Hi Amy,
It's actually beneficial to thal minors to have B12 and Folate levels that are high, so yours being high is good. Your D level is also in a good range. It could still go higher without posing any problems. As you get older, the importance of maintaining a nutritious diet becomes more important, and your numbers say you're doing well with it. Your body seems to be absorbing plenty of folate and B12 from your diet to keep up with the demand that overproduction of red blood cells creates. Your iron numbers are also good, so no supplements should be used. Platelets often test high in thal minors, part of it being the overactive bone marrow producing more platelets, too and the other part is that often pale irregular red blood cells are counted as part of the platelet total, making the number look higher than it really is. It's difficult to tell if low thyroid is connected to thal minor (it may be, just as it is in major), because there is a high rate of hypothyroid in the general population, so it could be coincidental to thal.
The more I hear from thal minors who are in their 40's or older, the more the problem of adrenal fatigue is mentioned. Adrenal fatigue is a known issue in a high percentage of thal majors, so like a lot of other problems, is there any reason that thal minors would not also suffer from a less severe version of the same thing? The exact cause in major is not known for certain, but it is speculated that hypoxia, lack of oxygen, plays a significant role, and specifically, lack of oxygen to the hypothalamus.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393555/ Thal minors regularly complain about numbness and tingling in the extremities, and this is directly related to reduced oxygen reaching the extremities. Thal minors live with chronic low Hb levels, which means they cannot carry the same amount of oxygen as non-thals. I don't think we can make any assumptions that this does not cause problems for thal minors, as the medical industry wants to. This also brings me back to the thyroid and if one gland has reduced function because of reduced oxygen supplies, why wouldn't other glands also be affected. Perhaps, there is a connection between thal in general and thyroid disorders.
There is a long discussion that includes the topic of adrenal fatigue at
http://www.thalassemiapatientsandfriends.com/index.php/topic,4275.0.htmlI want to mention that I take magnesium right before bed at night and it has helped me sleep a lot better. I also take my zinc and copper supplement at the same time, so I'm not sure if that adds to the effect. Taking zinc, while also working to raise my vitamin D level, has greatly improved my immune system. A B complex might also help with the stress. What I would suggest beyond what you mentioned is natural vitamin E and L-carnitine or L-arginine and glutathione (considered to be a super antioxidant). L-carnitine is needed for the production of nitric oxide, NO in the body. NO makes red blood cells healthier and also is needed to maintain the flexibility of blood vessels. Without enough NO, blood vessels lose their elasticity which causes the heart to work harder and makes it even more difficult to fully oxygenate the body. I believe L-carnitine to be one of the most important nutrients for all types of thalassemia, especially as patients grow older.
The main treatment for thal majors who have adrenal fatigue is oral replacement therapy with cortisone acetate. I don't know if it would be appropriate for thal minors or if any doctors would be willing to try it. As usual, thal minors are left to fend for themselves. Our understanding of what to do about it increases with every patient report.