ADVERTISEMENT

Q. Can you please provide a diet chart for a thalassemia patient?

Answered by
Dr. Prakash H Muddegowda
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Sep 22, 2015 and last reviewed on: Oct 23, 2019

Hi doctor,

My brother is a thalassemia major subject. His age is 18 years and height is 5'4''. His hemoglobin is always maintained between 9 and 10 units. His weight is 38 now and drastically reducing. Nowadays he has been having headache and fever now and then. Sometimes he feels that his heartbeat is fast. He is taking Desirox 500 mg (three tablets per day) for iron chelation process and folic acid (one tablet per day). Kindly suggest if he needs to take any other precaution.

Can you please provide a diet chart for a thalassemia patient which can help him to gain his body mass/weight (considering food with less iron amount)?

#

Hi,

Welcome to icliniq.com.

Based on your query regarding thalassemia, my opinion is as follows:1. Looking at a regular hemoglobin level of 9-10%, I would suggest you increase the levels. Maintaining at this level increases further erythropoiesis (production of red blood cells). Close to 12-13 g% maintenance would be much better. Reduced hemoglobin, will reduce oxygen, which will impact overall body (weight loss) and could be the cause of headache at present. Immunity is also reduced, which is resulting in frequent infections.

2. The antibodies may be increased in the blood, which could be more due to multiple transfusions. This could be causing a reduced increase in hemoglobin levels per transfusion leading on to iron overload. You need to look for regular blood donation from a small group (committed donors or donor adaption, 5-6 donors per case) to avoid any further antibodies risk.

3. Iron chelation should be regularly done to maintain iron within normal levels. It should be done regularly. If possible, hepatic iron through liver biopsy estimation can be done.

4. Heartbeats at a faster rate due to reduced hemoglobin and increased oxygen requirement (reduced hemoglobin means reduced oxygen carrying capacity). All the cells in the body have reduced oxygen, which is functioning below the capacity, which will affect weight. Recurrent infections will also impact weight.

5. Tea with meals will reduce the absorption of food. Meat intake should be reduced. Plant-source protein would be better. Avoid any vitamin C rich food in the diet like orange or lime juice. If needed can be taken separately after 2-3 hours of food intake. Adding vitamin E supplements will be helpful. Moderate weight gaining exercises with cycling, swimming, water aerobics will be helpful.

6. Diet rich in fruit and vegetables is better for overall nutrition. Avoid food like oysters, liver, pork, beans, beef, peanut butter, tofu or other nonvegan food. Also avoid iron-fortified cereals, wheat, ragi and among fruits and vegetables, avoid prune juice, prunes, watermelon, spinach, leafy green vegetables, dates, raisins, broccoli, peas, and fava bean. Also, look for iron in snacks, candies, etc. Try to maintain intake of iron from overall diet to less than 18 mg per day.

7. As I told earlier, it is important to take more of foods which decrease iron absorption and reduce foods which increase iron absorption.

  • Cereals like wheat bran, maize, oats, rice, and soy. Soy protein can be added in diet during muscle building exercises. It is important to avoid any vitamin C food along with this.
  • Tea particularly and coffee also will reduce iron absorption. Taking meals with tea and coffee, particularly with milk will reduce iron absorption. You can add spices like oregano to the diet.
  • Take more dairy products like milk, cheese, and yogurt which reduce iron absorption, particularly with meals. Make sure, all are non-iron fortified.
  • Also avoid pickles, vinegar fermented food, alcohol, soy sauce, turnips, and carrots. Alcohol consumption and smoking should be avoided.

For your diet, I would recommend cereals, particularly rice, oats or maize along with tea (2 cups). You can vary the diet based on taste. Vitamin C food can be taken 3-4 hours after food intake.

Try to improve hemoglobin through effective transfusions, choosing a small group of regular donors is essential. If transfusions are more, particularly in the last year, splenectomy may be necessary. Try to maintain pre-transfusion of 10 - 10.5g% and post-transfusion of 13-14g%, which would help in overall improvement. Iron chelation is very important.


Investigations to be done:

Liver biopsy for iron and regular serum iron levels.

Probable diagnosis:

Hypoxia (oxygen deficiency), reduced hemoglobin levels.

Treatment plan:

Small group donors for transfusion, maintaining hemoglobin at 12-13g%, modified diet with tea, addition of vitamin E supplements, regular exercises. Zinc rich diet would be better.

Preventive measures:

Avoid iron rich foods.


Was this answer helpful?

 | 

Same symptoms doesn’t mean you have the same problem. Consult a doctor now!



Related Questions:
Is thalassemia minor genetic?

.. your query, my opinion is as follows: Thalassemia inheritance is an autosomal chromosome related. In thalassemia minor, one gene is affected. There is a 50% risk in the next generation of having thalassemia minor, as you are completely normal. Ch...   Read full

What diet will you recommend for a beta major thalassemia patient?

Hi doctor, My daughter, who is 25 years old, is suffering from beta major thalassemia ... Based on your query, my opinion is as follows: Thalassemia is a disease due to reduced globin production ...   Read full

Hemochromatosis and Iron Overload: Causes, Diagnosis, Clinical Presentation and Management

.. condition in which an HFE gene mutation is present. So, increased iron absorption occurs irrespective of intake. More iron gets accumulated and iron storage increases. If the condition progresses, then iron gets accumulated in other organs apart f...   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Does a cold sore indicate cervical cancer?
Hi doctor,Can a cold sore virus cause cervical cancer? I never had sex before, but I have caught a cold sore from one of...  Read more»
I am experiencing abdominal bloating and severe acidity. Are these side effects of antibiotics?
Hello doctor, I have been experiencing bloating and acidity during the menopause years. After experiencing a burning se...  Read more»
Aspirin - Uses, Dosage, Side Effects, Drug Warnings, and Precautions
Aspirin is a non-opioid analgesic or non-steroidal anti-inflammatory drug used to relieve mild to moderate pain, fever, ...  Read more»

Ask your health query to a doctor online?

Ask a Hematologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.