Iron Deficient

Hello thalpal community

My daughter who is nearly 13 was diagnosed with thalasemia alpha carrier status earlier this year.  However ever since she has hit puberty her iron levels have dropped (heavy menstruation) and she is now anaemic (low ferritin and hb). I had been giving her sublingual b12 over the past few months as well.  I have two questions:

(1) Her active b12 is 128 pmol/l - this is off the reference range which is (23-100) so it is high. How can we reduce this?
(2) Most foods high in iron are also high in b12. I am trying to increase her iron via food instead of supplements because I am not sure how safe iron supplements are for carriers.

Thanks for your help

There is no need to reduce the B12 level. For thal minors, it is best at the high range of normal or even higher. What she needs is iron if she is having heavy bleeding.

Thank you Andy for your commitment to us thals.

I just purchased some Maltofer Oral Iron Syrup.
Each 10mL contains 370mg Iron polymaltose which is equivalent to 100 mg of elemental iron.

For some reason, I thought thalassemic carriers could not take iron supplements even when they are iron deficient which is why I have been confused about supplementation.  The pharmacist and doctors were not sure themselves!!!!

Perhaps this has to do with the fact that thalassemics carriers are not always iron deficient and get prescribed iron when they do not need it and which in turn can have a negative effect in terms of iron overload.

Thal minors can also be iron deficient and will need iron when they are. Female thal carriers tend to have iron deficiency at a much higher rate than male thal carriers. B12 and folate deficiency are also quite common in carriers. http://www.scopemed.org/?mno=41116

Because thal can cause anemia, it should never be assumed that they need iron, unless a full iron panel demonstrates deficiency.

Thank you Andy.

It is good to know that thalassemic carriers can take iron supplements if they are also diagnosed as being iron deficient anemic.  However it then becomes a challenge as to what iron supplement to take and at what dosages  There are so many on the market and they are not all the same.

Plus it is important to monitor ferritin levels frequently to avoid going over the llimit.

One form of iron that many people find tolerable and effective is Spatone iron water, a natural product that is water with a naturally high iron content.

Thanks Andy.  I will give this a try.