Do alpha thalassemia carriers have symptoms?

Hi all, so I've recently had DNA testing done and it shows I am an alpha thalassemia carrier with one gene missing.   Based on everything I've read I should have no symptoms and my only concern would be if I had children.   Yet for all my life I've had somewhat abnormal blood test results similar to these taken 5/1/13:

MCV   73.3 L   (80-100)
MCH   23.1 L   (27-33)
MCHC 31.5 L   (32-36)
RDW  16.6 H   (11-15)
RBC   5.05       (3.8-5.1)  was normal this time, but is often slightly high at 5.5
Hemoglobin   11.7 (11.7-15.5)  this is usually right on the bottom but still in the normal range

Most docs over the years attributed this to microcytic anemia due to iron lost through periods.   Recently I developed another separate health condition where I had frequent CBC's done and I was taking my iron supplement very carefully.   No change occurred in the values above and I finally said I want this investigated!!!   

So my question for you all is.....what is the real impact on me of this?   I'm not a silent carrier because my blood clearly is affected.   Would it explain the lack of "robustness" I've had since childhood as compared to my peers?

Have you had an iron panel done to make sure you have iron deficiency? Iron should not be taken by thals without having the iron panel done first, as iron supplements can lead to an increase in iron in the body, and this is not a good thing.

Hi Andy, yes I've had iron studies done.   My ferritin is 30 and I lose lots of blood every month and this has been going on for many years, without heavy periods perhaps my iron would be fine or even too high - I am not officially anemic but the hematologist says that I might feel better if my ferritin were higher so I am taking iron.   

I'd still love to hear your thoughts on whether I would actually have any thal symptoms with only one alpha gene missing....it's so easy to want to blame it for things, but who knows?

Hi Andy, I'm still wondering do you think there is any chance that I have any physical symptoms related to being an alpha thalassemia carrier? 

Sleepy,

Your Hb is slightly lower than would be expected with a one gene deletion, but the iron deficiency may explain that.

In theory, a single gene alpha carrier has no symptoms. In fact, two gene affected alpha thals are also told that the condition is asymptomatic, even though patients are often anemic, as they are with beta thal.

For non-transfusing alpha thals, the only recommendation is to take folic acid daily. This is important, as folic acid is required to build red blood cells. It does not seem sufficient, though. I suggest antioxidants like natural vitamin E also be taken to help deal with the imbalance of alpha and beta globin and the oxidative stress that goes along with that.

I am troubled by the number of alpha carriers we are seeing who have low ferritin levels. I'm wondering if it really means iron deficiency. One month on iron supplements is usually enough time to tell if IDA is truly involved. When Hb doesn't rise with the use of iron supplements, the presence of IDA should be questioned regardless of the ferritin report.

Thanks so much Andy, I am definitely taking extra folic acid in my b-complex and iron supplement both.    I read about wheatgrass in the history too - sure worth a try!