Answer: Mediterranean anemia is the name given to the group of diseases known as thalassemia in medical language. When Mediterranean anemia is mentioned, it is thalassemia carrier, also known as thalassemia minor. Thalassemia carriage manifests itself with a mild anemia. It is an inherited disease. In other words, if one of the parents is a carrier of thalassemia, there is a possibility that the child will also be a carrier; but it can also be normal. If both parents are carriers of thalassemia, the child is likely to have severe thalassemia. For this reason, blood tests of spouse candidates should be carried out before marriage and it should be investigated whether they are carriers of thalassemia.
As you have emphasized, thalassemia carrier is often confused with iron deficiency anemia. More precisely, since iron deficiency is the most common anemia in the society, iron deficiency is considered the most in a patient presenting with this complaint. Since the blood cells in both are similar, they are easily confused with each other if further research is not done. To distinguish the two, it is necessary to determine the iron stores in the bone marrow. There is no need for marrow examination for this. Looking at the ferritin level in the blood is sufficient to understand the bone marrow stores. Decreased ferritin levels indicate iron deficiency. To make a definitive diagnosis of thalassemia, a blood test called hemoglobin electropheresis should be performed. This is probably the test your doctor ordered.
Since storage iron does not decrease in thalassemia carrier, iron is not given in treatment. In fact, continuous administration of iron, considering iron deficiency, may even harm the patient by causing iron overload. Since anemia in thalassemia carrier is congenital, the body has generally adapted to this situation. Since the cause of anemia is the premature destruction of red blood cells, the bone marrow has to work harder to compensate for this condition. This increases the need for folic acid, a B vitamin. Therefore, thalassemia carriers should be supplemented with folic acid, not iron.
Prof. Dr. Coşkun Tecimer
