Questions

Hello!

Nice to meet everyone!

My name is Dawn. I have been lurking here for many years and have never had the courage to join. My doctor says I have Thalassemia. I am very confused about this as I had never heard of it before. I have never seen a hematologist, but my doctor consulted with a hematologist that said it looked like a Thalassemia minor. I have no family ancestry or anyone in my family that has this or even anything similar. I have been in denial about it, and it has bothered me that it could be something more.

This is my latest lab results:
Wbc 5.37
Rbc 5.17
Hemoglobin 12.9
Hematocrit 39.2
Mcv 75.9
Mch 25.0
Mchc 32.9
Rdw 14.8
Iron 131
Tibc 451
Sat 29
Vitamin D 30

Does this look like it could be Thalassemia? Iron was tried 17-18 years ago and made no difference so my doctor said no more iron.

Thanks I’m advance for any thoughts on this.

Dawn

Dawn,

I'm not convinced it's thal minor. The numbers are in normal range, but the MCV and MCH are low normal and the RBC is high normal. It is possible that you are a carrier of a mild mutation, but these numbers could go either way. Your hemoglobin level is normal, not low like most minors have. Have you ever had a DNA test done? That could tell you if you do carry thalassemia.
Your vitamin D is at the minimal range of normal. I would suggest supplementing with D and try to get the level over 40, as it greatly improves your immune system and has a great effect on overall health. Iron is not needed, so there would be no need to supplement. If it was an issue in the past, a healthy diet should help you to maintain a normal level.

Hi Andy!
Thanks for responding. I have not had a DNA test done. I am really quite frustrated with my labs because they don’t match anything typical. My mcv has been low like this for about 20 years, prior to that I never really had any labs done except for during pregnancy. So I have no idea if this has been life long or something that just came up. I switched doctors in 2007 and she put me on iron and tested every 4 months with no change to the mcv. She made a big deal of it and wanted me to see a hematologist. I was young and in my 30s and in reality freaked out and refused to go (I know stupid). I wasn’t sick and didn’t think it was necessary. She said she consulted with a hematologist and together they said thalassemia was likely. I am older and wiser now and feel like maybe that was a mistake to refuse that. As the years have gone by there really hasn’t been much change. In fact the mchc is now normal and that was always abnormal. My hemoglobin and hematocrit have always been in range. It’s always been just the mcv, mch, and rbc that have been abnormal. I did look through some of the vitamins and nutrition in here, and I am taking vitamin D and the B complex 100 vitamins. Just trying to figure out if it’s worth going in search of answers. Obviously it makes me think it could be chronic disease, but for 20 years?
Dawn

I should clarify. For 20 years I know I have had these results with no signs of any diseases present.

The RBC is the only thing that might suggest thal minor, but the only reason to test if you have no symptoms would be if you were planning a child. Minors should be aware of their status in this case, as a partner should also be tested if the other is known to carry thalassemia. Since the only real treatment for thal minor is nutritional, it isn't necessary to know you carry it to address and deficiencies you may have.

Hi Andy,

These numbers have fluctuated. If my MCV is higher than my RBC goes higher. The highest I have seen my MCV go is to 79 once, and 75 is the lowest I have seen. My doctor seemed to be most concerned with the MCV.

I do have two adult children. I have always told them if a doctor tells them they need iron to let me know.

So if I was to have trait, does this mean it would come from one of my parents? Could they also be carriers and not know it? I have asked them if they have ever been told their RBCs were off and they both said no. My ancestry doesn’t fit this either, but there could have been that one relative that we didn’t know about.

Thanks for all your input, I appreciate it!

Dawn

I take back what I said about the RBC and MCV values. They do fluctuate but with no rhyme or reason. I just looked back through past results and sometimes the RBC would go higher but the MCV would stay the same.

Dawn,
If you did carry thalassemia, one of your parents would also be a carrier. RBC, along with many other values can vary based on the level of hydration in the body. If any breathing disorder (asthma, etc.) is present, that can also cause fluctuation. Your MCV stays higher than what is normally seen in thal minor. I don't think further testing, like DNA is called for.