, if at all, after a donation. But in running and other more intense endeavors, the body’s oxygen supply is outstripped by its demand for oxygen.
Because they are in good physical condition, runners are prime candidates to donate blood. Dr. Spencer noted, “All donors are recommended to be well-rested, drink extra water, and eat a healthy meal prior to donating. And this also applies to athletes. We recommend donors avoid strenuous exercise the same day of donation.” For runners, one day might not be enough rest. “Research studies find that some donors experience lower energy and declines in peak performance that last longer.”
“Athletes,” he cautioned, “should avoid strenuous exercise the same day of donation, but [runners] should ‘listen to their bodies.’” He reminded that “the actual recovery of hemoglobin,” restoring the oxygen capacities, “to pre-donation levels takes several weeks at a minimum and up to several months for some.”
Because it takes several weeks, even months, to fully replace a unit of blood, it’s suggested that runners in serious training or competition, anything that requires maximum effort, do not donate. It can certainly decrease performance, especially for elite runners.
Runners can also donate platelets and plasma. Those are different from donating whole blood. Dr. Spencer explained, “The red blood cell loss in a plasma donation is very small, while that from a platelet donation is roughly equivalent to 1/5th to 1/4th of that of a whole blood donation. Platelet donors can donate up to 24 times a year.” Again he cautioned, “platelet donors need to be mindful of iron replacement, similar to whole blood donors who donate two to three times or more frequently [up to six times] annually.”
I’ve been donating blood for 55 years or more. My experiences fit Dr. Spencer’s scenarios. Short, easy runs within a few days of donating have been no problem. Some years ago, I even raced 5Ks and 10Ks shortly afterward with no ill effects. But I admit, I’ve never been close to one of those elite runners. At my more advanced age, I now run before donating and take 24 hours before running again, still shorter and easier. And I won’t plan any racing or hard workouts for a few weeks if I donate. I learned my lesson the hard way.
As I noted I had even raced 5Ks and 10Ks a week or two after donating blood. One time, though, running the Crim Ten Mile as a guide runner for my blind buddy Michael Holmes, I crashed on Miller Road between miles 7 and 8 after donating the week before. I just couldn’t go, not fast, not slow, not run. I had to walk, slowly, much of the last two or three miles. I felt bad, as Michael had a time goal and we were on pace to beat it, only I hit a wall and hit it hard and we missed by a few minutes.
Ironically, there is some anecdotal evidence that within two or three weeks of donating blood, good race times can be achieved. No real scientific research that I know of backs this yet, but it has been suggested this is a natural form of blood-doping. The theory goes, in rebuilding the supply of red blood cells, the body overcompensates, creating extra ones. These then carry extra oxygen to active muscles before finding their state of equilibrium. Dr. Spencer addressed this, “I cannot personally attest to this. But it is true that donating approximately 10% of one’s blood volume does stimulate the production of new red blood cell to replace those lost in a donation.” It should also be pointed out that blood-doping is prohibited by organizations such as the International Olympic Committee as well as governing bodies in other sports. It is also dangerous.
For most runners, donating blood is safe—and a charitable thing to do. Just take some of the common sense tips from Dr. Spencer. Don’t plan races or intense workouts immediately after donating. If a big or long race is in your plans, allow a few extra weeks or more for recovery. Use donation day as a rest day. Follow the guidelines for rehydrating, perhaps for a few extra days. There’s no need to avoid your local blood drive.
Dr. Spencer finished with, “Many serious athletes donate. The current need for blood is acute, so we encourage and welcome blood donation by healthy donors.” And runners are among the healthiest.
Runners can find local donation sites by calling their regional American Red Cross centers. They can also check the Red Cross Web site, www.semiredcross.org.