Iron deficiency anemia + thalassemia?

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Iron deficiency anemia + thalassemia?
« on: March 06, 2013, 06:49:34 AM »
Hey all, I have a pretty confusing (to me) situation going on right now and I'm hoping to find some insight. I am going to apologize for the length of this ahead of time. Sorry:[

In a nutshell: I'm 21 yrs old with thal minor, recently have been feeling way more horrible than normal with excessive hair loss and fatigue, went to the doctor, was diagnosed with iron deficiency anemia and am now on iron supplements. AHHH. What follows is the more detailed report.

For the past three to four years I've been steadily feeling worse - tired, depressed, pressured, panicked, looking very pale and being cold all the time etc., all of which I've attributed to my thal minor that I was diagnosed with as a 2 year old. My dad also has thal minor and has had some but not all of the same symptoms I've been experiencing.

Well when I was two, the doctors kept saying that I was iron deficient and put me on supplements to raise my blood count. The supplements barely touched me, only raising my count by one point, and eventually I went to a doctor that told me I had thalassemia and it was normal for my blood count to be how it was and I shouldn't have any symptoms. So up until I turned 18 I was fine, but like I said, since then it's been a steady decline with more and more symptoms increasing in their intensity.

A little history of the last 6 months:

Five months ago I started experiencing terrible joint pain. I had a hard time getting out of bed and couldn't use my thumbs or exercise for about two months. My fingers and thumbs are still sore every morning and I can't bend them completely. I attributed this to stress, and so did my doctor.

In November I had my wisdom teeth removed and had a horrible recovery, I was weak for two weeks after and wanting to sleep constantly. I looked unhealthy and on the verge of death (haha). I've had two other similar surgeries in the past four years and had recovered fairly normally from those, but I found I never really felt like myself after my wisdom teeth removal, always tired and lazy feeling. I'd wake up after a solid ten hours of sleep, eat breakfast and want to go back to bed, whereas before I'd always been at my most energetic at that time.

2 months ago I returned to the doctor for the persistent joint pain and for the fatigue, and I had a blood test and then he referred me to a hematologist after saying that my platelets/hemoglobin was low.

Then, about 6 weeks ago, my hair started falling out rapidly. And I mean rapidly. I'm getting chunks of strands falling out everywhere, and I have about half of what I did 3 years ago. Like I said I've had hair loss for the past 3 years, but never like this. This is AWFUL.

So I went to the hematologist, he took more blood samples, I went to a follow up with my regular doctor who had received the blood sample results and he said that I had developed iron deficiency anemia. I said wait - everything my dad's doctors have told him goes against that, that people with thalassemia minor are at risk for iron overload, and that too much iron is toxic to people like us with thal minor. But the doctor said my iron was low and that I definitely did not have an iron overload, and then told me that I should take iron supplements. He recommended Pure Absorb, vitamins, and healthy eating with a lot of meat.

OKAY so this is where I ask the questions. What the heck? Is this remotely normal? I seem to have most of the symptoms of iron deficiency anemia, and it would make sense with the blood loss I've experienced, but I was always under the impression thal balanced out iron deficiency cause it makes the blood hold on to it? I'm taking the iron supplements and I do definitely feel more energized, but my hair is still falling out like crazy. Some insight/advice/sympathies please!



Edit: don't know if this is the right area to be posting this, but I'm a noob and this is the only topic I could find with iron in the title... please put it in the right spot if there is one!

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Offline Andy Battaglia

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Re: Iron deficiency anemia + thalassemia?
« Reply #1 on: March 06, 2013, 03:23:44 PM »
Do you have the results of your blood work? I am looking for the results of any or all of the following: A complete blood count (CBC), an iron panel which would include serum ferritin, serum iron and at least one other measure of iron, and a hemoglobin electrophoresis, which shows the percentages of the various types of hemoglobin. I can't really comment without more info.
Andy

All we are saying is give thals a chance.

Re: Iron deficiency anemia + thalassemia?
« Reply #2 on: March 07, 2013, 06:06:38 AM »
My hemoglobin is at 9.5, when I was two yrs it was at 7, so it's improved over the years I guess. I'm planning on requesting the results from both of my tests either tomorrow or Friday and as soon as I get them I'll post them up. Thanks for your help!

