From the Research
Treatment options for anemia in Jehovah's Witnesses should prioritize blood conservation strategies and non-blood alternatives, focusing on erythropoiesis-stimulating agents, iron supplementation, and vitamin therapy to enhance the body's own blood production mechanisms. When managing anemia in Jehovah's Witnesses, it is crucial to consider their religious objections to blood transfusions.
- First-line treatments include oral or intravenous iron supplementation, with ferrous sulfate 325mg three times daily being a common oral regimen, or IV iron formulations like iron sucrose or ferric carboxymaltose for faster repletion 1.
- Erythropoiesis-stimulating agents such as epoetin alfa (starting at 150-300 units/kg three times weekly) or darbepoetin alfa can stimulate red blood cell production, particularly when combined with iron therapy 2.
- Vitamin supplementation with B12 (1000mcg daily or monthly injections) and folate (1mg daily) is essential if deficiencies are present.
- For severe anemia, the use of hemoglobin-based oxygen carriers (HBOCs) can be considered as a temporary measure to supplement oxygen-carrying capacity 1, 3.
- A multidisciplinary approach involving hematologists and specialists familiar with bloodless medicine protocols offers the best outcomes for these patients. Key considerations in the management of anemia in Jehovah's Witnesses include:
- Preoperative optimization for surgical patients, including correcting anemia weeks before surgery, intraoperative blood conservation techniques, and minimally invasive surgical approaches.
- The use of hemostatic agents such as tranexamic acid to reduce blood loss.
- Close monitoring of hemoglobin levels and adjustment of treatment as needed to ensure adequate oxygen delivery to tissues.