Sublingual B12 is great for an energy boost and building red blood cells.
L-methylfolate at 15mg is usually used together with an Selective Serotin Reuptake Inhibitor (SSRI) to treat depression.
Symtomatic thal minors may need anywhere from 1-5mg of methylfolate to bring up their haemoglobin levels, some may need 10mg to feel better.
Folic acid is synthetic and seven times less bioavailable than methylfolate. Not everyone is able to process folic acid and it can make them unwell if they have an MTHFR mutation.
I am not sure if you have this thread
http://www.thalassemiapatientsandfriends.com/index.php/topic,4890.msg46774.html#msg46774 but this what Andy recommends for thal minors to take. As for L-Carnitine, he recommends taking 5mg.
“Supplements:
Absolutely necessary are-
Folate 1-2 mg daily. Thal minor women trying to get pregnant or pregnant should be on doses of 2-5 mg daily. Folic acid is a basic building block of RBCs and it is essential in all forms of thal. The better form to use is l-methylfolate, as it is more bioavailable and many people cannot process folic acid properly. Studies have shown that women in general maintained higher Hb levels during pregnancy than those who used folic acid.
http://www.ncbi.nlm.nih.gov/pubmed/21440300 CONCLUSIONS:
In the present study, supplementation with a prenatal medical food containing L-methylfolate and high-dose vitamin B(12) may maintain hemoglobin levels and decrease rates of anemia in pregnancy more effectively than standard prenatal vitamins
Natural vitamin E complex. Use only natural d-tocopherol and mixed tocopherols. Do not use dl-tocopherol. It is synthetic and may actually be harmful in most doses. Take 400 IU natural E daily. This is one of the most important antioxidants you can take and it is good for the lungs and circulatory system. It also slows the aging process.
Vitamin C 500-1000 mg daily. (This dose should not be taken by thal majors). Vitamin C is also a powerful antioxidant, which also has the property of being able to reactivate vitamin E after E has already been used by the body as an antioxidant, making the E even more valuable. C is also essential for the circulatory system, as it is needed for the integrity of the walls of blood vessels. If you bruise easily, you are most likely deficient.
Magnesium 250-500 mg daily. In women, it is advised to take with calcium in a 2:1 ratio of Cal to Mag. Anyone experiencing heart palpitations should take cal/mag daily as these two minerals control the two sides of the heart beat. An imbalance or deficiency can lead to palps. Magnesium is also needed to build RBCs and deficiency is often a cause of restless leg syndrome.
B Complex (100 is recommended). Essential for building RBCs and maintaining energy levels. B vitamins are water soluble and need to be constantly replenished. The modern diet does not provide enough B vitamins.
Vitamin D levels should be checked in anyone experiencing tiredness or fatigue. D deficiency is the most common deficiency in today's world, with 1/2 to 2/3 of the world's population deficient. Get tested. If your level is not at least 35, correction is needed. Throw out any information about vitamin D that is more than 5 years old. It is now recognized that doses of at least 5000 IU daily are required daily to budge the level. Often, doses of 50,000-60,00 IU are prescribed weekly. Deficiency is behind a host of health issues, as D is essential for most minerals and many vitamins to be properly absorbed and used by the body. Taking minerals without taking D is almost useless. D deficiency is implicated in anything from a low immune system to depression. Get tested if you haven't already done so. No exceptions here, unless you get daily exposure to the sun year round (this mean short sleeves for over an hour a day).
Optional:
Trace minerals like selenium, zinc and copper should be considered, especially if the diet does not include a wide variety of nutritious foods.
CoQ10, glutathione, Alpha Lipoic Acid and L-carnitine (or L-arginine or L-citrulline) can also be considered. Patients finding they get more tired as they age should definitely use L-carnitine.