Manal,
I have read that it can take up to two years to see the maximum effect of hydrea. There is no rule, however. Each patient reacts differently and I think you are seeing that even in the same patient, things can vary. This may be related to something else he is also taking or even to his diet. If he is eating better now, that may make a difference. One thing evident from the article I posted about HQK-1001 is that the effect of hemoglobin inducers can be enhanced by using in combination with other blood promoters, and even iron supplements. I am not suggesting using iron at this point, but what was found was that even in cases where iron stores were high, adding iron resulted in a higher increase in Hb. The stored iron is not released easily and is little use in building blood. By adding iron, they provided the iron necessary for manufacturing new red blood cells. I have also read of another study where iron was given to intermedias and in spite of existing iron load, adding iron raised the Hb. Obviously, this would need much more study before anything is recommended, but it does seem that there has to be some dietary iron to build red blood cells. I would think that this also means that supplying the body with other supplements needed to make blood, like folic acid and magnesium, would also help raise Hb when used along with Hb inducers.
One question. Is Ahmad's diet any different than it used to be? Does he have more appetite for nutritious foods or even possibly, foods high in iron, like meats?