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Vitamin and Mineral Supplementation in Thalassemia

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§ãJ¡Ð ساجد:
Hi Zaini,

At JSF they always give Zinc Sulphate syrup to the patients on Ferrinill. See if that helps. Also you might want to try that Fizzy Calcium + Vitamin C soluble tablets. Kids love it. (I know I did when I was a kid :) ) Sorry I don't know the brand names but your chemist will help you out on that.

Andy Battaglia:
Hi Zaini,

I want to really stress this point, as at times I assume everyone knows this. Thals should NOT take vitamin C supplements, except when taking desferal and only 100-250 mg taken along with the start of the desferal. Vitamin C aids in the absorption of iron from food and should be avoided by anyone with iron overload. Citrus should only be eaten between meals so that the vitamin C in it does not increase the absorption of iron from the diet. 500 mg is far more than a thal should get daily.

I don't know if you'll find any multi vitamin that does not have vitamin C in it. I know recently we had some discussion about a specific children's brand that had only a small amount of C in it. One brand is called Yummi Bears. It has 30 mg of C and no iron. Try to find something like this for a good variety of vitamins with some minerals. You can see the label at

http://www.yummibears.com/modules.php?op=modload&name=Sections&file=index&req=viewarticle&artid=1&page=1

An example of an easy to take liquid calcium supplement can be seen at

http://www.iherb.com/productdetails.aspx?c=1&pid=7657

It has the basics; calcium, magnesium and vitamin D.

I am not promoting any specific supplements but am only giving examples of appropriate supplements for thals. Safe and effective products that are appropriate for thals are on the market but sometimes you have to hunt around a bit.

The pain below the ankles is not related to IP6. Very little mineral chelation takes place with IP6. The body uses it where needed and it has been found that IP6 works to inhibit the action of iron that damages cells and also promotes cancer cell growth. There is much interest in IP6 as a potential weapon against cancer. Unfortunately there is something else that is well known for causing joint pain in patients. Ferriprox (L1, Kelfer, deferiprone etc.) is well known for causing joint pain in some thals. This is usually tolerated and the patients continue using the drug. Some patients find using a reduced dose of ferriprox and also using desferal 2-3 times a week keeps their ferritin in check. If you can resume getting desferal it is highly recommended that you use it. The desferal/L1 combination is considered to be the most effective chelation method.

Zaini:
Hi Sajid,

I'll search for that zinc sulphate syrup in the market,and ABOCAL is the same fizzy calcium+vitamin c+d+b6 water soluble tablet you are talking about,but now i am worried that it's supplying about 250 mg of vitamin c,( zainab is taking half tablet daily) and as Andy very rightly said that thals should not be taking that much vitamin c ( ignorance on my part,MY GOD ,but sometimes it's hard to keep track of everything),so i think i'll be quitting it and go search for another calcium supplement with vitamin D.

Andy,thanx for such a detailed reply,we were able to find desferal atlast on very high rate, so i'll be resuming the therapy,i'll quit ABOCAL and search for another calcium supplement,but i think i'll continue VIDAYLIN,as it contains only 50 mg of vitamin C, I don't think yummy bears brand will be available here, i'll search for any alternative,thanx again for this "eye opening" reply  :wink.

ZAINI.

Ash:
Let me remind everyone that if you are taking Deferiprone/Kelfer/L1 then you should consult your doctor for mineral supplements. Most common causes of joint pains in India have been due to mineral deficiency caused by taking L1.

All thals who took the supplements then did not report joint pains again.

Take care
Ash

Andy Battaglia:
Hi Zaini,

I talked to one of our resident experts (Ashish) on the subject of L1 and he said if you want to know if it's the drug causing the pain, just have her stop taking it for 10-12 days and see if the pain clears up. If it does, please follow his advice and make sure that you are replacing the minerals lost in chelation, especially calcium, zinc and magnesium. If the pain does not clear, then it is most likely not chelation related. It may not even be thal related.

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