Bloodletting

A recent article labeled me and Tim Ferriss as guys who think “way too much about women’s orgasms, the weight of their own feces and how to game the Red Cross so they can do more bloodletting.” It’s ambiguous, but I think it’s the part about bloodletting that’s meant to be attributed to me.

Since I haven’t ever actually written about these adventures I may as well now. Here goes:

There is some evidence that excess iron in the body contributes to aging and disease. Though iron is an essential nutrient we don’t seem to need very much of it once our developmental years are over, after which this excess iron sits around in our bodies oxidizing. Men especially are prone to accumulating iron and women can begin to catch up too after menopause. It’s still somewhat speculative, but I’ve gone ahead anyway and made lowering iron levels part of my longevity strategy.

How to get ride of excess iron? Bleeding is the simplest way. And probably the most painless (and productive) way to bleed is by donating blood.

When I started tracking it, my iron (ferritin level, technically)[1] was at 98 ng/ml. Not excessive, according to normal standards, but in biohacker fashion my goal is to get down to somewhere around 25. Supposedly, each pint I give should dump about 30 ng/ml, so I gave blood twice that year, one pint each time, which is what they limit you to. And when I got my ferritin level checked at the end of the year? it was up to 110![2]

I must have lost some iron during those donations, but I was accumulating iron even faster. What was I supposed to do, give blood five times a year?

Then I discovered apheresis, a procedure that collects twice as much blood per visit. It works by keeping only part of the blood (the iron-rich red blood cells in this case), while returning my plasma and a bag of saline to the body.

I called the Red Cross and confirmed that they offer the procedure, which indeed they do readily perform as it yields twice as much of the good stuff they’re after. They were even offering apheresis at a pop-up blood drive near my home. A few days later, I went in.

What I liked:

– I was able to give twice as much blood just by sitting there for an extra 20 minutes — a big time savings over setting up a second appointment and one less needle prick.

– the needle is smaller: the next size down from what they typically use.

What I didn’t like:

– The technician performing mine had never taken a double red-cell donation before. Not encouraging. That said, he had used the machine for other procedures so maybe it wasn’t a big deal. The whole thing turned out to be highly automated anyway, with most of the work being done by the apheresis machine.

– I wasn’t thrilled with the thought of fluids coming out of this machine and back into me. I kept having panicky thoughts like, What if they haven’t cleaned the machine? What if it’s been contaminated? But the rational part of my mind knows that the actual risk must be quite low… shouldn’t it?

– Because fluids get pumped back into the body a “small” amount of anticoagulant in the tubes backwashes in. Is that unhealthy? I’m sure the Red Cross will say no, but these are also the folks who, after you’ve finished donating, try earnestly for ten minutes to feed you doughnuts and soda. So I’d like to look into it further.

What I liked but you may not:

– Since the fluids being pumped back into you are cooler than body temperature, you feel an icy chill from head to toe. After a while I realized that this was unlike any other chill I’d ever felt before, because rather than feeling cold as a result of the environmental temperature, I was getting cold from the inside out. Procedures like this (and maybe dying, I suppose) are the only possible ways to experience this particular kind of chill. And I found that fascinating.


[1] Your doctor almost certainly isn’t ordering a ferritin test during your routine blood work. It’s an inexpensive test, but something you’ll have to ask for.

[2] After seeing this, I logged in to 23andMe to double-check for hemacromatosis, a genetic predisposition to storing excessive iron. According to them, I’m not, and if I were my levels would likely be several times higher. So it may simply be that my diet is high in iron.

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