I am 29 years old working woman (single). In last February, I suffered from breathlessness. In addition to oxygen inhalation, doctor suggested ECG as my pulse was 120. Except for Sinus Tachycardia, ECG was normal. After few days, pulse became normal (80+).
The results of the subsequent tests were following:
Month Hb MCV MCH RBCs RDW Iron Ferritin TIBC
February 9.6 59 17.3 5.55 16 - - -
March - - - - - 82 27.6 411
August 8.7 - - - - 77 <5.0 297
September 9.8 56 17.2 5.7 20 74 43.88 345
September 10.8 57 17.9 6 20.5 - - -
October 10 61 19.1 5.26 19.7 - - -
December 9.3 61 22 - - - - -
Electrophoresis report (March) showed Hb A as 94.8 and Hb A2 as 5.2 %. Doctor told me that I have 10 % problem of Thalassemia. On his recommendation, I started to take folic acid (5 mg). Later on, when my Ferritin level was dropped to <5.0, I started iron supplement on the recommendation of doctor.
After taking folic acid for some time, I have to stop taking it, as it develops dryness in my mouth and some times allergy (sneezing due to excessive dryness) (I have the problem of allergy for many years). However, I have to start folic acid again after some time due to my health condition. In all, I have taken approximately 150 tablets (5 mg) since last march when my trait was identified.
The problem I faced during this year is Shortness of Breath. At times I am Ok, but at other times, I am in much trouble. During travelling by bus, occasionally my breath is no more comfortable and the most trouble I feel is in the abdominal muscles. In that condition, it becomes difficult for me to walk. And if still I walk, uneasiness increases. Once it happened (in August) that I have to walk in that condition, the result was out of control abdominal pain. The pain vanished after few minutes of taking folic acid. No other medicine was taken by me. After this, a couple of times, again I felt this type of pain and it disappeared few minutes after taking folic acid. When I discuss this uneasiness or pain in abdomen, doctors take it as some problem related to stomach or intestine. But, I feel that this is not the case. I can associate this with two things: walking (or physical exertion) and folic acid.
Some times, I feel this uneasiness in abdomen even in comfortable sitting with out any traveling as right now I am feeling. In laying position I feel better.
Kindly tell me
1. Which type of Thalassemia trait I have: Alpha or Beta?
2. What I have to do to avoid dryness cased by folic acid?
3. Should I continue iron supplements also?
4. Why I feel uneasiness in abdomen along with Shortness of breath (which if not addressed properly converts into pain)?
5. Before the last year, I didn’t use folic acid, what happened to me that now I am becoming folic acid dependent? Have my trait activated? What I should expect in my later life regarding my trouble?
I shall be very thankful for you for replying my questions and giving me suggestions.