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How should I improve my haemoglobin?

Q: I am a 41 years old female. I have thalassaemia trait and as a result of this I cannot take any iron supplements to improve my haemoglobin. My Hb hovers around 9 to 9.5. My serum ferritin level is 55 and my doctor says it should be at least 70. I take one Folvite every morning and one Eltroxin per day for my treatment for hypothyroidism. I have been asked to have 2 tablespoons of Hemfer syrup as well. I see that 15 ml of this syrup contains ferrous glycine sulphate which is equivalent to 50 gms of elemental iron. Is taking this syrup safe for my health? I also suffer from polycystic ovary syndrome. Please advise.

A:The presence of concomitant iron deficiency with beta-thal trait (BTT) is quite common in our country. The effect of iron deficiency in BTT is apparent as a significant lowering of the haemoglobin (Hb) concentration and an increased prevalence of anaemia. Iron therapy is warranted for such patients with iron-deficiency and helps to significantly raise the Hb concentration. There is no reason why you should not take iron supplement. Dietary iron is available in two valency states, Fe 2+ (ferrous) and Fe 3+ (ferric). The majority of ferrous form is found in haeme iron (as haemoglobin & myoglobin in meat and meat products) while most ferric iron is found in non-haeme iron (plant foods like cereals, vegetables, pulses, dried fruits etc.). Haeme iron is readily available and usually 20-30% of it is absorbed from the diet. This can increase upto 40% when an individual is iron deficient. The level of haeme iron absorption is relatively unaffected by other dietary factors. Non-haeme iron, in contrast, is relatively poorly absorbed (usually less than 10% of dietary intake and often under 5%). Its absorption is markedly influenced by an individuals iron status and dietary factors that can either inhibit or enhance it. Treatment of most patients with iron deficiency is with oral iron therapy. The cheapest and most effective form is ferrous iron. The side effects experienced on taking iron tablet are proportional to the amount of iron available for absorption. The iron preparation you take should contain between 30-100 mg elemental iron. Avoid enteric-coated or prolonged-release preparations. The dose you take should be sufficient to provide between 150-200 mg elemental iron per day and the tablet may be taken 2 to 3 times a day about 1 hour before meals, preferably with a glass of juice (as vitamin C enhances iron absorption). Take a normal nutritious diet and folic acid supplement twice a week. The treatment should be continued for 3 months after the haemoglobin has returned to normal so that the body iron stores are replenished. Response to treatment is confirmed by doing a reticulocyte count after 10-12 days of treatment and the rate of rise of haemoglobin.

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