Nutrition for people with hemolytic anemia

Hemolytic anemia (English name is thalassemia) is an inherited disease (i.e., passed from parent to child) that causes a blood disorder that occurs when the body does not make a protein called hemoglobin, which It is an important part of red blood cells.
When there isn't enough hemoglobin, red blood cells don't function properly and last for a shorter time than usual, so there are fewer healthy red blood cells moving around in the blood vessels.
Red blood cells carry oxygen to all cells of the body. Oxygen is a food that cells use to function. When there aren't enough healthy red blood cells, there isn't enough oxygen to deliver to all of the body's cells, which can lead to fatigue, weakness, or shortness of breath. People with hemolytic anemia can have mild or severe anemia. Severe anemia can damage internal organs and lead to death.

Hemolytic anemia has many complications from mild to severe, however, one complication related to diet is iron overload. People with hemolytic anemia may get too much iron in their bodies, either from the disease or from frequent blood transfusions. Too much iron can lead to damage to the heart, liver, and endocrine organs, including the hormone-producing glands that regulate processes throughout the body. Therefore, to avoid this complication, patients need to limit their intake of iron-containing foods and need iron chelation treatment.

Nutritional deficiency is a common condition in patients with hemolytic anemia due to anemia, increased nutritional requirements and other comorbidities such as iron overload, diabetes.
Patients should be evaluated annually by a dietitian for issues related to adequate intake of calcium, vitamin D, folate, trace minerals (copper, zinc and selenium) and antioxidant vitamins ( E and C).
In addition, patients should also have annual nutritional testing, such as albumin, 25-hydroxy vitamin D, fasting glucose, plasma zinc, serum copper, ceruloplasmin, serum selenium, alpha and gamma tests. tocopherol, plasma ascorbate and serum folate.

Nutritional recommendations for patients with hemolytic anemia should be made based on the nutritional status of the individual patient, the complications of the disease and, if in children, the stage of growth. Usually, a non-iron multivitamin supplement is usually indicated.
For patients with non-transfusion hemolytic anemia, folate supplementation (1mg per day) is recommended and a diet low in iron, for example, avoids iron-fortified cereals and limits red meat intake. Drinking black tea with a meal is recommended to reduce iron absorption from food.
For blood transfusion patients on chelation therapy, a low iron diet is unnecessary and may reduce the quality of life for some patients.
Vitamin D supplementation (50,000 IU once weekly until levels return to normal) is recommended for patients with 25-hydroxy vitamin D below 20 ng/dL. Calcium supplementation should be recommended if dietary intake is inadequate.
For patients with additional diabetes or lactose intolerance, vegetarians, pregnant women or those taking oral chelators or bisphosphonates, a nutritionist should be consulted. more specialized.
Patients with hemolytic anemia should not use alcohol and tobacco because alcohol increases the oxidative damage of iron and aggravates the effects of hepatitis B and C on liver tissue. Smoking affects bone remodeling and leads to osteoporosis.
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Articles source references: mayoclinic.org, thalassemia.com