Please help me understand my lab results

Dear Andy!
I am a 53 year old Armenian, I was diagnosed with Beta-Thalassemia minor at the age of 13.
Until some ten years ago I did not take any supplements, but now that I am getting older I do feel that I am having more health issues than before, which, in my opinion are directly or indirectly linked with my condition…. I have therefore been taking all kinds of supplements intermittently in the last few years, trying things out, experimenting, based on information found on the internet and also, I have to admit, based on my own (possibly wrong) judgement. It is quite a struggle to convince my general practitioner to have my blood tested by a hematologist specialized in this field in a hospital here in the Netherlands, he is simply not willing to comply, finding it unnecessary..because…Thalassemia is not curable, and probably the insurance companies encourage doctors to limit costs as much as possible. So far so good, I did get him to at least perform some testing of my blood. Now, he has prescribed iron supplements (Ferrous Fumarate 200 mg), I did take them, and, to be honest, it did help me just a little in feeling less fatigued, but I am not at all sure whether I should continue taking it, because of all contradictory things I have had the chance to read on the internet and in this fantastic forum. And most important of all: I really doubt my family doctor knows what he is talking about…. As I really feel that you have a far greater knowledge of the matter than all doctors in the Netherlands together I would like to kindly ask you to give me some useful advice on the use of supplements and give me more insight into my situation….
A ‘short’ list of my health related issues:
Bloating, abdominal swelling, occasional dizziness and lightheadedness…vague pains and a sensation of heaviness in the liver region, very mild form of fatty liver (although my alcohol intake is very very moderate), small-sized gallbladder polyps (which do not pose any harm according to my doctor), severe back pains (from top to bottom), pain in the rib cage area, front and back, when inhaling deeply…severe sleeping disorders (restless sleep), occasional (irregular) heart palpitations, weakened immune system, crackling (crepitus) sounds and sensations experienced in joints (back) reoccurring small infections (skin), depressive mood, mood changes…
One of the most important questions I would like to ask is: should I or should I NOT take iron supplements of any kind? As you can see from the chart, my hemoglobin level is quite low…whereas the ferritin level is slightly elevated…
As far as other supplements suggested by you in the forum, such as acetyl L-carnitine, folate, natural vitamin E, Vitamin C, Magnesium/Calcium, B-complex, Vitamin D3, I have been taking them all in the recommended quantities (quite a lot of pills to take every day!) for a year now and have decided to stop for a little while now, because I am not sure I notice a very real difference in my body/energy levels, well-being…and also… I am a bit worried to continue taking these supplements listed above…not knowing whether it would be harmful to continue without knowing for sure whether I have a deficiency or not…
My vitamin D has not been tested, nor have calcium / magnesium levels been tested….I won’t bother going to my GP with this, he won’t do it, anyway, so, could I continue using the tablets listed above without any risk of build up in my body? The folate, L-carnitine, calcium, magnesium..all the other stuff…do or don´t? Or would you recommend any other supplements (Resveratrol / Pterostilbene?), Zinc / Copper? Any dietary advice on foods to avoid or to indulge in? You are a God-like figure to me, so believe me Andy, anything you say on the many things I mentioned above would be much appreciated! Thank you sooo much Andy, God bless!
Below the test results from October:
Hemoglobine        7.3 mmol/l
MCV          60 fl
Ferritine       435 ug/l
CRP          < 1 mg/l
Vitamin B12       582 pmol/l
Iron (FE)       15.8 umol/l
Folic acid       >45.4 nmol/l
Transferrine      2.16 g/l
Transferrine (TFSTB) 29.3 %
Leucocyten       5.0 x 10!9/l
Thrombocyten    399 ug/l

Some results from tests done in 2016:
DDIM (fibrin D-dimeer)    0.57
Erytrocyten          5,83
Vitamin D          66
Calcium          2,38 mmol/l

Lavrenti,

Your serum iron looks low, but all your other iron numbers look normal. Do you know if your Hb has risen at all since you took the iron? That will usually tell you if you actually need iron. Also, did you have bloating before taking iron?

I don't think you need vitamin D and your folate level is high, so I wouldn't recommend folate. Do not take folic acid. Take folate when you do take it, if you do ever need it. Folic acid is synthetic and builds in the liver.

Your MCV is quite low, even for thal minor. It may indicate that you do need more iron, which can be verified if your Hb rises when you take iron. It may also indicate that your bone marrow is very overactive producing defective red blood cells. Again, I would back off on the folate. This would also explain the various body pains you experience. The overactive bone marrow does cause the bones to expand and that does cause pain. Your Hb is decent (converted to over 11), so I don't know if you will see much rise with any supplement, including iron, but if iron does not raise the Hb, it shouldn't be consumed, as it can add to body pains, especially joint pain.

I would suggest cutting down to magnesium, L-carnitine and vitamin C for now. If there is any indication that you may be forming gallstones, which is quite common among thal minors, due to the overproduction of red blood cells that are removed by the spleen, I would suggest also taking milk thistle.

Dear Andy!

I am sorry for replying so late, I never got a notification of your reply and forgot about my post, thank you so much for your assitance...my Hb does rise a little bit very slowly after taking iron, and bloating is something I have at all times, I feel I am holding lots of liquids in my body....

Regarding the gall bladder, I do have some amount of gall bladder polyps and a slightly fatty liver (although I don't drink alcohol a lot)...so this milk thistle, what dosage do you recommend? I already purchased Acetyl L-carnithine 500 mg... is this enough?

Thank you again, stay healthy!

Kind regards,
Robert

I suggest 1000 mg milk thistle daily. 500 mg of carnitine is a decent dose, but it can be higher with no problems. 1000 mg daily might be appropriate.