Supplements for these (related?) conditions

I am 28 and this is my first post to this invaluable forum.

I was told I have "thalassemia minor" about 5 years ago. I also have "spina bifida occulta" (the mildest and asymptotic version). I am fairly healthy and the discoveries of these two conditions were only accidental.

My current Haemoglobin is 12.6 gm/dl and Haematocrit is 39.2%. The report also mentioned "anisocytosis, hypochromic, microcytic, poikilocytosis, polychromasia, target cells".

One year ago I was severely Vit-D deficient and borderline adequate in Vit-B12. I now have normal Vit-D and Vit-B12, after vitamin injections and 6 months of Calcium + Vit-D tabs.

I have been under much stress in the last 7 years due to family/job/studies. Some of these causes, and hence stress, have now subsided.

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-> I have had some left-sided chest pains since 5 years, which are sometimes exacerbated when sleeping on left side, though my ETT-Exercise Tolerance Tests were excellent. The doctor told me to shut up and forget.

-> I have sometimes had weak and difficult to sustain erections in the last 2 years, which resolved completely with solid morning erections when I took synthetic 400 mg Vit-E for 3 months. The problem slowly returned after Vit-E discontinuation 1 month ago.

-> I have now noticed hair thinning at the middle of the top of my head. The doctor tells it is "male pattern baldness". He even gave me a good multivitamin but it contained iron, so I didn't consume it because of my thal-minor condition. Was I right?

-> Recently I also seem to be losing weight slightly, though I always have adequate meals.

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Currently I am getting a good diet, a multivitamin (ingredients below), natural vitamin E 200 IU, and one cod liver oil capsule daily. Getting some sunlight too but not enough probably.

INGEDIENTS ==> Vitamin C 500 mg | Nicotinamide 100 mg | Vitamin E 30 IU | Calcium pantothenate (Pantothenic Acid) 20 mg | Vitamin B1 (Thiamine) 15 mg | Vitamin B2 (Riboflavin) 15 mg | Vitamin B6 (Pyridoxine hydrochloride) 20 mg | Vitamin B12 12 mcg | Folic Acid 150 mcg | Zinc (equivalent to 100 mg of Zinc sulfate) 22.5 mg

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1. Do the above problems (chest pain, erections, thinning hair, slight weight loss) seem related?

2. What supplements should I regularly take and for how long?

3. Should I be watching the food I eat? For examples, apples (coz of iron) and citrus fruits (coz of vit-C)?

4. Am I at risk of developing iron overload? Should I check my ferritin levels?

PS: THANK YOU SO VERY MUCH TO THIS INVALUABLE FORUM. I HAVE READ THROUGH SOME SECTIONS AND THIS FORUM SEEMS MORE KNOWLEDGEABLE THAN MY DOCTORS

1) The pain on the left side is most likely from a slightly enlarged spleen. This can be easily confirmed by a doctor physically checking to see if the spleen is palpable. This is common in thal minor and a result of the breakdown of red blood cells, RBCs. We have had other minors post about erectile dysfunction, so there may be a connection to thal minor. I would suggest raising the vitamin E to 400 IU daily and make sure you are taking only natural E. I recommend the mixed tocopherols E. Hair loss is also commonly reported by minors. Some possible causes are low vitamin D and zinc deficiency. Weight loss is more likely to be related to other factors such as stress.
2) I would suggest taking a B complex 100 rather than the small amounts of individual B vitamins, and also at least 1 mg folic acid daily. Get your D level tested and then supplement if needed. If you are deficient, it may take high doses to correct. I am dealing with this myself. I take 5000 IU D daily and my level is normal now but still lower than I want and very difficult to budge. L-carnitine supplements may also be considered.
3) Unless you have supplemented with iron for long periods, you have nothing to worry about, as your Hb is not low enough to cause added iron absorption. Do not avoid fruits and vegetables, as the nutrients they contain are essential.
4) As stated, unless you have had long term iron supplementation, you are not at risk for iron overload.

Thank you very much Andy for your reply.

1) Never thought the pain could be spleen-related. The doctor did have me go through some chest x-rays, which were all good, though I am not sure if chest x-rays were appropriate for showing spleen-enlargement in the first place. I will have him check my spleen next time I have those pains.

2) I am taking GNC Natural Vitamin E 200IU. I have read 400IU or higher dose Vit-E for long durations may not safe in the long term, this is why I kept it down to 200IU. Further, the "natural" version is supposed to be twice as potent as the "synthetic" version, if I am not wrong. However, thals would probably have higher Vit-E requirements so high doses may be safe for thals after all- also the "natural" version may be safer. Do we have any studies on Vit-E dosing for thals?

3) I have a theory regarding ED in thals - higher anti-oxidant requirements run down the Vit-E reserves in thals, leading to blood-thickening, hence ED. Supplemental Vit-E brings everything to normal, hence normal erections. Further, as bone marrow turns from red to yellow with age, Vit-E requirements also go up, because the body has to make the most of whatever red-blood-cell production is available. I am no doctor, neither do I have the experience, so can you critique this theory?

