Could Bloodletting Reduce Risks of Metabolic Syndrome?

Metabolic syndrome is an increasingly prevalent but not very well understood condition characterized by insulin resistance, glucose intolerance, dyslipidemia, hypertension, and abdominal obesity. While, the relationship between cause and effect remains uncertain, it has been suggested that having an excess of iron in the body is associated with the development of metabolic syndrome. In a small randomized trial, German researchers tested the hypothesis that phlebotomy-induced reduction of body iron stores (bloodletting) would alter the clinical presentation of metabolic syndrome. Bloodletting was commonly used as a medical treatment throughout history, but in the 19th century the practice was abandoned when it was determined that it was not effective for most diseases. In this new study, however, the researchers found that two sessions of blood donation improved blood pressure, as well as markers of cardiovascular disease in obese patients with metabolic syndrome.

In the study, 64 people were divided into two groups, one of which underwent 2 blood donation sessions four weeks apart and the other group served as a control group and did not donate blood. The donation group first donated 300 milliliters (ml) of blood each and then 250–500 ml at the second session.  The patients were then evaluated 6 weeks after the final session, to allow for blood volume to return to normal levels. The researchers found that systolic blood pressure (the top number) fell from an average of 148 mmHg to 130 mmHG among those who donated blood. They also experienced improvements in blood sugar levels, heart rate, and cholesterol levels. The findings lead the researchers to conclude that blood donation may have beneficial effects for people with metabolic syndrome.

Some experts, however, are not convinced that the findings substantiate bringing back an ancient medical practice. Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in NY said “It’s true that excessive iron can worsen high blood pressure and diabetes, so it’s a good idea for anyone with those conditions to make sure they’re not unnecessarily boosting their levels by taking an iron supplement or multivitamin containing iron. But with the advent of diet and exercise and medications, we should probably leave this practice of bloodletting to the 19th century.”

We spoke with Dr. Toby Broussard, expert weight loss surgeon in Oklahoma, about the study’s findings. He said: “The short term benefits of donating blood possibly contributing to controlling hypertension is intriguing and the benefits of having a normal iron level in the face of diabetes and hypertension is true, but how “bloodletting” would be applied in current medical treatment is of significant question, to say the least.”

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