Mediterranean Anemia: Symptoms and Diagnosis Explained

Mediterranean anemia (also known as thalassemia)

Hello doctor, I have thalassemia and often experience dizziness.
I thought it was due to moderate thalassemia.
I recently had a routine blood test, and the results came back quickly.
The doctor said my blood is normal, with a hemoglobin level of 13.5, indicating no anemia.
However, I still feel dizzy.
Could it be that I have mild thalassemia?

Wei Ge, 20~29 year old female. Ask Date: 2016/03/24

Dr. Xiao Yongxun reply Internal Medicine

Dear Mr.
Wei,
Thalassemia, or Mediterranean anemia, is classified into α-thalassemia (determined by four α genes on chromosome 16) and β-thalassemia (determined by two β genes on chromosome 11), both of which are inherited in an autosomal recessive manner.
Problems arise only when there is a significant deficiency in the recessive factors, leading to lower hemoglobin levels and resulting in clinical symptoms of anemia.
Therefore, many individuals may carry the trait without exhibiting any symptoms, and you might be in this situation.
Moreover, with a hemoglobin level of 13.5 g/dL, it is unlikely to cause dizziness.
Your physician is commendable for being straightforward.
There are numerous potential causes for dizziness, including cardiovascular issues (orthostatic hypotension, hypertension, arrhythmias, subclavian steal syndrome, carotid artery syndrome, etc.), ear, nose, and throat conditions (benign paroxysmal positional vertigo, Meniere's disease, vestibular neuritis, etc.), neurological disorders (transient ischemic attacks, intracranial tumors, vertebrobasilar insufficiency, multiple sclerosis, cerebrovascular diseases, epilepsy, migraines, post-traumatic conditions, peripheral neuropathy, etc.), visual system problems (retinal disorders, cataracts, vision abnormalities, etc.), hematological issues (leukemia, etc.), endocrine disorders (hyperglycemia, hypoglycemia, thyroid diseases, adrenal insufficiency, etc.), and psychiatric conditions (anxiety disorders, depression, hyperventilation syndrome, etc.).

Please discuss this in detail with your attending physician; it is not advisable to speculate or panic on your own.

Reply Date: 2016/03/24

More Info

Mediterranean anemia, also known as thalassemia, is a genetic blood disorder characterized by the body’s inability to produce adequate amounts of hemoglobin, the protein in red blood cells that carries oxygen. This condition is particularly prevalent in individuals of Mediterranean descent, hence the name. There are two main types of thalassemia: alpha and beta, each with varying degrees of severity.
Symptoms of Mediterranean anemia can range from mild to severe, depending on the type and severity of the condition. Common symptoms include fatigue, weakness, pale or yellowish skin, and in some cases, splenomegaly (enlarged spleen). Patients may also experience dizziness or lightheadedness, particularly during physical exertion, due to reduced oxygen delivery to tissues.
In your case, you mentioned experiencing frequent dizziness and lightheadedness, which are indeed common symptoms associated with thalassemia. However, your recent blood test indicated a hemoglobin level of 13.5 g/dL, which is generally considered within the normal range for adults. This raises an important point about the diagnosis of thalassemia: it is possible to have mild forms of the disease, such as thalassemia minor, where individuals may not exhibit significant anemia but still experience symptoms due to the underlying genetic condition.

Diagnosis of Mediterranean anemia typically involves a combination of blood tests. A complete blood count (CBC) is often the first step, which measures various components of blood, including hemoglobin levels. In cases of thalassemia, the CBC may show microcytic (small-sized) red blood cells and a lower mean corpuscular volume (MCV).
Further diagnostic tests may include hemoglobin electrophoresis, which can identify the different types of hemoglobin present in the blood and help confirm a diagnosis of thalassemia. Genetic testing may also be performed to identify specific mutations associated with the condition.
Given your symptoms and the normal hemoglobin level, it is advisable to consult a hematologist who can perform additional tests to determine if you have a mild form of thalassemia or another underlying condition that may be causing your symptoms. It is also important to consider other potential causes of dizziness, such as dehydration, low blood pressure, or even anxiety, which can sometimes mimic the symptoms of anemia.

In summary, while your hemoglobin level appears normal, the symptoms you are experiencing warrant further investigation. A thorough evaluation by a specialist will help clarify your diagnosis and guide appropriate management strategies. If you are diagnosed with mild Mediterranean anemia, management may include regular monitoring, dietary adjustments, and possibly iron supplementation, depending on your specific needs.
Always remember to communicate openly with your healthcare provider about your symptoms and concerns, as they can provide personalized advice and support tailored to your situation.

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