The oxygen is there, as demonstrated by your Hb level, but is your blood circulating as freely through the body as it should? The answer in thals is usually no. There are a couple of things that restrict blood flow, especially through the smaller blood vessels. In addition to the good red blood cells you produce, you also produce a significant number of defective red blood cells. There are also changes to the blood vessels, themselves which can reduce the flow of blood. The production and breakdown of red blood cells produce "debris" in the blood that interferes with the passage of blood through the smaller blood vessels. The end result is circulation is not what it should be, even though the Hb level is normal.
What can be done to help and create a better blood flow?
Natural vitamin E is a mild blood thinner and powerful antioxidant. The antioxidant effects reduce the problems caused by the oxidative effects of the debris and help the blood flow.
Vitamin C will help build stronger blood vessels and is very important to capillary health.
L-carnitine will help to fix nitric oxide, NO which is depleted by the oxidation that takes place in thals. Nitric oxide is essential to keep blood vessels elastic and flexible. This helps the blood flow and takes stress off the heart, which has to work harder to push blood through the circulatory system when the blood vessels become less elastic. This is one of the most important things a thal can take. Much of the tiredness that thals experience is related to the loss of elasticity in the circulatory system, especially as they age.
Keep in mind, that correcting nutrient deficiencies and improving the health of the circulatory system take time.