Most doctors have little knowledge about thalassemia in general but even less about alpha thal. If you show sensitivity to certain foods or chemicals, and your Hb drops, you can be certain that favism is an issue. I would suggest paying close attention anytime you suddenly feel very tired and look for anything unusual you may have eaten or been exposed to. Although favism is a well known problem for those with HbH disease, it is not associated with alpha trait. However, I am beginning to believe this is simply due to lack of reports making the connection, as we are hearing from more and more alpha carriers who show signs of favism. Whether or not the connection is accepted, you can see for yourself when you are affected. Think to avoid chemical fumes in general, including many common household and beauty care items. There is a possibility that some chemical fragrances cause favism in sensitive people, so always watch for what you are exposed to. You may be able to recover your normal Hb level by avoidance. If it does happen that you have HbH, as with thal intermedia, the symptoms do seem to worsen with age.
In the end, it is difficult to give an accurate diagnosis for alpha thalassemia in adults unless a DNA analysis is done.