Dietary Considerations for Thalassemia

Written by Li Fang Fang
Hematology
Updated on September 05, 2024
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Thalassemia, also known as hemoglobin synthesis disorder anemia, is a genetic disease that falls under the category of genetic disorders. It is caused by abnormalities in the genes related to globin, leading to a deficiency in globin quantity, which in turn causes thalassemia. Since thalassemia is a genetic disorder, there are no specific dietary considerations. The severity of thalassemia is also defined by the number of affected genes; the fewer the affected genes, the milder the condition.

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Written by He Li Fang
Hematology
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Mediterranean anemia's blood routine manifestations

The hematological manifestations of thalassemia, including those of silent gene carriers, generally show normal complete blood counts. In thalassemia and mild thalassemia, hemoglobin levels are normal or slightly decreased. Patients with Hemoglobin H disease have hemoglobin levels between 70-100 grams per liter. In cases of Hemoglobin Bart's hydrops fetalis syndrome and severe thalassemia, hemoglobin levels are typically below 50 grams per liter, falling into the category of severe anemia, requiring regular blood transfusions for survival. Their MCV, MCH, and MCHC are significantly decreased. Blood smears may reveal anisocytosis and poikilocytosis including target cells, and even nucleated red cells, with a marked increase in reticulocytes. Typically, the white blood cell count remains normal for such patients, although the platelet count may be slightly elevated. During periods of increased spleen activity, there may be a reduction in both white blood cells and platelets. These are the hematologic features observed in different thalassemia patients.

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Mediterranean anemia has symptoms such as fatigue, paleness, delayed growth, and facial bone deformities.

Thalassemia is a hereditary hemolytic anemia, and the symptoms of patients with thalassemia are related to their specific types. Thalassemia can be divided into mild, intermediate, and severe types. Mild thalassemia clinically may have no symptoms or only mild anemia, sometimes accompanied by mild splenomegaly; Intermediate thalassemia can present with moderate anemia, noticeable fatigue, and splenomegaly, with a few cases experiencing mild skeletal changes and delayed sexual development; Severe thalassemia in children manifests within the first half-year after birth with pallor, progressively worsening anemia, jaundice, hepatosplenomegaly, delayed growth and development, and distinctive facial features such as frontal bossing, a depressed nasal bridge, and increased distance between the eyes.

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What to do and what to eat for dizziness caused by thalassemia?

Patients with thalassemia who experience dizziness first need to analyze the cause of the dizziness. The vast majority of causes of dizziness are not related to diet, nor can they be corrected by eating certain foods. For patients with thalassemia experiencing dizziness, it is first necessary to consider whether the cause is worsening anemia. A drop in hemoglobin can lead to ischemia and hypoxia in the body, which can manifest as symptoms of dizziness in the nervous system. If it is confirmed that the dizziness is caused by worsening anemia, then blood transfusion treatment is needed, usually requiring the transfusion of washed red cells. Once the anemia is corrected, the symptoms of dizziness can disappear. At the same time, folic acid supplements can be added to provide raw materials for hematopoiesis. Other possible causes of dizziness include diseases such as cranial, cervical spine, and otolithiasis, all of which require further differential diagnosis. (The use of drugs should be carried out under the guidance of a physician)

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Can thalassemia be inherited by children?

Thalassemia, originally known as Mediterranean anemia or thalassemia, was named due to the early discovered cases predominantly among the Mediterranean coastal populations. However, the disease is widespread in many regions around the world, with Southeast Asia being one of the high-prevalence areas. In China, it is more commonly seen in Guangdong, Guangxi, and Sichuan, and there are also scattered cases in the provinces and regions south of the Yangtze River, while it is less common in the north. It is caused by a hereditary defect in the globin gene, leading to the absence or insufficiency of one or more globin chains in hemoglobin, resulting in anemia. This pathological state is called thalassemia. Due to the complex diversity of genetic defects, the types and quantities of the missing globin chains, as well as clinical symptoms, can vary. Thus, thalassemia encompasses a group of diseases. Being a genetic disorder, Mediterranean anemia can be inherited by children.

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Is the level of ferritin high or low in thalassemia?

In thalassemia, ferritin levels are generally normal. Clinically, both thalassemia and iron deficiency anemia present as microcytic hypochromic anemia. The simplest differentiation between the two is by checking ferritin levels. In iron deficiency anemia, ferritin levels are usually significantly decreased, whereas in thalassemia, ferritin levels tend to be normal. If microcytic hypochromic anemia is detected with normal ferritin levels, further tests such as hemoglobin electrophoresis and screening for thalassemia genes are needed to confirm if it is thalassemia, the specific type, and the severity, to guide subsequent treatment methods.