Help to read blood test results please!

Hi
My dad asked his DR for a blood test as i have beta thal minor. I have always assumed I 'got' it from him as he is Greek/ Italian, and he wanted to know for sure.
I am not sure what test his doctor did, but this is what the results sheet says:

Hemoglobinopathy Screen:
Hemoglobin A0 - 85.7%
Hemoglobin A2 - 3.5%
Hemoglobin F - 0.6%
phenotype A/A
Conclusion; No abnormal hemoglobin detected. Normal pattern.

Does this mean for sure that he is not thal minor? Or did they not do all the tests?

Thanks in advance for helping me to decipher these results....

ps. Just to say that I have started taking a B complex and it's really helping (am going to phase in the E and everything else soon too) - I do feel it's giving me more energy which is good news!

Do you know which method was used for the testing?
There are few more values which might give a clear picture like the MCV (Red Blood Cell size) and also if the Iron Panel is known

The Hemoglobin A2 value of 3.5 is borderline. Levels equal to 3.5 or above are considered to have Thal(Trait). Different labs show different results and there might be a tolerence of few points in the tests.

I am NOT a doctor neither a medical person, so take the post as just a thought of a person who have been reading and learning about thalassemia like you!!

c123,

Is that HbA percent correct? Looks like maybe it is 95.7%. Otherwise you're missing 10% of your Hb somewhere.

There are some variants that are hard to see in electrophoresis, and if there is delta hemoglobin deletion, it can offset the HbA2 reading, to make it appear normal. DNA testing might be needed to confirm if he is or isn't a carrier.

Hi Andy
Thank you very much - the A0 reading is definitely 85.7% (I have the sheet in front of me now) but maybe they made a printing/ typing error? I didn't realise they were meant to add up to 100 but obviously that makes total sense!
Should he go back and ask for a different/ repeat blood test first or go for DNA testing?

Also, just wondering what tests I should get done. I am going to try and get my general DR to do the blood tests and then hopefully get referral to hematologist. EXactly what should I ask her to check? I know I am beta thal minor, so it's not about a diagnosis, but about understanding the different hemoglobin levels etc.... So I can see where I am at now and then track going forwards.
Thanks again for everything it's great to have this forum to come to for advice and support!

Hello c123,

Take a look at Thal(Minor) section under post:- http://www.thalassemiapatientsandfriends.com/index.php?topic=1575.0

Hemoglobin Electrophoresis test will give you an idea on possible Beta Thal Carrier Information. You might want to see what the Hemoglobin levels are as well as ask the doctor to get the Iron tests done (Low iron can also cause fatigue, dizziness)

Hi C123,

From what i have read, I have seen that the values for HBA2 differs.  For instance the max normal value of HBA2 is 3 for the french (read that bcos i am bilingual) and for the english speaking it is 3.5 . However the mean value of HBA2 for a non-thal is 2-2.6 (from an article).

Also from one article the range of values of HBA2 for minors start from 3.8 onwards.  However interpreting values from 3.3 to 3.8 should be made with precautions bcos it may refer to minors or non-thal.  Most of the time the electrophoresis has to be made all over again.

By the way MCV and MCH values(from CBC test) also have to be considered.The cut off values for MCV is 78 (from an article that I have read) and MCH is 25.  In other words any values less than 78 for MCV and less than 25 for MCH have to be investigated further.

Also the total of all the different HBs in the electrophoresis must equal 100. 

If you can afford to choose between methods for testing thal and if the methods are available, it would be better to do :
1. Iron ferritin( to ensure that there is no iron deficiency anemia)
2. CBC
3. HPLC (instead of electrophoresis bcos it is more accurate)

If anyone can confirm ( or otherwise) what i have said.
Hope this helps.

Jade

Hi,

My result;

H inclusion Test : Negative

HPLC (Bio-Rad Variant):

AO: 81.3%

HbA2: 6.4%

HbF: 1.3%

P2: 6.1

P3: 4.1

(I am not sure what is P..maybe peak 2 and 3? in HPLC)

Agarose Gel Elctrophoresis
pH8.6, Hb Subtypes: A + A2

My MCV: 61.5
    MCH: 19.8

I am female, 28 years old, not married and also diagnosis with hypertension (132/86)

so far, i never fainted..only tired but i suspected that i am overweight (161cm/79kg)

before this i never think that i am thalassaemia carrier before i done the test.

i am a bit worried because it will affect my quality of life. do i need to change my lifestyles?

Hi Ina_farhana,


My 2 month old child got detected for EBeta thal.I got tdetected for Beta thal arrier and my husband for Haemoglobin E, during my pregnancy. So, my daughter now needs treatment.

I am in my mid 30s and never knew about this. I have had the  most active life one can imagine. Befor emarriage I used to work for wildlife/environment conservation. I was travelling almost 20 days a month to all sorts of villages, jungles, countries, with a careless eating and workout lifestyle. Also, as I youngster I was actively into dance and music.

The only thing which, now in retrospection I feel is th, I did have undiagnosed breathing problem, which the docs ascribed to dust allergy. And as a kid very few times i passed out in very strong sunlight, while shopping. Thats all.But all taht went away on their own.
I cant remember of anything different in my life due to thal.

I guess its good you know about your thal minor now. So, you could be more vigilant with your diet and exercise, doctor's advice etc.

And just marry a non thal to be safe or get tested when you are pregnant.

I can assure your qualitry of life is not 1 % diminished being a thal minor!
Infact here in trhis forum  all thal major or intermediate friends are working hard so that their  quality of life is as good as anyone's.
And they are getting successful at it.

So, dont worry at all!:)

best wishes.

Hi Ina,

The high HbA2 does indicate that you probably do have thalassemia trait, and that would also explain your tiredness. You can read more about thal minor at http://www.thalassemiapatientsandfriends.com/index.php?topic=1575.0

Following a good diet with proper nutrition and avoiding junk foods might help with the hypertension. It is not seriously high so it might be possible to treat it without drugs. I do think this is the main health issue you face right now, as thal minor is actually a protective factor against hypertension, so when it is high in minors, it should be addressed.

If you haven't had many symptoms other than fatigue, you might not have much to be concerned about with the thal minor, other than trying to live a healthy lifestyle.

Hi there

" thal minor is actually a protective factor against hypertension,".  why is that?

I usually have the reverse of hypertension that is my blood pressure falls from time to time.  I may be quite active and feeling well one moment and the next it is like a lead cloak has been placed on my shoulders.  i may even have my neck aching and feel faint though i do not faint.  The last time I had this my mum checked my Blood pressure after she gave me vitamins etc and it was 9/6.  When i was pregnant it was worse, I felt it very very often then.  When I went for check up my blood pressure would always be 10/6 and my hb would not increase to the normal level despite taking the required medication.  Well I gues that's my usual self.
Jade

From http://www.springerlink.com/content/pq71n0778807r47x/

Previous studies have shown the protective effect of BTT (beta thalassemia trait) on myocardial infarction that may be due to lower cholesterol levels or lower arterial blood pressure in BTT subjects...BTT has a protective effect on the development of hypertension in young male adults.

http://www.journals.elsevierhealth.com/periodicals/ymehy/article/PIIS0306987702002645/abstract

high hematocrit levels are considered to be potential stroke risk factors. Minor thalassemia is associated with decreased prevalence of arterial hypertension

(One thing this does is make me realize how really bad the health of my thal minor employee is. He has seriously high blood pressure and high cholesterol, both of which are typically low in thal minors. Bad diet and a bad temper don't do much for one's health. hehe, I hope he never reads this.  ).