My hemoglobulin is great, but no bleed for me: A Drug that Annoyed Me to No End When Being Developed Rules Me Out.

[NNadir]

I indicated I was going to donate blood today in another post: I hope to bleed like hell on Saturday.

I indicated that I'd failed the hemoglobulin test several times in recent years, so this time I took Slow Fe iron supplements every day all week. My hemoglobulin was great: 14.7, way over the cutoff at 12.

They have this enormous list of drugs they want to know if you're taking. I'm taking one: Finasteride, the development of which I was peripherally involved. I take it because of urinary urgency, prostate related, since most old men have enlarged prostrates. My urologist says my prostrate is fine, but possibly it's because, um, I'm taking the drug.

That was the original task for which the drug target for the drug, prostate issues.

But the reason it was being pushed hard - and it was - was the discovery for which it was repurposed, a "cure" for male pattern baldness, a cosmetic purpose.

At the time - this was 30 years ago - there were no major discovery developments in the pharmaceutical industry for malaria, at least none of which I was aware. The reason to my mind: Poor people in the global south get malaria; rich people in the global north do not. (With an overheating climate, this will no longer remain true.)

And that's the purpose for which finasteride was originally approved: Male pattern baldness. Prostate applications came later.

I was not in a position to say a damned thing about it, but internally and privately it pissed me off. Poor people died because there was no money in malaria, but old bald men chasing young women: They mattered.

The punch line is that finasteride has a side effect that is kind of fun given the application for which it was commercialized: Impotence, which led me to think of the internalized joke that fat, old, rich bald guys could now get the girl, but they couldn't do anything with her.

I'm taking it now as an old man for the original purpose in the discovery target, prostate enlargement, but I'm still fat and bald, so there's that, and, irrespective of the private joke I kept to myself, everything works as required when required, but the wild things do not matter as much as when my wife and I were younger.

I have no idea why you can't donate blood if you take it. Since it's a daily dose - I last took it until a few minutes ago, yesterday morning - it suggests it has a pretty fast pk (pharmacokinetics). I just looked it up. It has a Cmax (the maximum concentration after a dose) of 9.2 nanograms per milliliter, meaning a liter of blood has about a millionth of a gram of the drug. (The dose is 1 mg.)

Maybe I'll look into the issue, but I can't imagine for an approved drug, this is a big deal. Are they worried that a bleeding accident victim will grow hair?

I certainly hope that the blood supply is never so short as to lead to a loss of life because of rules that may be overly restrictuve, but it's their rules, not mine.

Urinary urgency is not a pleasant thing. I'm going to keep taking the drug; I'm not going to wash out for a month (what the tech suggested) needing to pee every 20 minutes or so. I guess my donor days are over.

It was a good run, and I hope that over the decades of donating, some life was saved somewhere by using my blood, just as my own life was saved by a donor over 50 years ago. Nevertheless, I'm done.

Sigh...

[mahatmakanejeeves]

1. No problem. I filled in for you the day after Thanksgiving. NT

[NNadir]

3. I thank you on behalf of humanity.

[quaint]

2. Is donated blood segregated by men and women?

Note: Women who are pregnant or may become pregnant should not use finasteride or handle the crushed or broken tablets. Finasteride can cause birth defects in male babies.

[NNadir]

4. Thanks for the updated explanation. It still strikes me as overly restrictive.

It would seem to me that with modern tracking systems, the issue could easily be addressed with a label: Do not use on potentially pregnant women.

I'm annoyed, but I guess I understand.

My oldest son had a "birth defect," despite my wife's exposure scrupulosity - one that generated a lot of unsolicited comments - but there's nothing defective about him as a man.

[Raven123]

5. When you need blood, you need blood

I’m sure they are just trying to make the system as easy as possible in an emergency. Maybe overkill, but don’t tell RFK Jr, or we may not have any blood donation system

[NNadir]

7. This is a modern issue in the poor valuation attached to risk. It's not just in the medical field, but in other...

...areas as well, notably in energy.

Major risks, which are well known are allowed to persist and do great harm, because minor risks - almost to the point of triviality - are given huge attention diverting resources unnecessarily.

I suppose there is some sets of psychological reasons driving this outcome, but nonetheless, it strikes me as absurd.

[quaint]

10. I've never donated because I was only 110 pregnant.

When ever there is a blood drive due to shortage I restart my futile campaign to the Red Cross to collect half pints from all of us healthy, small women.

They say the have one-size and too many small women pass out. They advise 600 pound people to call first to make sure they have a couch that will support them, but our blood isn't wanted. Geez.

[Totally Tunsie]

6. Your original post prompted me to also check my eligibility,

and, alas, I find I can no longer donate due to taking Eliquis. It prohibits the blood from clotting normally. Better to find out now, I suppose, but it saddens me that I can't contribute.

Thank heavens for all who can and do give.

[Ziggysmom]

8. Bless you for trying so hard to be a donor. I feel like you and cannot donate due to a history of ITP.

That’s idiopathic thrombocytopenia, AKA low blood platelet count. See if there are other ways you can help instead of blood donation. Volunteers are needed in so many areas.

I agree that pharmaceutical companies should concentrate on developing disease treatment and not vanity promotion drugs.

Happy Holidays

[WmChris]

9. I donated for years

Then while being treated for rheumatoid arthritis the drugs methotrexate and remicade made me ineligible.