Hi,
I want to preface my response by letting you know that I do NOT have thal. I have another kind of rare hemolytic anemia called pk deficiency. That said, my normal hb level is about 6. I have many of the same symptoms of those with thal intermedia - iron overload, bone thinning, misshapen skull due to over active bone marrow. Until the age of 3 i was transfusion dependent until I had a splenectomy. Since then I only have transfusions when I am very sick and my hb has fallen below 5 ish. ( it's been over 10 years since that has happened.
Anyway, I am also 44, am married, have a child, and I have lived a very normal life.. Active as far as everyday activities, full time job etc. No real strenuous sports.. Never kept up to well in that area. Since about 42 Years old i started to notice a pretty drastic decline in overall energy. Lots of naps! After exercise I also often need a nap or at least need to rest. It's very frustrating as most of my friends and colleagues have no idea I have a blood disorder. I feel very awkward discussing it as its not like I just got diagnosed or anything. It has drastically affected my social life.. I'm just too tired during the afternoon / evening to do anything to get together with people. I certainly was not like this in my 20's. I believe there must be something about getting older. Perhaps our body just doesn't tolerate such a low hb as when we were younger.