Cause and management of nutritional deficiency in thalassemia

Parents of thalassemic children have several queries regarding the treatment regimen and overall health of their children. Factors that affect growth of the child comes out as a major concern in interaction with parents. In this article, we look at a 2 important aspects which lead to deterioration in growth factors for children with thalassemia and the possible remedies.

1.Iron Overload: Iron intake in the body from regular healthy diet is in the range of 1-2mg/day. In comparison to this, children with thalassemia who receive regular blood transfusions absorb approximately 200mg of iron from one pint of PRBC (Packed Red Blood Cells). Iron when present above the normal permitted levels in the body has the following damaging effects:

a. Acts as a very notorious oxidizing agent leading to reduction in circulating antioxidants (required for proper functioning of several organs) which inturn leads to damage to the cells and their functioning.

b. Leads to rapid fall of hemoglobin after blood transfusions.

c Leads to growth of oral microbes (iron overload in gums)

However, avoiding iron rich foods is not quite easy, and hence the focus must be on consuming some well-balanced diet rich in antioxidants, minerals and vitamins to fight the detrimental effects of iron overload. Green tea (which has an antioxidant effect) could be added in the diet after every meal as. It also reduces bacterial activity in the oral cavity thereby helping in remineralization of dental tissue. However, it must be noted that the best way to decrease serum ferritin is by using chelators (right dose) regularly.

2. Nutritional deficiency: Nutritional deficiency, especially deficient micronutrients is a primary factor for growth failure. Here is a table explaining how essential nutrients are lost for children who take treatment for thalassemia and what can be done to negate the same


1. "Attenuation of oxidative stress-induced changes in thalassemic erythrocytes by vitamin E." Das N1, Das Chowdhury T, Chattopadhyay A, Datta AG.

2. "Oxidative stress in β-thalassaemia and sickle cell disease" S. Voskou,a M. Aslan,b P. Fanis,a M. Phylactides,a,⁎ and M. Kleanthousa

3. "Inadequate Dietary Intake in Patients with Thalassemia" Ellen B. Fung, PhD RD,1 Yan Xu, MS,2 Felicia Trachtenberg, PhD,2 Isaac Odame, MD,3 Janet L. Kwiatkowski, MD, MSCE,4 Ellis J. Neufeld, MD,5 Alexis A. Thompson, MD,6 Jeanne Boudreaux, MD

4. "Effects of Vitamin E and Zinc Supplementation on Antioxidants in Beta thalassemia major Patients" Mohammadreza Rashidi, PhD,1 Maryam Aboomardani, MD,2 Maryam Rafraf, PhD,3,* Seyed-Rafie Arefhosseini, PhD,2 Abbasali Keshtkar, PhD,4 and Hamidreza Joshaghani, PhD4s T. Quinn, MD, MS,8 Elliott P. Vichinsky, MD,1 and for the Thalassemia Clinical Research Network

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