help needed

Hi every one,

Recently i found this site by surfing the internet and it is very good for people who want to know about thalasimia,
I was recently diagnosed by thalasimia trait and i am getting scared about this even doctor told me that no no problem for y0ur life.

below are my blodd test reports.

Iam from India and 27 years old recently married and currently working in singapore .
Any life threatning in future ?and what kind of diet i have to maintain for this trait and will it blow intermidiate at any worst cases.please guide me and am so much wondering about this.




 Test name                   Results references Range

AP5 -Anaemia Profile E

Iron ..............   72           65-175
TIBC                313         250-450
Iron Saturation    23.0       25-56.

Haematology

wbc                6.9  4.0-11.0
Rbc                7.02 4.50-6.30
Haemoglobin        14.0 13.5-18.0
PCv(HCT)           45.2 38.0-52.0
Reticulocyte Count 1.2  0.2-2.0
Platelets          179  150-400

Haematological Indices

MCV                64.4  76.0-98.0
MCH                19.9  27.0-33.0
MCHC               31.0  30.0-36.0


Differential Count

Differential Count
neutrophil                 57.8      40.0-75.0
Lymphocyte             32.7     20.0-45.0
Monocyte                7.2       2.0-12.0
Eosinophil                2.0        0.0-6.0
Basophil                  0.3        0.0-0.2

peripheral Blood film

Majority of the RBC's are moderately hypochromic and normocytic.many microcytes,some elongated cells poikilocytes and target cells are present.no blast cells seen

hb electrophoresis

Normal HBA fractions
Increased HBA2 fraction :
4.1*(2.1-3.3 %)
Hbh inclusions :negative
no abnormal haemoglobins detected.
comment:findings are consistent
with Beta thalasimia trait.


Biochemistry

iron             78   59-158

HB Eloctrophoresis

Haemoglobina     present
Haemoglobin A2       *5.3  1.9-3.9
Haemoglobin F         <0.1 0.0-1.5
Haemoglobin H         not detected
comments

No abnormal band present but there is a slight increase in hba2.findings indicate beta thalasimia trait.

Haematology

Peripherial Blood film  Rbc are moderately hypochromic and microcytic with few elliptocytes and target cells.No early cells seen.
Ferritin, serum   67.8  42.0-389.0

Test

Vitamin B12   483
Folic Acid    21.0

reference Ranges
            B12    serum  Folate

           (pmol/L)  (nmol/L)

Normal    >185       >12.9
Equivocal 148 -185   7.7-12.9
Deicient  <148        <7.7 


 
             

Hi Venket,


Just keep a watch on your blood counts and Serum Ferritin levels since you don't have Iron deficiency anemia. These figures can fluctuate with Thal. Minors. Your Hb. is on the lower side of the normal range but since your S.F is within normal range and you are a Thal. Minor; there is nothing much you can do about it. However, if your S.F levels falls below normal, so will the Hb. which you can treat with Iron rich diet.

For now, just follow a healthy diet, exercise and enjoy life without any worries. Keep your blood counts in check and there is nothing to worry about if you don't feel sick.

However, you should get your partner checked too because if she is also a Thal. Minor then you are a couple at 25% risk of conceiving a Thal. Major baby which requires the most of the treatment that you read about on this site.

Hello Venkat,

Welcome to the site. I know how you feel when doctor's say don't worry and your search shows different results. But, I think your worry is a good thing. First because you want to find out what it is and NOT be Ignorant.

With your health, as Sajid has mentioned you will be fine as Thal(Minor)s do NOT turn into Thal(Intermedia). You just have to listen to your body and take it accordingly. There are lots of Thal(Minor)s who do NOT know they are having it through out their life. You have inherited the Thal(minor) gene from either of your parents, and I think there is a classic example, they might NOT even know they are carriers.

As Sajid mentioned, you might definately want to make sure your wife is NOT a Thal(Carrier) either. If you both are Thal(Carriers), it is a good idea to get genetic counselling before you guys plan for a family. With your Thal(Minor), you don't have to be depressed. It is NOT a killer. Look at Amitabh Bachhan, he has Thal(Minor), there are others like Amisha Patel and Pete Sampras who are Thal(Minor), so the main thing you want to do it find out if your wife is Thal(Minor). I have heard in India there are approximately 4 crore people who are thal(minor), that is roughly 4% of the population, but due to thal(minor) mostly being Asymptomatic, people don't even know about it. Do you remember the movie Salaam Namaste starring Saif Ali Khan and Preity Zinta? In that movie, the director tried to send a message to the audience that it is good idea to get oneself tested for Thalassemia (Preity Zinta in the movie said she had thal(minor) and wanted the partner to get tested to make sure their baby is safe).

You can find good information at http://sickle.bwh.harvard.edu/thal_inheritance.html

As always, there are members here if you have any questions

Thank you so much for your reply.

please tell me about classifications of thalasimia minor and trait and minima.

will minor become to inter or major at any case.
Is there anychances to get  life threatning in my life.
Please tell me  what kind of diet i have to maintain and can i do excercizes(gyme) and can i do vegetable with leafs .
and please tell me if i take more iron food what will happend (is there any case like iron over loaded).
what is SF and what is the relation between HB and SF(my case both are in range)
and please tell me how to maintain HB levels constants and if ido gyme hb levels may vary some times down ).

Hi Sajid and Narendra,

Thank you so much for your help and  your support.

