Thalassemia Minor and Iron transfusions- Confused?

Hello there I am new to the site and would love some advice. I have always known I have had thal beta minor and that I inherited it from my dad. I know that iron pills don't work for me and make me sick. I'm now 14 weeks pregnant and 2 weeks ago my Hemoglobin level was 11 and when I went to my appointment on Wednesday it was 9.5. I have been experiencing headaches, fatigue, and shortness of breath. The nurse called to tell me about my HB level and that they were going to call in iron pills to my pharmacy. I explained again that iron pills have never worked for me. She then proceeds to tell me that they could do an iron transfusion and would discuss it with the doctor and call me back. My question is that if iron pills do not work then how is an IV full of iron going to help? My frustration is that my doctor doesn't seem to be familiar with thalassemia and I can't seem to find a doctor that specializes in it. Not sure what to do. Any advice anyone can give me about this would be so helpful.

Thanks,

Laura 

Laura,

During pregnancy the demand for iron does increase, so it's best to have an iron panel done to see if your iron stores are low before taking iron. Hb level alone is not enough to determine iron deficiency in thal minors, and the Hb does commonly drop in thal minors when pregnant. As long as it stays above 8, it usually poses no problems other than the tiredness low Hb causes. You should be taking a high dose of folic acid daily, 2-5 mg, as this can help your Hb level. Most doctors will not be aware of this and may prescribe up to 800 mcg, which is insufficient for thal minors during pregnancy.

There are issues doctors are not aware of in pregnant thal minors. Some thal minors will develop clotting disorders during pregnancy and this can cause miscarriage. One thing you can do to help avoid the clotting is to take 400 IU natural vitamin E daily. Do not use synthetic vitamin E. Natural will say d-alpha tocopherol and synthetic will be dl-alpha. Some doctors may prescribe a baby aspirin daily, but E is preferable, as it is also a powerful antioxidant.

Thanks so much Andy!