Do I really need Folic Acid?

Hi,

I am new here. I am a 44 year-old man. Believe it or not, I just found out I have beta thal minor through some blood tests. My wife, however, is not a carrier. I include an excerpt of my tests below (normal range in brackets, and asterisks denote outside the normal range). Please comment on the test results because my questions about supplements would be related to the test results.

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Total WBC = 8.9 x 10^9 / L (4-11)
Hb = 142 gm/L (125-175)
Platelet count = 217 x 10^9 / L (150-400)
ESR = 12 mm/hr (0-15)
PCV = 0.47 L (0.4-0.5)
MCHC = 310 g/L (310-350)
* RBC = 6.9 x 10^12 / L (4.5-6.0)
* MCV = 67 fl (82-98)
* MCH = 21 pg (27-33)
* RDW = 16.6 % (11-16)

Serum iron = 24.9 umol/l (10.6-28.3)
% Iron saturation = 44.6
Serum TIBC = 55.9 umol/l (40.8-76.7)
Transferin = 215 mg/dL (200-300)
* Serum Ferritin = 413.12 ng/mL (16.4-293.9)

Hb Electrophoresis Pattern:
a slight increase in intensity is noted at the A2 region. No other significant abnormality is seen.
H inclusions = negative (repeated)
Red blood cell morphology: Hb is within normal limit. Hypochromic microcyctic.
* Hb A2 = 5.1% (2.1-3.7)
* Hb F = 1.1% (<1)

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My doctor said this test confirms I have beta thal minor. My Hb level is within normal range (14.2 g/dL). I thought I read that beta thal minor would definitely have lower levels (between 9-11).The doctor explained that I have the "quantity but not the quality" in terms of Hb.

1. Since my Hb level is within normal range, do I need to take folic acid? My doctor said no.

2. My iron levels are within normal range except for Ferritin. Does that mean I have excessive iron storage?

3. I read here that IP6 is recommended to help to remove the iron. However, I don't remember reading a recommended dosage for IP6. How much should I take?

4. You guys recommend taking vit E as an anti-oxidant. Even before the thal results, I was already taking CoQ-10 (50 mg per day) and French Pine Bark Extract (100 mg) daily. I am also taking fish oil (that has 380 mg EPA and 254 mg DHA) daily. Any problems with them with thal condition? Do I need to take anything else?

I am not a big fan of popping pills, so I am hoping I don't have to add to my battery of pills each morning! My doctor advised there was no need to take any supplements except to watch out for iron-rich foods.

Your help and comments would be much appreciated, and good job on maintaining this forum.

Chris

Hi Chris,

Your Hb is normal, as is the case for many thal minors. These are the carriers more likely to not be diagnosed because there is little, if any  difference between them and non-thals. You will have some smaller red blood cells that are reflected in the low MCV, but otherwise there isn't much difference between you and a non carrier. For you, folic acid would be optional and would more likely be suggested in the context of a B vitamin complex, if at all. Unless you have previously taken iron supplements, your iron level is more likely to be in line with the serum iron results and TIBC than the ferritin, as ferritin levels can be affected by any infection, even a cold or inflammation. I wouldn't say that IP6 is necessarily needed because only the ferritin is high. If later testing still shows a high ferritin level, then IP6 could be considered. For low iron levels, 2-4 capsules daily, about 1000-2000 mg should suffice. As far as your personal supplementation program, antioxidants are important and you are taking some. A good diet including fresh fruit and vegetables also provides plenty of antioxidants. If you are healthy and feel healthy, there is no need to adjust your regimen.

One bit of advice is that if you have children, you should get them tested, because even mild minors can produce thal majors and intermedias when they have children with another carrier. Children always should understand their status and its implications if they are carriers, even when minor does not affect their health. The husband of our moderator, Sharmin has an Hb similar to yours. They have a thal major son. Awareness of your status is absolutely essential.

Many thanks Andy for the helpful comments.

I am puzzled too about my high ferritin level. I used to get sneezing fits and runny nose (not flu or become sickish) quite often in the mornings, so could this explain the high ferritin?

I am going to try IP6 anyway just to see if I can improve on my iron levels. I plan to do another checkup on my iron levels in a year from today. Is that too long a wait?

I do have a 5-year-old son, and thankfully, he is healthy, active, growing well, and learning well. I plan to send him too for a thal checkup and other blood tests when he is slightly older. Since my wife is not a carrier, I understand he has a 50-50 chance of being a carrier.

It is significant that the serum iron is normal and the TIBC shows no sign of iron loading. I doubt the ferritin level is the result of excess iron. The body sequesters iron into the serum ferritin whenever any bacterial or viral infection, or inflammation is present, so if you had a mild sinus infection, you could expect an increase in ferritin. And yes, your children would have a 50/50 chance of being a carrier.

Ok, thanks. Save myself from yet another pill!