Does my bloodwork suggest Thalassemia???

I have been fighting disabling fatigue for about 15 years......Wondering if anyone has any comments in regards to my bloodwork.....

WBC......7.9   (3.8-10.8)
RBC.......6.2   (4.2-5.8)
Hg........16.3   (13.2-17.1)
Hct.......47.5   (38.5-50)

MCV......76.6.....(80-100)
MCH......26.2.....(27-33)
MCHC....34.2......(32-36)
RDW.....15.1......(11-15)

Platelet..184......(140-400)
Iron.......88........(40-190)
TIBC......351.......(250-400)
Sat%......25.........(15-50)
Ferritin.....66.........(20-345)
ESR.........2..........(0-15)
Folate.......449......(greater than 280)

Hg-A........85.3.........(96-100)
Hg-A2......4.8...........(0-3.7)
Hg-F........9.9...........(0-2)

HI kingneptune42  ,
How  r u?? ... i hope you'll b fine and happy .. ... i hope you'll find this forum very usefull and informative and you'll find all the answer of your concerns and questions .. please keep posting & stay in-touch with us ... i hope our senior member will reply you ASAP , keep visiting the site  .. ( yeah , exactly  ... i m not and exprty like member )

Best Regards
Take Care
Umair

Hello,

And welcome on the forum,I am not sure if you can have thal minor with the hb of 16,Please wait for our administrator Andy and see what he has to say about that.

Zaini.

Hello,
Welcome to the site.  I do not think that your blood work suggests beta thalassemia.  I believe this because your hg is quite high, 16.3 and your mcv number is 76.6 (it is usually in the low 60s for beta thal carriers).  Everything else seems well within the normal range as well.  Andy and a doctor can confirm my opinion. 

Once again welcome to the site

Sharmin

This is a very unusual blood report. The MCV and MCH are both borderline but on the low side. The fetal hemoglobin is much higher than one would normally see with thal trait. The HbA2 is slightly high for thal trait but within reason.

I would suggest there is a possibility that this is both thal trait and hereditary persistence of fetal hemoglobin trait, although the high HbA2 level is not seen in hereditary persistence of fetal hemoglobin.

Whereas high HbF is beneficial for thal intermedia and major it may not be an advantage for thal minors, as HbF has a high affinity for oxygen, which means it does not release oxygen into the body as easily as HbA (regular adult hemoglobin) does. Therefore, the total hemoglobin level may be inflated but the result does not match the tested level due to the amount of the less useful HbF involved. So, we can see a high Hb level but it does not mean that the problems often associated with thal minor will not also be present. With that in mind, I think an approach to improving the quality of life should involve supplements that help the circulatory system function better, rather than attempting to raise the Hb level. In this group of supplements that I would recommend are vitamin D (at least 2000 IU daily and even higher amounts if improvement is seen with a dose of 2000 IU), L-carntine (400-1000 mg daily), which will aid in fixing nitric oxide in the body which will improve the health of the blood vessels and help to maintain the flexibility needed to promote proper blood flow. This is also extremely important in helping to prevent pulmonary hypertension, which I believe to be a major problem in aging thal minors. In addition, vitamin E, magnesium and B-complex should all be added to the daily regimen.

Because this may be a case of thal minor being masked by another benign condition, I think you should defintely try the supplement approach and see if you feel any less tired. The importance of vitamin D has long been overlooked and it is now becoming the "hot" supplement to take and for very good reasons. As a species, we no longer get anywhere the amounts of vitamin D that are bodies need and researchers are finding that it has importance in all levels of functions in the body and the prevention of cancer and other diseases. If you were to pick only two things to use for supplements, I would say that vitamin D and L-carninte may have the most value for your particular condition.

I just want to add that the diagnosis is probably not as important as combating the fatigue. Regardless of whether or not it is thal trait involved, the symptoms are the same and the approach should also be the same. A high Hb and normal iron levels where tiredness is chronic is unusual, but as I said, the high HbF may be masking what your useful hemoglobin level really is, so working on the fatigue should be the main goal.

I wanted to thank all of you guys for the great responses.......Its really nice to have so many intelligent people who care on this site........Have not had very good luck with the doctors as far as answers to my condition......

I have had a couple doctors tell me that they think I have the beginning stage of MS and others say I have Chronic Fatigue Syndrome/Fibromyalgia.......Personally, I dont know what to think after 15 years of searching for answers.......I have battled fatigue my whole life and my mom told me that I had anemia as a baby too......I have been unable to work as a Chiropractor due to my condition, which really makes things hard on me mentally........Fatigue by far is my major complaint, its as if I am stuck in concrete shoes and my endurance is pretty confined to a couple of hours a day........I try and stay positive though, what else can you do.......

Andy.......you are incredible........I cant tell you how much I appreciate your time and knowledge......I learned more from you than all my doctors combined.....which is pretty sad.....lol    I agree with you 100 percent......I think no matter what my diagnosis is, I need to address the fatigue.......I did pretty well with L-Carnitine in the past, I will start back up on this again......I didnt realize Vit D would be that important for me, but I have read the new research on this as you said.......I know I am not in the sun enough, so I am sure I dont get enough Vit D......thanks for that tip.........I also seem to do better on B-complex, so I will add this too.....

