A blood transfusion can save your life. We take for granted that the replacement blood will be healthy and safe since donors are screened before giving up some of their vital bodily fluid. But a new study shows that 70 percent of the serum intended for transfusions contains Xanax, caffeine, and other drugs.
Richard van Breemen and Luying Chen at Oregon State University (OSU) used mass spectrometry to test 18 batches of human blood serum pooled from multiple donors.
Blood serum is the clear, yellowish fluid part of blood that includes all proteins not used in blood clotting, electrolytes, antibodies, antigens, hormones, and any foreign drugs or microorganisms. Serum contains no white blood cells (leukocytes), red blood cells (erythrocytes), platelets, or clotting factors. It is blood plasma without fibrinogens.
Blood banks draw blood from healthy people above a certain minimum age and may exclude those with recent hypodermic marks as from injection or acupuncture. The blood collected is sold to hospitals, biomedical companies, academic centers, and pharmaceutical companies.
The OSU research duo contacted several biomedical suppliers that get older inventories of blood from blood banks for testing purposes.
The random samples of donated transfusion-ready blood were assayed (measured) for the following chemical contaminants:
- Caffeine (the common stimulant found in coffee and tea and the world’s most widely consumed psychoactive drug)
- Tolbutamide (a potassium channel blocker used to treat type 2 diabetes, along with diet and exercise)
- Dextromethorphan (a cough suppressant)
- Alprazolam (trade name Xanax, used in the short-term management of anxiety disorders)
The study authors, whose findings were published in the February 5, 2020 edition of the Journal of Pharmaceutical and Biomedical Analysis, knew that pooled human serum available commercially contains caffeine (because so many people consume caffeinated products) and included it in their chemical assay. But there were measurable amounts of other medicinal pollutants as well:
“Out of 18 lots of pooled human serum tested, caffeine was detection in all lots, alprazolam was detected in 13 lots, 8 lots contained dextromethorphan, and no tolbutamide was detected.”
18 out of the 18 blood batches – 100 percent – revealed the presence of the stimulant caffeine, as expected
13 out of the 18 blood samples – 72 percent – contained the anti-anxiety medication alprazolam (Xanax)
8 out of the 18 blood specimens – 44 percent – contained the over-the-counter cough medicine dextromethorphan
0 out of the 18 blood lots evaluated – 0 percent – contained tolbutamide
Furthermore, only serum prepared from the blood of select individuals tested drug-free.
The researchers were surprised that the sample blood batches weren’t as clean as they were supposed to be. The purpose behind their analysis of transfusion serum was to look at how taking plant botanical extracts used as dietary supplements (such as ginkgo, echinacea or CBD oil) changes how the body breaks down and metabolizes pharmaceutical drugs.
The presence of anti-depressants and cough medicine in addition to caffeine in sample blood could significantly alter the results of natural and synthetic drug testing.
Luying Chen, a PhD student at OSU, and study co-author, commented on consumer safety issues that arise from this scientific examination:
“From a ‘contamination’ standpoint, caffeine is not a big worry for patients, though it may be a commentary on current society. But the other drugs being in there could be an issue for patients, as well as posing a problem for those of us doing this type of research because it’s hard to get clean blood samples.”
The other study co-author, Richard van Breemen, noted that their limited analysis of 18 blood lots may be just the tip of the iceberg:
“The study leads you in that direction, though without doing a comprehensive survey of vendors and blood banks we can only speculate on how widespread the problem is.”
The Director of OSU’s Linus Pauling Institute wondered what other contaminants might lurk inside blood bank serum used for transfusions and in medical research:
“Another thing to consider is that we found drugs that we just happened to be looking for in doing the drug interaction assay validation – how many others are in there too that we weren’t looking for?”
Impure pooled blood thwarts a scientific approach to understanding how the human body processes a combination of natural and artificial medications. According to van Breemen:
“Botanicals basically contain natural products with drug-like activities. Just as a drug may alter the drug-metabolizing enzymes, so can natural products. It can become a real problem when someone takes a botanical supplement and is also on prescription drugs – how do those two interact? It’s not straightforward or necessarily predictable, thus the need for methods to look for these interactions. The odd thing in this case was finding all the tainted blood.”
The OSU research project was supported by the Office of Dietary Supplements and the National Center for Complementary and Integrative Health, parts of the National Institutes of Health (NIH).