Tests, supplements, healthy RBC

Hello,

I have thalassemia, my current blood work is as following:

RBC = 7.11
Hemoglobin = 14
MCV = 65
MCH = 20
RDW = 19
MPV = 11

I have swollen lymph nodes and I did some tests which came all good so there is a chance that my lymph nodes are enlarged due to the high turnover of RBC.. I see a lot of people report enlarged spleen while I have have enlarged lymph nodes... in the past I had enlarged and fatty liver due to that, so I guess that thalassemia might be causing some of my problems. I also have fatigue, tiredness, hair loss, itchy and pale skin, brain fog, mouth sores, canker sores etc.

So now I am taking thalassemia more seriously. I started supplementing folate of 1 mg per day, vitamin E 400 IU, wheat grass. I will have my vitamin D levels checked but most likely I will start supplementing it, too.

I want to ask you if it is essential to have my vitamin B12 levels checked. I am paying for all the tests since doctors do not take me seriously and does not want to prescribe such tests so I want to have my costs at minimal and do not make unnecessary payments.

1. So, should I have my B12 levels checked first or I can start supplementing with B12 without checking the levels? Can B12 be harmful? I see there are some links to cancer, but I am not sure how accurate this information is. I see it is water soluble vitamin and if there is more than enough it should go to the toilet, but I am concerned not to get overdosed.
2. What other tests should I do? I will check my vitamin D levels for sure. I see that you can check folate levels, but I do not see it recommended here in the forum.
3. What should I do to lower the turnover of RBC and have healthier and longer living RBC? I am sure that the high turnover of RBC cause my fatty and enlarged liver some years ago.
4. I think my immune system might be struggling due to the thalassemia so what can I do in order to improve it?

Also, should I have my iron checked since my RDW is above 18?

B-12 testing isn't of much value for a thal minor. Levels don't take into account the added need that thals have due to the overproduction of red blood cells. B-12 also washes out of the body very quickly, meaning it constantly needs to be replenished.

Have you had your ferritin checked? Your RBC is so high, it would make iron deficiency more unlikely. The RDW is slightly high, but usually iron deficiency will cause the RBC to drop, even in thal minors.
I have found vitamin C, vitamin D and zinc to be the most valuable for the immune system.

Supplements to consider for building better red cells are wheatgrass in any form, folate, vitamin B-12, B Complex, magnesium, L-carnitine and natural vitamin E.