How to increase hemoglobin in a thalassemia minor patient?

Question

Hi doctor,

I am a 76-year-old male who is 5 feet 7 inches and weighs 150 pounds. Presently, I have anemia, and my hemoglobin is 9.6 g/dL. I also have a high serum ferritin level of 1900 ng/mL. I have had this problem for some time.

Many years ago, I was diagnosed with thalassemia minor. I was feeling tired, and I have had a headache in the right temple area more frequently for the past two years. At that time, I had high blood pressure of 160/80 mmHg and low testosterone of 4.6 ng/dL.

My blood pressure was controlled by Losartan 50 mg and Hydrochlorothiazide 25 mg. I am also taking Viagra. A year back, I also had platelets clumping.

My doctor is considering iron-chelating tablets. Will chelated tablets lower hemoglobin?
I used to take iron supplements, but due to iron overload, I stopped taking them. What can be done to increase hemoglobin and lower serum ferritin?

I am attaching all my blood reports.

Kindly help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have seen all your reports (attachment removed to protect patient identity).

Thalassemia, particularly beta thalassemia, is an inherited blood disorder characterized by abnormal hemoglobin production. Since you are already aware of the condition, I will focus on the important aspects you should monitor.

Some symptoms and complications associated with beta thalassemia include infections, bone deformities, congestive heart failure, and abnormal heart rhythms

A major complication to watch for is iron overload. This can occur due to repeated blood transfusions or increased breakdown of red blood cells.

Regarding weakness, it is usually due to low hemoglobin levels. Anemia can lead to symptoms such as fatigue and pale skin.

Fluctuations in hemoglobin levels are common and often related to transfusion requirements. In some cases, iron supplementation may be advised, and it may take a couple of months to see improvement.

Ferritin is a protein that stores iron and releases it when needed. Most ferritin is stored inside cells, with only a small amount circulating in the blood. Monitoring ferritin levels is important, especially in patients receiving transfusions.

Treatment depends on multiple factors, including how the patient responds to chelation therapy and overall clinical condition.

I hope it helps.

Please let me know if I can assist you further.

Thank you.