Is iron chelation therapy helpful for high ferritin levels?

Question

Hello doctor,

I have hemoglobin E-Beta thalassemia and have been undergoing treatment for 14 years, including blood transfusions and medications such as Folic acid, Vitamin B complex, Hydroxyurea, and chelation therapy with Deferasirox, Deferoxamine, or Deferiprone, depending on my condition. Over the last four months, I have not required a blood transfusion, and my hemoglobin (Hb) level is at 8.2 g/dL, with a 56% Hb variant. However, I have been experiencing abdominal pain and fatigue, though I do not feel particularly weak.

It is worth noting that I work as a banker and often have to eat lunch at restaurants or other places. Due to my busy schedule and the lack of a nearby hematologist, I have not been in contact with my doctor for 18 months. My last recorded serum ferritin level was 1236 ng, approximately a year and a half ago. I would greatly appreciate your advice on whether I should continue taking Deferiprone alongside Hydroxyurea, Folic acid, and Vitamin B. If you have any other recommendations, I would be open to your suggestions as I seek to improve my quality of life.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern. Pain in the abdomen could result from gastritis caused by consuming outside food. You can take a capsule Rabeprazole 20mg once daily for seven days. If necessary, a Helicobacter pylori test, such as the urea breath test, can be performed. Consider including yogurt in your diet and avoid consuming excessively spicy foods. Regarding your hemoglobinopathy, you may require iron tablets or injections. If your hemoglobin (Hb) does not improve, a blood transfusion may be necessary. Iron chelation therapy is typically administered when the serum ferritin level exceeds 1200. Therefore, please have your ferritin level checked again. Both oral chelation and subcutaneous infusion can be considered. The course of action will be determined after reevaluating your serum ferritin levels. If a hematologist is not available, you can consult a physician for an examination and receive further prescription accordingly.

Hope this will help you. Thank you.