***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: To determine if high doses of oral iron could shorten the duration of therapy necessary to treat Fe deficiency anemia , high-dose Fe 600 mg three times per day ( given as nontoxic carbonyl Fe ) was compared with st and ard ferrous sulfate 60 mg Fe++ three times per day in a r and omized , double-blind , 3-wk trial involving 36 female blood donors with mild Fe deficiency anemia . In animal studies , both forms of Fe have similar bioavailability when administered in equal amounts . High-dose carbonyl Fe was well tolerated with gastrointestinal side effects similar those observed with st and ard FeSO4 therapy . The 10-fold larger amount of Fe result ed in a mean 1.5-fold increase in estimated Fe absorption . Both regimens corrected anemia but neither replenished storage Fe . These results suggest that the principal advantage to the use of carbonyl Fe would derive from its safety rather than from the large doses that can be given We assessed changes in iron stores and iron absorption after repeat blood donations  using a combination of biochemical measures of iron status : ferritin , hemoglobin , and transferrin saturation . Thirty-six volunteers with a mean ( + /- SD ) age of 67.7 + /- 3.7 y donated an average of 15 units of blood over 3.5 y.  Initial iron stores were 12.45 + /- 3.09 mg/kg for men and 12.53 + /- 3.24 mg/kg for women . Of the 20 men and 16 women who completed the study , 6 men and 10 women were taking a self-selected supplement providing approximately 20 mg Fe/d . Dietary iron intake was determined to be approximately 20 mg/d for men and approximately 18 mg/d for women . Decreases in iron stores in supplemented men were not significantly different from those in nonsupplemented men : 9.52 + /- 2.57 and 11.31 + /- 2.74 mg/kg , respectively . Nonsupplemented women showed a significantly ( P < 0.05 ) greater decline in iron stores than did supplemented women : 13.09 + /- 2.46 and 10.60 + /- 4.15 mg/kg , respectively . Mean maximal iron absorption was approximately 4.10 mg/d for men and approximately 3.55 mg/d for women regardless of iron intake BACKGROUND Iron depletion or deficiency in blood donors frequently results in deferrals for low hemoglobin ( Hb ) , yet blood centers remain reluctant to dispense iron replacement therapy to donors . STUDY DESIGN AND METHODS During a 39-month period , 1236 blood donors deferred for a Hb level of less than 12.5 g/dL and 400 nondeferred control donors underwent health history screening and laboratory testing ( complete blood counts , iron studies )  . Iron depletion and deficiency were defined as a ferritin level of 9 to 19 and less than 9 µg/L in females and 18 to 29 and less than 18 µg/L in males . Deferred donors and iron-deficient control donors were given a 60-pack of 325-mg ferrous sulfate tablets and instructed to take one tablet daily . Another 60-pack was dispensed at all subsequent visits . RESULTS In the low-Hb group , 30 and 23 % of females and 8 and 53 % of males had iron depletion or deficiency , respectively , compared with 29 and 10 % of females and 18 and 21 % of males in the control group . Iron-depleted or -deficient donors taking iron showed normalization of iron-related laboratory parameters , even as they continued to donate . Compliance with oral iron was 68 % . Adverse gastrointestinal effects occurred in 21 % of donors . The study identified 13 donors with serious medical conditions , including eight with gastrointestinal bleeding .  No donors had malignancies or hemochromatosis . CONCLUSION Iron depletion or deficiency was found in 53 % of female and 61 % of male low-Hb donors and in 39 % of female and male control donors . Routine administration of iron replacement therapy is safe and effective and prevents the development of iron depletion and deficiency in blood donors BACKGROUND The consequences of temporary deferral are not well understood . This study sought to investigate blood donor return after deferral expiration . STUDY DESIGN AND METHODS A retrospective cohort analysis of allogeneic whole-blood donation was conducted . All deferred donors and a r and om sample of eligible donors were identified from the year 2000 , with subsequent blood center visits through December 2005 captured . Stratified results are reported as the percentage returning , rates of return , and time to return . Measures of statistical association and Cox regression modeling are reported . RESULTS For first-time ( FT ) donors , 25 percent