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my drug therapy for thalassemia intermedia

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Andy Battaglia:
Andy,

Hydroxyurea has two main actions with thal intermedia patients. It can activate the gamma globin gene in some patients, but the second action of suppressing ineffective erythropoiesis is possible for all patients and the importance of this is often overlooked. There is the obvious benefit of a reduction of bone expansion by lowered bone marrow activity, and there is the important effect of not having so many bad red blood cells produced. These bad RBC's destroy good RBC's and their absence can allow more good RBC's to survive. This would explain the increase in Hb without an increase in HbF.

andyross:
Thanks Andy for your quick and clear reply.
I think the cure I've been doing for many years is still working and maybe I don't need to interrupt or change it.
Apart a moderate iron load in liver that I should decide to manage soon, my only concern is about a low platelets count (between 100000 and 120000) I'm having in the last three years. I don't understand if it's Hydroxy or L-carnitine or more probabily their combination.
Anyway I'm monitoring close this count.

Thanks again.

Andy 

andyross:
Hi Andy I've just had my blood test results and I would like to ask you somenthing about them.
I post only low/high values.
 
WBC 4,07 (N.V. 5,00 - 10,00)
PLT 121 (N.V. 130 - 400)
Fibrinogen 147 (N.V. 150 - 400)
Creatinine 0,67 (N.V. 0,80 - 1,30)
Total cholesterol 103 (N.V. 140 - 240)
Folic acid 51,7 (N.V. 3 - 17)
Ferritin 530 (N.V. 20 - 320)
Parathyroid 75 (N.V. 12 - 72)
B12 vitamin 249 (N.V. 179 - 1162)
D vitamin 16,3 (N.V. 30 - 100)

I'm keeping my drug therapy and everything else is going good (for instance Hb is 10,9) but I think it's time to make some changes.
Since I've been taking 7,5mg folic acid for many years I'm wondering if I should stop or reduce.
Maybe I should consider B12 and D vitamin integrator.
What do you suggest?
Thanks a lot.

Andy
 

Andy Battaglia:
Andy,

I suggest attacking the low vitamin D. Your folate is fine so reducing the dose is not a problem. My experience with D is I saw no change until I went to 5000 IU daily and I am currently taking 10,000 IU daily. I also feel that it is difficult to analyze other deficiencies when the D is low, as D affects the absorption of so many nutrients. You also might want to take sublingual B-12 tablets a couple times a day. I also take my D as  liquid so I can swish it under my tongue before swallowing.

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