Taking Iron Supplements

Hey everyone,

I'm new to the forums, and I'm so glad such a place exists. I've been searching all over the internet for information and I'm still confused with a lot of things. I've been informally diagnosed with being a caarie of thalassemia when I was a child (around 10 years old) because my mom is a carrier. I am getting electrophoresis done, but I'm pretty sure I have beta thalassemia minor. I have symptoms of fatigue, dizziness, cold hands and feet and heart palpitations. I've had this as far as I can remember. I'm exhausted when I get out of bed, and it lasts through out the day. Everyone thinks I'm just lazy, but I'm just so tired even without doing any work. I don't know if this is due to thalassemia, or a comorbiding problem. Enough of the intro.

I have been put on iron rich cereal when my doctor noticed my iron deficiency as a child. Then my parents got a new family doctor who knows about thalassemia (her son is a carrier) and told my parents that I should not intake iron because of my disease. When I turned 19, I got my own family doctor. She tested my blood and found that I had low iron levels and I was slightly anemic. I started taking iron supplements even though I informed her of my thalassemia minor condition and what the previous doctor said. I've been taking iron supplements on and off for 1 year. I went back to my previous doctor (my parents' doctor) and told her about this and again she said iron supplements are forbidden for thalassemia patients. I can however eat iron rich foods. I am very confused. I don't know whether to continue the iron supplementation or stop taking it. Can someone help me out with this?

Hi Dackerie,

Generally, thal carriers shouldn't take iron unless a co-existing iron deficiency has been diagnosed through a panel of tests that usually test for serum ferritin, serum iron and TIBC (total iron binding capacity). Iron should not be taken unless these tests show that your iron stores are low. I would suggest asking for an iron panel to determine if you are currently deficient, as your hemoglobin level alone cannot be used to diagnose iron deficiency. I imagine that there is a similar percentage of thal minors who have iron deficient anemia (IDA) as the general population. The problem arises when doctors decide it's IDA by Hb level only. Once you get your electrophoresis results, I will be happy to take a look and also your iron results when you can get them.

Thanks a lot. I will look into that.

Hello everyone,

I am a new member.  I am mum of a 12 years old boy carrying Thal minor (from dad).  He is a very sporty boy, loves sport, however, as like other Thal Minor carrier, experiencing fatigue, low appetize, lack of focus.  So he is very skinny, as he does not eat enough (not good appetize), but his energy output is so much. He is frustrated as he cannot concentrate over his study well, though he is working hard.  All these actually make him very tired, and frustrated.  He get tired easily, so I have to make sure he has to sleep at least 8 hours a day even sometimes he have not completed his homework.   

Thanks to this website, I get to understand what is it all about Thal minor and the root cause of the whole thing.  My husband live like a normal person but he told me he was very weak when he was young.  After reading this website, I have decided to bring my son for a blood test. I would like to know what sort of test we should do for him.  What is iron panel test? What does it test?  Please give me advice over this so I can seek appropriate testing for my son.  We hope that the test result will give us information about what supplement to give our son.

Moreover, I would like to ask if climate minimise the symptoms of Thal Minor. We live in Beijing where the winter is very long and dry. He also has asthma.  So is it better for my son to live in warm weather, which will help his blood circulation and consequently increase his energy level?

Looking forward to any advice. Many thanks.

Hi Leung,

The two groups of tests he should have are a Complete Blood Count, CBC and an iron panel. Thal minors can be iron deficient just like anyone else, so it's a good idea to check for it. An iron panel usually consists of tests for serum ferritin, serum iron and total iron binding capacity, TIBC. The results of the 3 tests can normally determine if iron deficiency is also present. Because he is tired, I would also suggest a vitamin D test. Low D contributes to tiredness, fatigue and depression. It is also the most common vitamin deficiency is today's world.
I have heard most thals like cooler weather better, but I don't know how much difference climate can make to a thal minor. Natural vitamin E is a mild blood thinner and also can help improve the quality of red blood cells and the circulatory system. I recommend natural E to all thals. For a boy his age, 200-400 IU daily is sufficient. Avoid synthetic vitamin E completely.
With thal minor, nutrition is very important and even more so when appetite is poor. A daily multi-vitamin, in addition to vitamin E and D if needed, is suggested. Find out his iron status before using a multi that contains iron.

Many thanks, Andy.

You mentioned that Thal minor prefers cooler weather. Is there any reason for this? 

I have read a lot of articles on internet about Thal minor who should do plenty of exercise to keep the blood circulation which helps to boost up the oxygen level.  It is true that when my son not doing any exercise for that particular day, he looks pale and fatigue. So it seems that exercise does help raise his oxygen level.  I have been thinking whether the cold weather will slow down the blood circulation and cause more fatigue, so it won't do any good to his health by staying in Beijing?  So if we move to warmer climate, or back to Malaysia (we are from Malaysia), will this do more good to his health?

The iron panel test you mentioned, is it common testing in any hospital ?  It seems local doctors here in Beijing are not famliar with Thal minor, I guess this is not common in Bejing. But I will definitely get those tests done for my son, but I do not know if we will get the appropriate advice here or not with the test result, or we will get the appropriate supplements here.  You mentioned the natural Vit E, where can I get it or what brand recommend?

Andy, many thanks for this website. This gives tremendous help to me in understanding about the root cause of my son's fatigue.  Once I get the test result, I will probably get back to you for help. Thanks again!

Andy, I got my test results back. I really appreciate you looking through them.

Hemoglobin         109 G/L - low
Hematocrit          0.351 L/L - low
WBC count          5.6 x10 9/L
RBC count           4.94 x10 12/L
MCV                   71.0 FL - low
MCH                   22.0 PG - low
MCHC                 310 G/L - low
RDW                  15.2% - high

Hypochromia        mild
Microcytosis          mild
Ovalocytes           few
Platelets              normal

Ferritin                14 UG/L
Iron                    20 UMOL/L
UIBC                   43 UMOL/L
TIBC                   63 UMOL/L
Iron saturation     0.32

HB Electrophoresis

HB A1
HB A2
HB F
HB S
Cresyl blue stain
Abnormal HB

The doctor said everything is fine and I don't need to take any supplements. I do feel fatigue, which is most likely due to the mild anemia. I have been told I am a thalassemia carrier. I self diagnosed it to be beta thalassemia minor through reading, I don't know if this is correct. I am of Turkish decent if that helps. Also, if there is anything I can due to treat the mild anemia, I could really use some tips. My B12 levels are good and I am getting my vitamin D tested now.

Your reports look very much like thal minor. Your iron levels also appear to be slightly low. I would not suggest supplements, but rather that you concentrate on making sure you are getting foods rich in iron. Low D levels can also cause fatigue etc so let me know once you receive your test results.

Andy, I have gotten my results back. My vitamin D level is 40, I forgot to ask the units. My doctor has said I fall below the normal range of 100-150 so I am deficient. I am going to start taking supplements. I hope fixing this problem will aid my fatigue.

I have looked through the forums but couldn't find what I wanted. Is there anything I can do to increase my hemoglobin levels?

Some people see a benefit from wheatgrass and resveratrol in raising Hb. Both have excellent properties in addition, so there is benefit even when Hb does not rise.