Thalassemia Patients and Friends
Discussion Forums => Thalassemia Minor => Topic started by: Melissa31 on February 23, 2020, 12:30:07 AM
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I've known that I've had beta-thalassemia since I was a teenager. I'm now in my early thirties, a couple of years ago I was diagnosed with a provoked PE after having a cholecystectomy. My doctors at the time didn't feel that a workup was necessary. I moved and my new doctor felt that I should see a hematologist due to my continual iron deficiency despite using iron pills. I saw a hematologist and he thinks I would benefit from having two IV iron infusions. My labs don't look as bad as they have in previous years, but physically I am feeling worse. I was just wondering if I could get someone else's thoughts based on my labs? Thanks!
Lab Result Range Source
Unsaturated iron binding capacity measurement (Iron, % saturation)
17.2% 20.0 - 50.0 Serum
Basophil, percent (BA %)
0.3% 0 - 1.0 Whole Blood
Eosinophil, percent (EO %)
4.8% 0 - 3.0 Whole Blood
Lymphocyte, percent (LY %)
29.5% 15.0 - 41.0 Whole Blood
Neutrophil, percent (Neu %)
58.8% 40.0 - 77.0 Whole Blood
Plt Est (Platelet estimate)
Agrees with Analyzer Smear
Monocyte, percent (MO %)
6.1% 3.0 - 11.0 Whole Blood
Hemoglobin F (Hgb F)
0.6% 0 - 0.9 Whole Blood
Hemoglobin S (Hgb S)
0% Whole Blood
Hemoglobin C (Hgb C)
0% Whole Blood
Hemoglobin A2 (Hgb A2)
5.6% 1.7 - 3.5 Whole Blood
Hematocrit determination (HCT)
36.8% 37.0 - 47.0 Whole Blood
(Platelet morphology)
Normal Smear
Red cell distribution width determination (RDW)
15.1% 10.5 - 14.5 Whole Blood
Mean corpuscular hemoglobin concentration determination (MCHC)
31 g/dL 33.0 - 37.0 Whole Blood
Mean corpuscular hemoglobin determination (MCH)
20 pg 27.0 - 31.0 Whole Blood
Platelet count (PLT)
475 x 10^3/uL 130.0 - 400.0 Whole Blood
Basophil count (BA #)
0 x 10^3/uL 0 - 0.2 Whole Blood
Eosinophil count (EO #)
0.4 x 10^3/uL 0 - 0.3 Whole Blood
Monocyte count (MO #)
0.5 x 10^3/uL 0 - 1.0 Whole Blood
Lymphocyte count (LY #)
2.2 x 10^3/uL 1.2 - 3.4 Whole Blood
Mean corpuscular volume (MCV)
64.7 fL 81.0 - 99.0 Whole Blood
(MPV)
---- Whole Blood
Hemoglobin determination (HGB)
11.4 g/dL 12.0 - 16.0 Whole Blood
White blood cell count (WBC)
7.3 x 10^3/uL 4.8 - 10.8 Whole Blood
Red blood cell count (RBC)
5.69 x 10^6/uL 4.2 - 5.4 Whole Blood
Neutrophil count (Neu # (ANC))
4.3 x 10^3/uL 1.5 - 6.5 Whole Blood
(Hgb A, %)
93.8% 95.0 - 100.0 Whole Blood
(NRBC, #/100 wbc)
0 #/100 wbc Whole Blood
Granulocytes, immature, automated, % (IG %)
0.5% 0 - 0.5 Whole Blood
(NRBC %)
0 /100 wbc Whole Blood
Other hemoglobin (Hgb other 1)
0% Whole Blood
(Hgb electrophoresis interpretation)
Results Below Whole Blood
Alkaline phosphatase measurement (Alkaline phosphatase)
85 U/L 46.0 - 116.0 Plasma
Albumin measurement (Albumin)
3.6 g/dL 3.4 - 5.0 Plasma
Potassium measurement (Potassium)
3.8 mmol/L 3.5 - 5.1 Plasma
Bicarbonate measurement (CO2)
20.5 mmol/L 21.0 - 32.0 Plasma
Glucose measurement (Glucose)
78 mg/dL 74.0 - 106.0 Plasma
Calcium measurement (Calcium)
8 mg/dL 8.5 - 10.1 Plasma
Creatinine measurement (Creatinine)
0.7 mg/dL 0.6 - 1.3 Plasma
Chloride measurement (Chloride)
112 mmol/L 97.0 - 107.0 Plasma
Urea nitrogen measurement (BUN)
16 mg/dL 7.0 - 18.0 Plasma
Sodium measurement (Sodium)
146 mmol/L 136.0 - 145.0 Plasma
(Factor V Leiden mutation results)
Normal Whole Blood
