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Phlebotomy is a procedure that removes blood
from the body. Regular phlebotomy treats people who have too much iron in their
blood, such as with
hemochromatosis, or who are producing too many red
blood cells, such as with
polycythemia. Removing blood regularly decreases iron
levels in the body by reducing the number of iron-rich red blood cells.
Health professionals perform phlebotomy in a medical clinic. The process
is similar to donating blood. A health professional inserts a needle into a
vein in your arm and removes about
500 mL (17 fl oz) of blood.
The procedure takes about 30 minutes. You do not need to fast or make special
preparations before phlebotomy. But try to eat a good meal and drink plenty of fluids before phlebotomy. This will prevent dizziness or fainting.
Health professionals will have you
sit or lie down. During the procedure, they monitor your blood pressure and
Some people feel tired or dizzy after
phlebotomy. You might get relief from these symptoms by resting for the next 24 hours and drinking plenty of fluids.
You may want to have a
family member or friend take you home after the procedure.
Excess iron is often stored in the
organs, especially the liver. Eventually, the excess iron can cause serious
organ and tissue damage. Phlebotomy lowers iron levels by removing iron-rich
blood cells from the body.
Removal of excess iron can
significantly reduce the possibility of severe and even life-threatening damage
to the liver and other organs.1
Phlebotomy is safe when done by a health
professional. You may get a small bruise at the puncture site. You can reduce
the risk of bruising by keeping pressure on the puncture site for several
minutes after the needle is withdrawn. In rare cases, the vein may become
inflamed after the blood sample is taken. This condition is called phlebitis
and is usually treated with a warm compress applied several times a day. There
is also a small risk of infection at the puncture site.
Depending on the cause of iron
excess, you may not need phlebotomy as often after iron levels are at a safe
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Bacon, BR et al. (2011). Diagnosis and management of hemochromatosis: 2011 practice guideline by the American Association for the Study of Liver Diseases. Hepatology, 54(1): 328–343.
October 15, 2012
Kathleen Romito, MD - Family Medicine & Brian Leber, MDCM, FRCPC - Hematology
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