Thalassemia Patients and Friends
Discussion Forums => Thalassemia Intermedia => Topic started by: Janene01 on May 22, 2016, 07:55:21 PM
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I was recently told I may have thalassemia minor, I have never heard of it until recently:
Lab Results :
MCV 69.9
HEMACRIT 31.6
MCH 20.6
HEMOGLOBIN 9.3
MCHC 29.4
RDW 24.4
HEMOGLOBIN A2 -1.7
A previous blood work showed I had iron overload, and I was taking an iron supplement at the time.
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Is it correct to assume you are a woman? Please keep in mind that I am only a forum use and not a doctor. I had to look up a few reference values:
MCV 69.9 (your red blood cells are smaller than normal)
HEMACRIT 31.6 (the concentration of red blood cells in your blood is lower than normal)
MCH 20.6 (your red blood cells carry less hemoglobin than normal)
HEMOGLOBIN 9.3 (the amount of hemoglobin in your blood is lower than normal)
MCHC 29.4 (seems like a less important marker for this question)
RDW 24.4 (the size of your red blood cells varies in size more than normal)
HEMOGLOBIN A2 -1.7 (in normal range)
The RBC count would be around 4.51 x 106/µl and in normal range.
The Mentzer index (MCV/RBC count) would be around 15.5 in this case.
Andy created an interesting topic with more values: Iron Deficiency vs. Thalassemia Minor & Hemoglobin Parameters of Thal Groups (http://www.thalassemiapatientsandfriends.com/index.php/topic,3480.msg35538.html#msg35538)
I personally couldn't say for sure which type of anemia your blood test would indicate. Maybe the others can help.
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The low HbA2 would rule out beta thal minor. It could possibly be alpha minor. The high RDW suggests it may be iron deficiency, but it could be both alpha minor and iron deficiency. A full iron panel of tests will help determine if it is iron deficiency. It may take a DNA analysis to check for alpha minor.
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Have you had any blood work in the past that could be compared to the recent blood work? It would be helpful to know if you have had such a low hemoglobin level for a long time.
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Hi Andy,
I have always been told I was Anemic, but always told it was due to iron deficiency, I have always had the craving for ice as well. The labs that I have reported in the earlier post is most recent- 3weeks prior to those results were:
RBC 4.18
HEMOGLOBIN 8.8
HEMATOCRIT 30.2
MCV 72
MCH 29.1
RDW 22.0
TIBC 412
UIBC 39
IRON, SERUM 373
IRON SATURATION 91
From these results is when they started to suspect thalassemia.
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The TIBC is quite high in spite of the high serum iron and saturation. This means your body is still trying to absorb more iron, even though there is already more than it needs. The high serum iron shows iron loading. Yet, your Hb does not rise even with a good supply of iron. This does look like thalassemia, but the HbA2 is below normal, and this is found in alpha thalassemia. Those with beta trait almost always have an HbA2 of over 5. Your Hb level is low for any type of minor. I think a DNA analysis looking for both alpha and beta thal should be done. In many ways, this looks like HbH disease, the 3 gene affected alpha thalassemia. The Hb is in the right range, as is the HbA2, and iron loading from diet can occur with HbH. But the MCH doesn't fit for HbH.
Have you taken iron supplements long term?
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I have always taken iron pills on and off, but prior to having the blood work done, I had only been taking the iron pills for a couple of weeks
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This is my hemogloinopathy evaluation:
Hemoglobin A 98.3
Hemoglobin F <1.0
Hemoglobin 2 1.7 L
This blood work was completed early march- I went and took some more labs today, I will put up one they come back
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I have a typo on my MCH:
MCH 20.6
MCHC 29.4
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That does fit more with alpha than beta thal. Beta thals usually have HbF >1 and HbA2 >5. Alpha thals have a deficit of alpha globin, so their HbA2 levels are often lower than normal. It is difficult to confirm alpha thal without a DNA test.
I think the high iron may be throwing some of the other levels off. I think you should make an effort to lower the iron with natural chelators. Drinking tea a lot can help some, as it does slowly remove iron. There are natural supplements, IP6 and green tea extract that both chelate iron and can be helpful with relatively low iron loads. Too much iron is harmful and can cause physical problems.
I just saw the note on your MCH. That makes much more sense. DNA analysis would be extremely helpful. Family history is often used to help guide which tests should be done.
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Thank you so much for your help, I will see about requesting a DNA analysis, and also drinking more tea.
It's just weird because no one in my family is familiar with thalassemia, and If I have it, why did it take 37 years to be diagnosed with it.
Some times I get really weird feelings in my head, I guess light headed, that's what originally caused me to go to the Dr, and have the blood work done, it's there anything that you would recommend for that symptom? I recently started taking folic acid from reading other stories here.
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The low Hb alone would cause the light headed feeling, due to insufficient oxygen.
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Eventually will the folic acid help for that, I also take a probiotic do you recommend that?
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Yes to both. FYI, some people are unable to process folic acid, so the form of L-methylfolate is preferred.