(Factor V Leiden mutation reference range)
Results Below Whole Blood
(Factor V Leiden comments)
Results Below Whole Blood
Albumin/Globulin ratio (A/G ratio)
0.9 0.8 - 2.0 Plasma
Alanine aminotransferase measurement (ALT/SGPT)
30 U/L 14.0 - 59.0 Plasma
Iron measurement (Iron)
48 ug/dL 50.0 - 170.0 Serum
(TIBC)
279 ug/dL 250.0 - 450.0 Serum
Microcytes (manual) (Microcytosis)
3+ Smear
Poik (manual) (Poikilocytosis (shape))
1+ Smear
Anisocytosis (manual) (Anisocytosis (size))
1+ Smear
Hypochromia (manual) (Hypochromia)
3+ Smear
Globulin measurement (Globulin)
3.9 g/dL 2.2 - 4.2 Plasma
(BUN/Creatinine ratio)
21.6 6.0 - 25.0 Plasma
Bilirubin, total measurement (Bilirubin, total)
0.3 mg/dL 0.2 - 1.0 Plasma
Aspartate aminotransferase measurement (AST/SGOT)
19 U/L 15.0 - 37.0 Plasma
Ferritin measurement (Ferritin)
45 ng/mL 8.0 - 252.0 Serum
(Sickle cell identification, solubility method)
Not performed Whole Blood
(Prothrombin 20210 comment)
Results Below Whole Blood
(Acid hemoglobin electrophoresis)
Not performed Whole Blood
(Anticardiolipin, IgM)
<10.0 Serum
(Anticardiolipin, IgA)
<10.0 Serum
Granulocytes, immature, automated (IG #)
0.04 x 10^3/uL 0 - 0.03 Whole Blood
(Prothrombin gene mutation reference range)
Results Below Whole Blood
Teardrop cell measurement (Teardrop cells)
Occasional Smear
(Schistocyte)
Occasional Smear
(Prothrombin-20210A mutation)
Normal Whole Blood
Glomerular filtration rate, calculated (GFR estimate)
105 mL/min/1.73m2 Plasma
(Anticardiolipin antibodies, IgG)
<10.0 Serum
(MTHFR interpretation) See Note Whole Blood
Protein measurement (Total protein)
7.5 g/dL 6.4 - 8.2 Plasma
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First, gallbladder removal is common in thal minors, as the higher turnover of red blood cells causes excessive bilirubin production, which in turn causes gallstones and sludge in the gallbladder. You may not have ever been told about the connection.
Your iron numbers are not significantly low. I'm not sure infusions are justified. Have you had infusions before or been on oral iron for extended periods of time?
L-methylfolate may help more than iron. I would suggest trying 2000-5000 mcg daily to see if you feel any better. A sublingual B-12 tab should be taken, as well. I would suggest trying this before you take iron infusions.
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Thanks for your response!
Yes, I’ve been on iron tablets for a year and a half now, taking them twice a day. I think the hematologist thought process is that if I can get my iron stores up, I would feel better and wouldn’t have to keep taking the iron so often. I’ve never had iron infusions before, but I have always struggled with iron deficiency anemia. I have heavy menstrual cycles which drops my hgb and iron levels. This is actually the highest it’s been in a while. I have also been taking methylfolate as well as a multivitamin (it does not have iron in it), magnesium, vitamin D, probiotics, biotin, and milk thistle (both my parents had issues with their livers and during my cholecystectomy, they did a liver biopsy which showed early inflammation).
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I hesitate to recommend iron infusions, as many patients have reported the infusions are tough on them physically. I usually will recommend trying Spatone Iron water before settling on an infusion.