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

55027 Posts in 5854 Topics by 6115 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: I Need Help/Insight On My Lab Results  (Read 267 times)
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« on: April 23, 2019, 03:45:33 PM »

Hey all, new member here. My name is Andrew and I am 27 years old and live in Chicago. I've had "possible" beta thalassemia for a few years now. It's been loosely confirmed by one doctor, and a rather hot shot (very good) internist on Michigan Ave downtown here.

The Thing is, I've been having sickness symptoms for almost 2 months now. It started with confusion, weakness, head tingling and facial numbness. Then came the intense headaches, of multiple varieties. I've seen a new doctor at my university, and a neurologist so far. I've had a CT scan with contrast of my brain and head. I've also had an MRI of my brain and head with contrast. BOTH negative and looking good. I also passed the neurologist's physical exam with flying colors. The facial numbness has passed and not returned. The headaches are less frequent too. I don't use drugs or drink alcohol at all. I'm a little out of shape (5'11 and 205lbs) but really muscular and my blood pressure is fine. Clean urinalysis too! Everything else checks out fine... except my small red blood cells, elevated RBC, and kind of weird hemoglobin.

So, I'm going to post up my results and see if anyone here has any insight at all. I still have many doctor and psych visits lined up. But the only abnormality is some of my red blood numbers. So okay, here goes:

« Last Edit: April 23, 2019, 04:00:28 PM by cannondale91 » Logged
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« Reply #1 on: April 23, 2019, 03:48:17 PM »

And here are my iron results. They are from 2014, but nonetheless, here they are. I'm also scheduled for a hematology appointment in about a month (ugh the wait seems forever).
Andy Battaglia
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« Reply #2 on: April 29, 2019, 04:08:39 PM »

Your iron numbers were all normal when they were tested. The RDW is noted as high, but the high end varies from lab to lab. Usually, it will be more than 18 if you are iron deficient. Together with the iron tests, it indicates that iron is not as issue.
Your MCV and MCH are low. Your HbA2 is high, which is found almost exclusively in beta thalassemia minor. Your RBC is also high, which is typical for thal minor. Your Hb level is normal. It looks very much like beta minor.
This is similar to reports I have seen from other beta minors with normal Hb levels. What stands out each time is the high RBC, which means your body is producing a lot of red blood cells, enough so, that your Hb is normal. Every thal minor who reports numbers like these reports problems, in spite of the normal Hb level.
The problems stem from the high output of red blood cells, RBC's. Many of the RBC's produced are defective and are filtered out by the spleen and liver. However, it also tends to create more by products from the breakdown of the defective RBC's and this leads to high oxidation and also can affect the flow of blood to the extremities because of the debris in the blood that is a combination of defective RBC's  and the unmatched alpha chains that form because there is a deficit of beta globin and a normal amount of alpha globin. The unmatched alpha globin forms tetramers which add to the debris in the blood and also add to the oxidative stress. One of the symptoms you mention, numbness, is due to poor circulation in the extremities and this is a result of poor blood flow through the smaller blood vessels.
Cases like this are difficult to advise, because the Hb isn't low. Folate and B-12 may help, but it's also important to focus on improving the quality of RBC's produced. L-carnitine or L-arginine can improve the quality of RBC's, as can natural vitamin E. Vitamin C can help to build stronger blood vessels and help improve the circulation in the extremities. Milk thistle can help to protect the gallbladder, which is usually affected when there is a high RBC. The defective RBC's are filtered out by the spleen and excess bilirubin is produced, which can eventually lead to gallstones or sludge build up in the gallbladder. Milk thistle can help reduce this problem. These are all antioxidants, as well, which can help with the ongoing oxidative stress.

As I said, it is difficult to do much when the HB is in normal range, but focusing on the quality of RBC's produced can help.


All we are saying is give thals a chance.
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