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Offline Andy Battaglia

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Re: Iron deficiency anemia + thalassemia?
« Reply #3 on: March 07, 2013, 03:12:50 PM »
Thal minors can have iron deficiency, IDA just like anyone else. It is not related to the thalassemia and is simply coincidental when it does occur, but it can occur. The fact that your Hb has risen so much does suggest IDA was and may still be present. As long as the doctor has run an iron panel of tests showing iDA, it is safe to take iron.

An iron panel will include at least 3 of these tests.
Serum ferritin measurement
Serum iron measurement
Total iron binding capacity measurement
Transferrin saturation index
Andy

All we are saying is give thals a chance.

Re: Iron deficiency anemia + thalassemia?
« Reply #4 on: April 13, 2013, 11:46:56 PM »
Super sorry for the delayed response... just got my computer back

Here are the results from my test taken 2/15

Red blood cell count: 4.77 (in range)
Hemoglobin: 9.3 L (out of range)
Hematocrit: 30.4 L (out of range)
MCV: 63.6 L (out of range)
MCH:19.5 L (out of range)
RDW: 15.8 H (out of range)
Hemoglobin A: 92.8 L (out of range)
Hemoglobin F: 1.4 (in range)
Hemoglobin A2: 5.8 H (out of range)

And the interpretation: Evaluation is consistent with beta thalassemia trait with anemia.

I went to see a hematologist and he suggested that I have a bone marrow biopsy, which I had a week ago. My next appt with him is in two weeks and I'm anxious to find out the results.. my hair loss has been awful. He said the main concern was the low platelets and that it shouldn't be causing my hair to fall out, but something is, so he's checking for autoimmune disorders now.

Thanks for the help!

Re: Iron deficiency anemia + thalassemia?
« Reply #5 on: November 17, 2013, 11:21:43 PM »
Hi, I just read your post and have been searching high and low if someone knew anything about this. I have been feeling ill since April and I went to the dr. and after my initial blood test was told I need to boost my iron level and was given iron dextran shot(I am red meat intolerant so no lamb/pork/beef etc. I can only eat fowl and fish). I had a sever reaction from it and so my dr sent me to a hematologist. I finally got an appt. and saw the hematologist last month. I was sent to get more test and the hematologist thought I had thalassemia, I now have the results stating that I have thalassemia, also some other results about ferritin and long list of even more tests. I have to wait for another month before I can see the hematologist again.

initially when I went to the dr. I was feeling exhausted and nauseous and slightly light headed after the iron shot I was unable to stand for more than 5mins before fainting(Dr. could not get a pulse or blood pressure unless i was lying down.) after about 3 weeks of rest i started feeling better.

now in the last month I feel nauseous and light headed almost constantly. until a month ago i used to be able to run 10k every other day and now a trip to the grocery store is hard. I do not have hair loss but my entire body hurts.

sorry for the long post.

Do you have any advice?
Thanks.

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Offline Andy Battaglia

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Re: Iron deficiency anemia + thalassemia?
« Reply #6 on: November 18, 2013, 03:49:50 PM »
Do you have copies of your blood work that I could see? And has your vitamin D level ever been checked?
Andy

All we are saying is give thals a chance.

Re: Iron deficiency anemia + thalassemia?
« Reply #7 on: November 20, 2013, 12:22:59 AM »
Hematology
WBC 6.8
RBC  4.89(Abnormal)
Hemoglobin  115(Abnormal)
Hematocrit 0.36(borderline Abnormal)
MCV 73(Abnormal)
MCH 23.5(Abnormal)
MCHC 320
RDW 14.4
Platelet Count 236
    
Differential
Neutrophils 3.1
Lymphocytes 2.8
Monocytes 0.5
Eosinophils 0.2
Basophils 0.0

Hemoglobin Investigation
Hemoglobin A2/Total Hemoglobin 2.0
Hemoglobin F/Total Hemoglobin 0.2
Hemoglobin Frationation HPLC

Biochemical Investigation of Anemias
Iron 8 (Abnormal)
TIBC 76 (Abnormal)
Iron Saturation 0.17 (Abnormal)
Vitamin B12 318
Ferritin 6 (Abnormail)

General Chemistry
Glucose Random 4.3
Creatinine 53
Calcium 2.22
Albumin 43
Total Bilirubin 7
Alkaline Phosphatase 69
ALT 19
AST 17
Lactate Dehydrogenase 260

CRP 1.9

I do not recall ever having a vit D level check.

 

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