Q. I have thalassemia minor. How to increase hemoglobin and decrease ferritin levels?

Answered by
Dr. Saravan Pramod Settipalli
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 27, 2017 and last reviewed on: Oct 09, 2018

Hi doctor,

I am a 76 year old male, who is 170 cm tall and weigh 68 kg. Presently I have anemia, and my hemoglobin is 9.6 g/dL. I also have high serum ferritin level of 1900 ng/mL. I have this problem for some time. Many years ago, I was diagnosed with thalassemia minor. I was feeling tired, and I had a headache in the right temple area more frequently for the past two years. At that time, I had high blood pressure of 160/80 mmHg and low testosterone of 4.6 ng/dL. My blood pressure was controlled by Losartan 50 mg and Hydrochlorothiazide 25 mg. I am also taking Viagra. A year back, I also had platelets clumping. My doctor is considering iron chelating tablets. Will chelating tablets lower hemoglobin? I used to take iron supplements, but due to iron overload, I stopped taking them. What can be done to increase hemoglobin and lower serum ferritin? I am attaching all my blood reports.

Dr. Saravan Pramod Settipalli

General Medicine Internal Medicine


Welcome to icliniq.com.

I have seen all your reports (attachment removed to protect patient identity).

Thalassemia is an inherited blood disorder characterized by abnormal hemoglobin production. I do not have to explain you much about thalassemia as your doctor might have told you the details and consequences about it.

Few symptoms and complications that you need to be aware of due to thalassemia are as follows:

  1. Infection.
  2. Bone deformities.
  3. Congestive heart failure.
  4. Abnormal heart rhythms, etc.

Major complications that you need to consider is iron overload, which could either be due to recurrent blood transfusion or due to excess cell break down.

Comming to the weakness, it is generally due to low hemoglobin. Symptoms of anemia can result in feeling tired and pale skin. A decrease in the hemoglobin level was mainly due to blood transfusion. The patient can be on iron supplements, and it requires about two months on an average to improve hemoglobin level.

Ferritin is a protein that stores iron and releases it when the body needs it. It usually lives in the body’s cells, with very little circulating in the blood. Treatment will be based on patient's response, how the patient responds to the chelating agent, etc.


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