Mediterranean Anemia: Symptoms, Diagnosis, and Management

Q: Mediterranean Anemia: Symptoms, Diagnosis, and Management

Hello： <br>1. <br>Your anemia is classified as microcytic anemia, and the possible causes include "thalassemia" (formerly known as Mediterranean anemia) or iron deficiency anemia, or both. <br>It cannot be concluded that you definitely have "thalassemia" just because your mother

Mediterranean anemia (also known as thalassemia)

Red blood cells (RBC) 5.84 (reference range 3.70–5.50) Hemoglobin (Hb) 10.9 (reference range 11.3–16.0) Mean corpuscular volume (MCV) 59.4 (reference range 80.0–100.0) The above data was obtained two years ago when I was in high school.
I would like to ask the doctor if this indicates thalassemia? My mother also has thalassemia with very mild symptoms, almost none.
I often exercise and play basketball (I should say I often engage in intense exercise...), but I frequently feel particularly fatigued and always need more sleep than others.
When I look at the sky, I sometimes see spots, and I feel dizzy when I suddenly stand up.
Are there any ways to improve this? Also, why are my red blood cell (RBC) levels higher than average? Thank you, doctor.

Xiao Ding Dang, 10~19 year old female. Ask Date: 2016/07/07

Dr. Li Zhiyao reply Internal Medicine

Hello:
1.
Your anemia is classified as microcytic anemia, and the possible causes include "thalassemia" (formerly known as Mediterranean anemia) or iron deficiency anemia, or both.
It cannot be concluded that you definitely have "thalassemia" just because your mother has it.
It is recommended that you consult a hematologist for further evaluation.
2.
Due to your low hemoglobin level (Hb: 10.9), you may experience the symptoms you described, so please be cautious and move slowly when changing positions.
3.
The characteristic of "thalassemia" is an elevated red blood cell count and a low mean corpuscular volume (MCV).

Reply Date: 2016/07/07

More Info

Mediterranean anemia, commonly known as thalassemia, is a genetic blood disorder characterized by the body’s inability to produce sufficient hemoglobin, which is essential for transporting oxygen in the blood. Your laboratory results indicate a high red blood cell (RBC) count of 5.84 (normal range: 3.70–5.50), low hemoglobin (Hb) at 10.9 (normal range: 11.3–16.0), and a significantly low mean corpuscular volume (MCV) of 59.4 (normal range: 80.0–100.0). These findings suggest microcytic anemia, which is often associated with thalassemia or iron deficiency anemia.

In thalassemia, the body compensates for the low hemoglobin levels by producing more red blood cells, which explains your elevated RBC count. However, these cells are often smaller and less effective in carrying oxygen due to the low MCV. Symptoms of thalassemia can vary widely, and many individuals, especially those with mild forms, may experience few or no symptoms. Common symptoms include fatigue, weakness, pale skin, and in some cases, more severe complications like splenomegaly (enlarged spleen) or bone deformities.

Your experience of feeling particularly fatigued, requiring more sleep, and experiencing dizziness upon standing could be related to your anemia. The fatigue is likely due to insufficient oxygen delivery to your tissues, while dizziness may stem from low blood pressure or reduced blood flow to the brain when you stand up quickly.
To manage Mediterranean anemia, especially if it is diagnosed as thalassemia, several strategies can be employed:
1. Regular Monitoring: Regular blood tests to monitor hemoglobin levels and overall blood health are crucial. This helps in assessing the severity of the condition and determining the need for treatment.

2. Dietary Adjustments: A diet rich in iron and vitamins (like folic acid and vitamin B12) can help improve your overall blood health. Foods such as leafy greens, legumes, nuts, and fortified cereals are beneficial. However, if thalassemia is confirmed, iron supplementation should be approached with caution, as excessive iron can accumulate in the body and cause damage.

3. Hydration: Staying well-hydrated is essential, especially if you are engaging in vigorous physical activities like sports. Dehydration can exacerbate fatigue and dizziness.

4. Rest and Recovery: Ensure you are allowing adequate recovery time after intense physical activity. Listen to your body and take breaks when needed.

5. Medical Consultation: It is advisable to consult a hematologist for a comprehensive evaluation. They may recommend treatments such as blood transfusions or chelation therapy if iron overload occurs.

6. Genetic Counseling: Since thalassemia is hereditary, genetic counseling may be beneficial, especially if you are considering starting a family. This can provide insight into the risks of passing the condition to offspring.

In conclusion, while your symptoms and lab results suggest a possibility of Mediterranean anemia, a definitive diagnosis can only be made through further testing and evaluation by a healthcare professional. It is essential to address your symptoms and seek medical advice to ensure proper management of your condition. Regular follow-ups and a proactive approach to your health can significantly improve your quality of life.

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