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Thalassemia Patients and Friends and thalpal Ā© A. Battaglia 2018





54727 Posts in 5800 Topics by 6030 Members
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A message for all  parents who are thals. Keeping your iron load under control is an absolute obligation to your children.
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Author Topic: " Normal variation " or alpha thalassemia trait? A doctor is asking...  (Read 124 times)
Amyntas
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« on: August 10, 2018, 05:50:05 PM »

Hello, I am finishing my residency in cardiology in Greece and a routine blood test showed very low folic and b12 ( first time checked). What I knew from old tests,  was that I used to have a mild microcytosis and a little elevated bilirubin (Gilbert syndrome), near normal As I was said, but without iron deficiency.
After that I had full blood test,  and check for b12 deficiency without anything else it is worth mentioning.
  Even if it isn't such a severe disease,  I have some symptoms to mention : I get pale very easily, especially after tiredness or stress even if I feel well. Is it possible that an alpha thalassemia trait could have caused this situation? And what should I do?
B12: 145,  folic: 2.8 (3-20), LDH 197(normal), HbA2: 2.5, normal electrophoresis, negative celiac antibodies, the rest on images.
Thank you for your time...
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Andy Battaglia
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« Reply #1 on: August 18, 2018, 03:02:04 PM »

Yes, alpha trait can cause these issues. Your MCV is low enough and your RBC is high enough to suspect some type of thal and with the normal HbA2 level, it would't be beta thal. DNA analysis would be needed to confirm alpha trait.
The problem seems to stem form the low B-12 and low folate levels, and this is likely related to being a thal carrier, as the overactive bone marrow depletes nutrients needed to manufacture red blood cells. Your B-12 is very low and it is best to be near the high end of normal when you carry thal, >800. I would recommend a 2500 mcg sublingual B-12 tablet taken daily, and for the time being, 5 mg L-methylfolate daily. Was your vitamin D level also checked? This can often be part of the problem.
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Andy

All we are saying is give thals a chance.
Amyntas
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« Reply #2 on: Yesterday at 05:57:16 AM »

Thank you for your valid answer. I will look for a dna analysis.  Your question is accurate : I also had low vitamin d , near the low end of normal. I have already taken b12 , folic as you said and cod oil for vitamin d and feel more active . In thal trait, Do you think there is need for the rest b complex too? And what would be a usual daily intake of these vitamins, after normalization?
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