Now i got relief better compare to previous thank you so much for your suggestions .

i was feeling very badly for this even doctor was told me like dont worry.

please tell me one thing will i get any time in my life life threatning for this.
and if i do more gyme then i will lose more calories then HB will be automatically  down that time do i get any problems
please mention what kind of food i have to follow.

Hi Venkat,

I cannot overemphasize that you absolutely must listen to Sajid and Narendra about having your wife tested to see if she is a thal carrier, like yourself. Please do not have any children until you are certain she is not a carrier. If by some chance she is, then you will definitely need genetic counseling before having children. In vitro fertilization can assure that you will not have a major if you are both carriers.

Your blood tests are all very good for a minor. Follow a nutritious diet and it may help as you age if you also take a few supplements like folic acid, vitamin E and B-complex. Iron does not appear to be of any concern, nor will it be as long as your hemoglobin level maintains its current good level. For optimal health, minors need a good diet, regular exercise and rest when the body says rest.

The most you can expect as you age are some minor symptoms like fatigue but this may never happen to you as your Hb level is quite normal. You will never be more than minor so relax and get your wife tested.

Hi Venkat,

Welcome aboard,Believe me when i say that you have no need to worry about anything,just keep your blood counts in check,you have an exceptionally good hb level for a minor, i am also a minor and i've never seen my hb any further then 11,going to gym won't effect your hb,instead it will give you more strength and sense of fitness as in any normal person's case,and thal minor can't be and won't be life threatning if you hb is that persistent.

ONLY THING YOU HAVE TO WORRY ABOUT RIGHT NOW IS GETTING YOUR WIFE TESTED FOR THAL TRAIT,BECAUSE IF SHE HAS THAL TRAIT,THERE IS A 25% CHANCE THAT YOU CAN HAVE A THAL MAJOR BABY,WHENEVER YOU PLAN TO HAVE A BABY,AND THAL MAJOR NOW A DAYS IS MANAGEABLE,BUT IT CAN BE LIFE THREATNING,SO IT'S BETTER NOT TO HAVE YOUR CHILD GO THROUGH IT.

regards,

ZAINI.

Hi venkat,

I've noticed that you are quite concerned about turning into Thal. Major or Intermedia. Well, you don't have to worry about that too as we are born with what we are and it cannot change. There are some cases of Thal. Intermedias that become transfusion dependant but still they are not Majors; they are just misdiagnosed.

As for the Thal. Minima and Minor classification; well we had a healthy talk on it as it is a fairly new classification and most of us (including me) didn't knew much about it But thanks to international forum like this, everyone gets the chance to learn about the latest developments. I think I still don't understand much about it. The only thing I understand is that some Minors exhibit some symptoms such as extreme lethargy, enlarged spleen and a compromised immune system which makes them fall sick much often. However, those who don't exhibit any symptoms (classified as Minima) go unnoticed until tested and lead a fairly normal life. I think you are the Minima type if you don't fall sick often and have a blood figures like you have now thorough most of your life.

I hope Mr. Andy and other more experienced members can shed some more details on this fairly new classification of Thal. Minor.

Hi  All,


Thank you so much for your help and support .

Initally i was so much fear about this now my condition is ok anyway it takes some time to digest and forget this.please give me your support and  suggestions always.

Hi Andy,
Thank you so much for your help and support for my doughts in my head.
what is sickle anemia and HB E trait becoz i read some where in tthe internet these are combinations of thalasimia minor also possible in the south east asia.
Could you please tell me status of those based on my HB electrophoresis reports below HB Eloctrophoresis or do i need do any other tests for confirming like which are i dont have? and what are the symtoms of these two .
 

Haemoglobina     present
Haemoglobin A2       *5.3  1.9-3.9
Haemoglobin F         <0.1 0.0-1.5
Haemoglobin H         not detected
comments

No abnormal band present but there is a slight increase in hba2.findings indicate beta thalasimia trait.

Haematology

Peripherial Blood film  Rbc are moderately hypochromic and microcytic with few elliptocytes and target cells.No early cells seen.
Ferritin, serum   67.8  42.0-389.0

Test

Vitamin B12   483
Folic Acid    21.0

reference Ranges
            B12    serum  Folate

           (pmol/L)  (nmol/L)

Normal    >185       >12.9
Equivocal 148 -185   7.7-12.9
Deicient  <148        <7.7 

Hi Venkat,

HbS (sickle cell trait) is easily seen in any blood test that uses a microscope, as the sickle shape of the red cells is readily apparent. A hemoglobin electrophoresis would easily determine carrier status. You do not carry the sickle gene. It would be reflected in your report. I will almost guarantee that you are also not an HbE carrier, as the combination with the beta thal gene would lead to a much worsened condition and possible transfusion dependent state. However, your wife should be tested for this, as HbE beta thal can be a serious condition and should be prevented if possible. This is tested with a specific electrophoresis test.

http://www.specialtylabs.com/books/display.asp?id=1117

The HbE variant can be detected by agarose gel electrophoresis, isoelectric focusing (IEF), 5 or high-performance cation-exchange liquid chromatography (HPLC).4,6,7  Methods for DNA-based diagnosis of HbE mutation include mismatch-priming PCR,8 allele specific PCR,9  PCR-allele specific oligonucleotide (ASO) probe hybridization, and minisequencing.

Do you take a folic acid supplement?