4) I do understand the Vit-E part, but why is B-Complex and Folic acid important for thals? Should I take those (high) doses for life?

I have some whey protein supplements lying around - will that do for the L-carnitine? My stomach does get upset with whey-protein though, although I can tolerate cow milk.

What about magnesium and calcium? I have had leg tightness when I wake up in the morning which goes away with exercise/stretching. Also, my astigmatism was only discovered when I was 27 - apparently, until then, my eye muscles were strong enough to compensate for my congenital astigmatism.

My Vit-D was as low as 5 one year ago. It was up to 60 after some injections in few couple of months. Later it was 45. Haven't tested in the last 6 months though.

Thank you so much for your feedback on hair and weight loss, and iron-overload. (I do remember taking multivitamins with iron when I was very small, as my parents didn't know about my thal then. I think thats an old irrelevant story now anyway.)

Andy, have you read my post? I would really appreciate your comment. Thank you so much.

1) The spleen is checked by a physical examination. Any competent doctor can tell if it is enlarged simply by feeling the area.
2) Forget what you have read concerning vitamin E. There is a concerted effort to undermine the supplement industry by those who prefer people stay sickly and dependent on a very expensive health care system. I have taken 400 IU natural vitamin E daily for 37 years. I am a believer. It keeps me young. I am also absolutely convinced that is has a very positive effect on sexual function. Just avoid synthetic E completely. This is what is used in almost every study and it is not a safe product.
3) I do believe that the thickening of the blood in thals, which is the result of the production of ineffective misshapen red blood cells is a factor in the ED being reported. Vitamin E, of course, can help to counter this.
4) B Complex, folic acid and magnesium are all essential for building red blood cells and maintaining their health. I suggest calcium and magnesium be taken together, as they are both necessary for proper heart function and should be kept in balance. Calcium without magnesium may not be a safe long term strategy, as heart palpitations can occur if there is an imbalance of the two minerals. Vitamin D is needed for absorption of the minerals. With your previous deficiency being so severe, it might be wise to take D daily. In my own case, 5000 IU daily has gotten me up to 38 from 19, but it isn't rising at all from that level. Lower amounts of D are virtually useless.
Whey protein does not replace L-carnitine. I would suggest concentrating on foods high in L-carnitine, such as berries and watermelon.

1) The spleen is checked by a physical examination. Any competent doctor can tell if it is enlarged simply by feeling the area.
2) Forget what you have read concerning vitamin E. There is a concerted effort to undermine the supplement industry by those who prefer people stay sickly and dependent on a very expensive health care system. I have taken 400 IU natural vitamin E daily for 37 years. I am a believer. It keeps me young. I am also absolutely convinced that is has a very positive effect on sexual function. Just avoid synthetic E completely. This is what is used in almost every study and it is not a safe product.
3) I do believe that the thickening of the blood in thals, which is the result of the production of ineffective misshapen red blood cells is a factor in the ED being reported. Vitamin E, of course, can help to counter this.
4) B Complex, folic acid and magnesium are all essential for building red blood cells and maintaining their health. I suggest calcium and magnesium be taken together, as they are both necessary for proper heart function and should be kept in balance. Calcium without magnesium may not be a safe long term strategy, as heart palpitations can occur if there is an imbalance of the two minerals. Vitamin D is needed for absorption of the minerals. With your previous deficiency being so severe, it might be wise to take D daily. In my own case, 5000 IU daily has gotten me up to 38 from 19, but it isn't rising at all from that level. Lower amounts of D are virtually useless.
Whey protein does not replace L-carnitine. I would suggest concentrating on foods high in L-carnitine, such as berries and watermelon.

HEY ANDY,
I AM TAKING VIT TAB A 2 Z. BUT DON'T KNOW IT CONTAIN NATURAL OR SYNTHETIC VIT E BUT IT HAS VIT E. WOULD YOU PLEASE SUGGEST ANY BRAND NAME FOR ME AND MY MOTHER(THAL. MINOR) AVAILABLE IN INDIA.?

The amount of vitamin E in multis is generally quite low. Can anyone help us with the brand name of a natural E supplement available in India? I am at a disadvantage here.

Thank you Andy so very much. Please correct me I the following is inappropriate, but I guess I should be taking these:

GNC Natural Vitamin E 400 IU
GNC Big 100 (Vitamin B)
GNC Folic Acid 400
GNC Calcium Plus 1000 with Magnesium & Vitamin D
GNC Vitamin D 5000 IU

and of course, good diet and exercise.. Thanks!

Those are all good. How much magnesium is in the calcium supplement? The goal should be a 2:1 ratio of cal/mag. Folic acid could be higher. I would suggest taking two daily.

That calcium supplement contains 1000 mg Calcium, 500 mg Magnesium (half as you said) and 800 IU Vit-D. Then there would be the additional 5000 IU of Vit-D separately.

I kept Folic supplement down to 400, because there is an additional 400 in the B-Complex supplement. Total Folic then becomes 800. Does this sound Ok to you?

Yes.

thanks!