Just to add some overview........I seem to do better on a "raw diet", with no meat......My digestive system seems to be pretty bad, especially when I consume gluten and meat......I mainly eat salads, fruits and veggies and nuts........try not to cook my food, as it hurts my digestion......I seem to do better on some armour thyroid too, but it has not "cured me".........

When I had the electophoresis of my hemoglobin, the pathologist simply wrote that elevated levels of HgA2 and Hg F suggest the possibility of Thalassemia minor.......but that is the only thing they wrote.......and my GP has no idea what to think of my elevated levels of the Fetal Hg........

Quick question Andy.......should I look into this further on the high levels of Hg F ?   Is this amount consistent with what you see in Persistant Fetal Hg ??   Just wonder if this might explain why I have always battled fatigue compared to other kids when growing up......Thanks again.......John   

One more Question for you Andy and others........Is it possible the high levels of Hg F could justify the level of fatigue I am feeling or is it more likely that it could be a viral condition such as CFS or MS???    I apologize for all the questions, but I am so baffled by the fatigue I have experienced even in my childhood........I am 42 now and have been on disability for the past 10 years.......Thanks in advance......... 

John,

Your fetal hemoglobin level is higher than what is normally seen with thal trait and is consistent with what would be expected in a carrier of hereditary persistence of fetal hemoglobin. Of course, this does not mean you necessarily do carry that trait but there are not many things that can explain an HbF of that level. You can be tested to see if this is a possibility.  Most thal minors have 1-4% HbF, so it is substantially higher than what we would expect. Also, as I mentioned, this can "disguise" your true hemoglobin level and make it look higher than it functionally proves to be. Also, from talking with other who have gluten intolerance, this can definitely be a factor in fatigue. I really think diet and supplements is the best approach combined with whatever mild exercise you can handle with the fatigue.

John,

I think the benefit of testing for these possibilities is that you can rule things out which will help you narrow down what is the real problem. I am curious if you have ever been told that some of your red blood cells are small or oddly shaped. That would help in determining if thal trait is involved. DNA testing would tell you 100% if you are a thal carrier.

Thanks again Andy.........I feel like I should pay you for the office visit.......

My biggest concern is with my 14 year old daughter..........She is starting to display some of the things I battled growing up........Tires so easily compared to kids her age, she is so pale like myself, some problems with headaches and some anxiety at times........I guess my pursuit of answers is more for her quality of life, especially if she has to battle fatigue later in life.......

Just out of curiosity Andy, what doctor would I see for my Hg F levels.......Would it be a Hemetologist?     Thanks for all of your help.......I am going to start immediately on my supplements.......John

PS.......Shape of RBC's.............Yes Andy, I had a couple doctors tell me that I have RBC's that are mis-shapen, some were oversized, but I want to say they told me most were microcytic...........I think one doctor explained that the RBC's were just not normal shapes.......some small and some large........I need to get my notes out to see what they said specifically.........pretty sure most were microcytic though........they told me iron supplements would not be a good idea for me......thats about all they said.......

Yes, a hematologist can order the proper tests.

I also think your daughter should be on supplements. We are seeing that thal minors who do follow the recommendations are seeing improvements in health, although I do have to say, don't expect miracles. I do think you can see improvements but a life of low oxygen supplies to the body does have an effect. I think your daughter can avoid many long term problems if she does supplement and pays special attention to her diet and nutrition.

You might also have to deal with the old thinking that thal minors don't have any problems but that has finally been proven wrong and the admission that more research is needed into the health consequences of thal minor. I recently posted about a study done in 2008 that showed thal minors do indeed have symptoms. http://www.thalassemiapatientsandfriends.com/index.php?topic=2769.msg26748#msg26748

Thanks again Andy.......I am going to follow your supplement regime and try to get in to see a hematologist in my area.......I know what you mean about finding one who understands blood disorders.....I will try to locate one here in Illinois.......

I really appreciate all of your help......I think I finally have a grasp on the symptoms I am feeling, it all makes sense the way you have explained it.......  

Try contacting

Alexis Thompson, MD
http://www.childrensmemorial.org/findadoc/doctor.asp?dID=1009
Sees patients at
    Children's Memorial Hospital
    2300 Children's Plaza (Lincoln and Fullerton)
    Chicago, IL 60614
    1.800.KIDS.DOC

Director: Alexis Thompson, MD
Contact: Janice Beatty, (773) 880-4618

Ask them where an adult can go for testing in your area. They should be able to connect you with a thal familiar hematologist. Again, a doctor may tell you that thal minor has no symptoms but it would be helpful to have you and your daughter tested so that you know exactly what you are dealing with and can take the appropriate steps.

Andy.......thanks for the footwork on this, I am definitely going to contact them for some testing.......I will let you all know what I find out........John