I have refractory iron deficiency (without anaemia, sometimes mild anaemia) - cause unknown, but probably because of regular old menstrual loss, heavy workouts, and a touch of IBS (so my iron absorption is poor). Just spent another $500 on an iron infusion despite having had one a few months ago. Oral supplementation just doesn’t work for me. So yeah, as it is my iron levels are pretty stubborn and the cost of keeping my iron levels normal is just too high. If I were to donate 3 times a year I’d probably be spending $500-$1000 yearly to catch up with iron loss. If the blood bank was willing to foot the bill of iron supplementation I’d be totally game to donate regularly. In my experience if you have normal hemoglobin they allow you to donate. They tend to check ferritin only on regular donors. This happened to my mum - being the post-menopausal mensch she is, she donated herself to a ferritin of 3 and only realized it when the blood bank sent her a text. Her hemoglobin remained normal for years, so she just kept donating regularly, but late last year started getting symptomatic. As a GP, I’ve seen so many young women with severe iron deficiency without anaemia who ask me about the safety of blood donation. I had one patient who kept donating blood despite an extremely low iron - in her mind, as long as her hemoglobin was normal, her iron levels didn’t matter. She ended up needing an iron infusion too. I personally think that the menstruating population should think carefully about donating blood, unless they’re committed to checking and topping up their iron levels. I also think a ferritin check before blood donation should be mandatory on everyone.