Hematocrit range for beta minor

I'm trying to interpret my complete blood count results and specifically the levels of hematocrit and how they relate to my condition. For a brief background of me: I'm an adult male with confirmed thalassemia beta minor and have been feeling quite unwell for the last 18mo with bouts of fatigue and lightheadness after a severe reaction to prescription pain medication and sedatives. I have had a range of tests done but the only thing that's come up is polyuria and low RBC stats.

From what I understand, people with thalassemia should have higher than normal hematocrit to compensate for the impaired oxygen transport capacity. According to Mayo Clinic, the normal range of HCT for an adult male is 0.39 to 0.5.

Now here are some results relating to RBCs from the 3 most recent blood counts I've had


 Date               16/09/14  04/02/15  05/06/15
 Lab Id.                                                        Units     Reference

 Haemoglobin     123 L      130         121 L          g/L       (130-175)
 HCT                 0.40       0.40        0.38                       (0.38-0.50)
 MCV                 68 L       66 L        68 L             fL        (80-100)

(I also had my serum B12 found to be 684  pmol/L (>150); I didn't serum folate tested but I have been supplementing 800mcg methylfolate daily for several months.)

Now my HCT levels are at the lower end of the normal range for a normal male adult, so my question is, what is the normal range for a thal. beta minor male adult and could my HCT levels explain my episodes of lightheaddness and fatigue?

Also, if appropriate, what therapies could I consider to increase my HCT?

Thanks so much, and best luck to all.

Nasos

c60,

Most people with thalassemia minor will have a lower than normal hematocrit and Hb level, as their bodies don't produce enough good red blood cells to maintain normal numbers. Yours is on the low end of normal. Thal minors will usually fall within the 10-12 Hb range, so yours is not bad for a minor.

Have you had your vitamin D level checked? This is most often low and deficiency will exacerbate the other problems of thal minor. Ideally, you want the level over 50, with a minimum of 30 (although at 30, you may still have issues). Thals should also strive for a B-12 level on the high end of normal.

Hi Andy,

Thanks a lot for your reply. So is my impression that people with thalassemia should have elevated RBC count to compensate for the reduced MCV and oxygen transfer capacity incorrect?-I thought that elevated RBC count should translate to elevated HCT?

I did have my Vit. D checked at the same time as B12- it was 65 nmol/L (ref >49).

I will be getting another full blood count, and also reticulocyte count and iron studies in the next few weeks.

Thanks again.