of temporarily deferred donors returned during the 5-year follow-up period compared to 47 percent of eligible donors ( p < 0.0001 ) ; for repeat donors , 81 and 86 percent of deferred and eligible donors returned , respectively ( p < 0.0001 ) . Depending on the deferral category , 14 to 31 percent of FT and 58 to 90 percent of repeat donors returned . Rates ( per year ) of successful donation during the follow-up period were 0.09 for index-deferred FT donors , 0.28 for eligible FT donors , 1.0 for deferred repeat donors , and 1.45 for eligible repeat donors . Multivariate modeling indicated that in addition to deferral , age , sex , race , and education were associated with return in both FT and repeat donors . CONCLUSION The effects of deferral were more pronounced than expected , affecting both FT and repeat donors . For FT donors , the type and duration of deferral , while important , were not as relevant as hypothesized because so few returned , suggesting the need to develop appropriate interventions to recapture those donors likely to be eligible Absolute iron deficiency is treated by correcting the causative lesion and then , traditionally , administering sufficient amounts of ferrous salt to return the haemoglobin level to normal and replenish body stores . The bioavailability of ferric compounds has been question ed and accordingly their therapeutic role remains controversial . A special problem is posed by regular blood donation , where the frequency of phlebotomy is limited by the haemoglobin level , which , in turn , requires maintenance of an adequate supply of iron from dietary sources . Since this latter situation may not always occur , it would be of practical benefit to have a form of supplementation that is effective and can be taken without side effects . These issues were prospect ively examined in a consecutive series of otherwise healthy blood donors who developed absolute iron deficiency anaemia and were then r and omly allocated to receive 60 mg of this metal as ferrous sulphate twice a day ( Group 1 : n = 51 ) , 100 mg as chewable ferric polymaltose daily ( Group 2 : n = 53 ) , or the latter product twice a day ( Group 3 : n = 55 ) . Serial studies showed that 80 % of patients in Groups 1 and 3 had reached normal haemoglobin levels by 12 weeks , but this figure was only 50 % in Group 2 . Similarly , the proportion of patients improving their percentage saturation of transferrin to within the normal range was significantly better in Groups 1 and 3 than in Group 2 ( P < .01 ) . However , body iron stores , reflected in serum ferritin level , was significantly better in Group 1 ( P < .01 ) ; there was no difference in this respect between Groups 2 and 3 . ( ABSTRACT TRUNCATED AT 250 WORDS Background Iron deficiency without anemia is related to adverse symptoms that can be relieved by supplementation . Since a blood donation can induce such an iron deficiency , we investigated the clinical impact of iron treatment after a blood donation . Methods One week after donation , we r and omly assigned 154 female donors with iron deficiency without anemia , aged below 50 years , to a four-week oral treatment of ferrous sulfate versus a placebo . The main outcome was the change in the level of fatigue before and after the intervention . Aerobic capacity , mood disorder , quality of life , compliance and adverse events were also evaluated . Hemoglobin and ferritin were used as biological markers . Results The effect of the treatment from baseline to four weeks of iron treatment was an increase in hemoglobin and ferritin levels to 5.2 g/L ( P < 0.01 ) and 14.8 ng/mL ( P < 0.01 ) , respectively . No significant clinical effect was observed for fatigue ( -0.15 points , 95 % confidence interval -0.9 points to 0.6 points , P = 0.697 ) or for other outcomes . Compliance and interruption for side effects was similar in both groups . Additionally , blood donation did not induce overt symptoms of fatigue in spite of the significant biological changes it produces . Conclusions These data are valuable as they enable us to conclude that donors with iron deficiency without anemia after a blood donation would not clinical ly benefit from iron supplementation . Trial Registration Clinical Trials.gov : Regular blood donors were enrolled in a double-blind , parallel group study to evaluate the side effects of two iron supplements , one containing both heme iron and non-heme iron ( Hemofer , 2 tablets = 18 mg iron/day ) , the other non-heme iron only ( Erco-Fer ; 1 tablet = 60 mg iron/day ) . No differences were found between the two alternatives in regaining predonation iron status as measured by serum ferritin and hemoglobin levels . Despite this therapeutic equivalence , participants ' symptom diaries showed substantial differences in the side effects for the two treatments . The frequency of constipation ( p < 0.05 ) and the total incidence of all side effects ( p < 0.01 ) were significantly higher for non-heme iron when compared with the heme iron-non-heme iron combination and a placebo . The study demonstrates that a low-dose iron supplement containing both heme iron and non-heme iron ( Hemofer ) has fewer side effects when compared with an equipotent , traditional non-heme iron supplement Seventeen conscripts gave blood every second month , the amount representing an average iron loss of 3.5 mg daily . Seven of them were given 20 mg and ten 100 mg iron as ferrous carbonate once daily throughout the study . Before the first and after the fourth and sixth blood donations they were examined with regard to packed red cell volume , serum iron , total iron-binding capacity and stainable bone marrow iron , and a diagnostic iron absoprtion test was performed . Ten conscripts receiving no iron and giving no blood but comparable to those in the test groups with regard to age , exercise and diet served as controls . The stainable bone marrow iron was found to become stabilized at a level with reduced but still perceptible amounts when 20 mg iron was given , and at a level with somewhat greater amounts when the daily dose was 100 mg . Both levels were lower than before blood donation in most subjects , and the negative iron balance was also reflected in the diagnostic iron absorption test . When a healthy person loses 3.5 mg iron daily , supplementation with a 100 mg tablet per day is therefore insufficient to maintain the iron stores at their previous level . The decrease in storage iron is not progressive , however . When the storage iron is reduced , iron absorption seems to be stimulated sufficiently to establish a balance at a reduced storage iron level Background There is no recommendation to screen ferritin level in blood donors , even though several studies have noted the high prevalence of iron deficiency after blood donation , particularly among menstruating females . Furthermore , some clinical trials have shown that non-anaemic women with unexplained fatigue may benefit from iron supplementation . Our objective is to determine the clinical effect of iron supplementation on fatigue in female blood donors without anaemia , but with a mean serum ferritin ≤ 30 ng/ml . Methods / Design In a double blind r and omised controlled trial , we will measure blood count and ferritin level of women under age 50 yr , who donate blood to the University Hospital of Lausanne Blood Transfusion Department , at the time of the donation and after 1 week . One hundred and forty donors with a ferritin level ≤ 30 ng/ml and haemoglobin level ≥ 120 g/l ( non-anaemic ) a week after the donation will be included in the study and r and omised . A one-month course of oral ferrous sulphate ( 80 mg/day of elemental iron ) will be introduced vs. placebo . Self-reported fatigue will be measured using a visual analogue scale . Secondary outcomes are : score of fatigue ( Fatigue Severity Scale ) , maximal aerobic power ( Chester Step Test ) , quality of life ( SF-12 ) , and mood disorders ( Prime-MD ) . Haemoglobin and ferritin concentration will be monitored before and after the intervention . Discussion Iron deficiency is a potential problem for all blood donors , especially menstruating women . To our knowledge , no other intervention study has yet evaluated the impact of iron supplementation on subjective symptoms after a blood donation . Trial registration BACKGROUND AND OBJECTIVES Iron depletion is common in regular blood donors . The objective of the study was to investigate the frequency and severity of iron depletion in regular blood donors and whether IV iron is more effective than oral to avoid iron depletion and symptoms thereof , especially restless legs syndrome ( RLS ) . METHOD 
    Output:
    
There is moderate quality evidence that rates of donor deferral due to low haemoglobin are considerably less in those taking iron supplements compared with those without iron supplementation , both at the first donation visit and at subsequent donation .
Iron-supplemented donors also show elevated haemoglobin and iron stores .