Difference between intermediate and minor(trait)

Hi everyBody,

This forum gives more information about thalasimia and related issues.i am confused about thalasimia intermediate amd minor.
how do we differentiate these two?  what kind of test find this exactly ?
what is the max age to find out intermediate (if any body has)to find out if no symtoms?

Hi Venkat,

You can have a DNA test if available,it will clearly determine if you are just a minor or intermediate.

ZAINI.

There are two beta hemoglobin genes. When one is a thalassemia gene, it results in thal minor. When both are thalassemia genes, the result is major or intermedia, depending on various factors, such as type and extent of the gene mutation. Minor cannot become major. Intermedia can be reclassified as major if the patient becomes transfusion dependent. These classifications can normally be determined by a hemoglobin electrophoresis test which separates the hemoglobin into its different components. The different percentages of types of hemoglobin can indicate which type of thalassemia is present.

Hi Andy,

Thank you so much for your post Andy.
In my Electrophoresis test HBA2 is 5.3 normal range is 1.9-3.2 .is it (5.3)related to more affected beta gene or what is max Range HBA2 fot beta thalasimia Tarit(minor) and how do i know how much my bete gene is affected as per my Electrophoresis test 5.3 is minimal or maximum for affected beta gene and i have mentioned othere separations also in the attachment of my this reply.
Please refer my  report attachments and tell me how much affected this.
Thanks&regards,
venkat.

Hi Venkat,

The normal HbA2 range for thal minor is 3.5-8%. Your HbA2 level and MCV indicate that you are a thal minor. Your Hb level of 14 is very good and indicates that you are what is known as a silent carrier or thalassemia minima. Your normal serum ferritin shows that there is no excess iron being absorbed, which would be expected with a normal Hb.  I think if you follow a nutritious diet, take a vitamin supplement and get moderate exercise, that you will continue to do well. The exact nature of your thal gene can only be determined by DNA testing and in your case, it probably isn't warranted. As we have said before, your main concern should be that your wife is not also a thal carrier. The danger lies not with you, but with your future children, if she is also a carrier.

Hi Andy,


Thank you so much for your reply and suggestions and this forum gives very good support for people who really fears about their feelings about thalasimia like me.
I will do Thalasimia test tomy mother and father,wife and my brothers also.
could you please tell  any chances my hb level fall down becoz i tested my hb recently in india it was 13.4 but 3 months before in singapore it was 14 and what are thehba2 levels of  intermediate intermidiate.
Recently not so far iam facing tingliness of my hand and foot fingers is it due to thalasimia trait or some other reason?
i have read so many websites telling that there are different mutations like HBE and others......these are all diagnosied by HB elctrophoreses or any other test  also required to know  other mutations? and can you clarify me as per my reports i have only beta thalasimia trait? for any ohter muttation  needs to be tested or not?
why bilrubin is more for thalasimia people?at  any time become to janduice ?

Hi Venkat,

Small changes in hemoglobin are normal. Hb changes with hydration levels and also will test slightly different from lab to lab. It isn't possible at this time to say if some day your Hb may drop. It may drop as you age but it will never drop to levels where you would need transfusion. If it does drop as you age, you might consider some Hb inducing products like wheatgrass tablets. The numbness and tingling is reported by many thal minors and it may be related to not enough oxygen getting to the extremities. Does the numbness lessen with moderate exercise like a brisk walk?

There are many different mutations but not all can be found with electrophoresis. However, if you were a carrier of another mutation you would see some symptoms from the combination. Beta thal and HbE together can cause a transfusion dependent state.  HbE should be ruled out in your wife, along with thal carrier state, as it is more prevalent in Indians.

In thalassemia, minor through major, there are varying amounts of defective red blood cells. These are filtered out by the body and one of the results is a buildup of bilirubin. It is possible that this can lead to gallstones. We have had some earlier posts about milk thistle and black onion seeds as herbal remedies for gallbladder and liver ailments. If gallstones become a problem, you might consider a natural remedy before removing the gallbladder. (However, if the situation becomes acute, the gallbladder should be removed). I don't want to scare you, as this is not as likely in minors as majors, but minors should be aware of any potential problems throughout their lives.

HbA2 in intermedias can approach the levels seen in majors...90% or higher. For the sake of reference, an intermedia of your age who does not transfuse would have an Hb no higher than 8.