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What is Mediterranean Anemia?

By Amanda Barnhart
Updated Mar 03, 2024
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Mediterranean anemia, also called thalassemia, is a blood disorder inherited from defective genes in one or both parents. Those afflicted have less hemoglobin and fewer red blood cells than normal. Hemoglobin is a protein that allows red blood cells to carry oxygen throughout the body and to carry carbon dioxide to the lungs to be exhaled. When the body does not have enough oxygen supplied to its organs and tissues, it causes fatigue.

The most common symptoms of Mediterranean anemia are fatigue and weakness due to the lack of oxygen being distributed throughout the body. Sufferers of the disorder may also experience shortness of breath, unusual paleness, or a yellowing of the skin called jaundice. Symptoms range from mild to severe, and can be present as early as birth. Some patients do not experience any symptoms at all, while others may not show signs of the disorder until later in life.

Mediterranean anemia patients can get an overabundance of iron in their bloodstreams from the disease or frequent blood transfusions. Infections are also common due to blood transfusions and can be serious, as with hepatitis. Severe cases can cause bone deformities, enlarged spleen, slowed growth rates, and heart problems, including congestive heart failure and abnormal heart rhythms.

Blood tests to measure the amount of iron in the blood, the amount of red blood cells, and hemoglobin distribution are performed to diagnose this disorder in children. Prenatal testing can also be done if the parents carry the defective genes responsible for the disorder. Prenatal testing methods include chorionic villus sampling of the placenta at around 11 weeks, amniocentesis of the amniotic fluid at 16 weeks, and fetal blood sampling after 18 weeks.

Treatment for mild cases is usually minimal, though patients may need blood transfusions periodically. Blood transfusions are common following surgery, infection, and giving birth. Individuals with severe Mediterranean anemia often need more frequent blood transfusions. Iron can build up in the bloodstream quickly after multiple transfusions, so iron chelators are often given to help the body dispose of the excess iron. In rare severe cases a bone marrow or stem cell transplant may be given if a suitable donor can be found, but these procedures are risky so they are reserved as a last resort.

Most Mediterranean anemia symptoms can be managed by following a few basic health guidelines and lifestyle changes. Patients should avoid excess iron, and eat a nutritious diet high in folic acid, calcium, zinc, and vitamin D to aid the production of new red blood cells and keep the bones healthy. Since the risk of infection is high, it is vital that patients receive an annual flu vaccination and stay up-to-date on other vaccines.

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Discussion Comments
By anon997815 — On Mar 04, 2017

I am pure blood Italian: 3/4 Sicilian and 1/4 Rome, Italy. I have Mediterranean anemia too. I have worked since I was 10 years old doing whatever job I could find. Worked as a carpenter's laborer to help pay for college. Worked as a teacher, insurance sales, and worked toward a MA degree and then a JD degree. I had to earn more to support my family and now have been a lawyer for the past 22 years.

Yes, I am tired at 68 years of age but never missed a day of work or school all of my life. My son is now 27 and discovered he has it and is driving me crazy always complaining he can't do anything, has a poor quality of life. I try to explain to him that you make life the best you can and move on, beyond sickness and pray that God will help you each day to get beyond your troubles, but he refuses to believe in God and blames the world for his problems. I am so tired of it. I feel bad that I just don't have pity. What the hell has happened to this world? There are times where you just have to man up and move on the best you can.

By anon344824 — On Aug 12, 2013

I was diagnosed as a child. My father had it active in him, as well as my grandmother (his mother). No one else in the family has it. It only started becoming active about three years ago. My hemoglobin dropped to a 7.3 (which is just about transfusion level) at this time I was having heavy menstrual cycles.

I went for twelve weeks of iron infusions which brought it up. Just recently at the age of 3,1 I started feeling so tired to the point where I was dragging all day and was getting light headed and dizzy just by walking across the room. I got my labs my hemoglobin down to an 8.6 (without bleeding) so I'm waiting to see what insurance approves for iron.

By anon340541 — On Jul 03, 2013

I am almost 58 and have had Mediterranean Anemia all my life (or at least as early as I had my first labs done). I inherited it from my pure Italian mother and my sister has it as well.

I am tired all the time and have been most of my life. I always felt like I never had enough energy, or at least not as much as others seem to have. I was never overly athletic as I felt I couldn't do it.

I don't normally have to nap, but I do rest a lot at night. I'm not a good sleeper, so that doesn't help much. As one previous posts said, I don't feel much different whether I've gotten six hours of sleep or 10. However, I do not believe there is any shortened life expectancy that I know of, but it my case my levels are usually not that significantly lower than the normal range. They have always been in the "Out of Range" group consistently, just not excessively so. Hope this helps someone.

By anon311118 — On Dec 29, 2012

I've been reading up on this disease and I suspect that I have this illness. I have an aunt on my Mother's side who was diagnosed with Mediterranean B (that's what she called it) and I believe my Grandmother had this illness.

I wake up tired (it feels like I never get enough sleep), and when I do the smallest activity, I have to go home and take a nap. I'm constantly fatigued.

I lose muscle control and it is so embarrassing. My right leg (the lower part) feels like it is pulling apart. I take pain pills for the pain but they don't help. I have shortness of breath, and my hair constantly falls out in one particular area of my head.

The doctors have told me that I have a large spleen, irregularly shaped red blood cells and anemia, so I don't understand why they didn't put it all together and say something about this illness.

I also have been diagnosed with Fibromyalgia, which causes fatigue also and I'm in constant pain. This has really impacted my quality of life and it's very frustrating because I never know how to plan my day.

By anon295311 — On Oct 05, 2012

I was just surfing around and came across this site. I was diagnosed with Mediterranean anemia years ago and I'm 40 now. The last few years I have seen an increase in being tired.

My wife said I need to get checked out, as I fall asleep uncontrollably at times and am exhausted most nights around 8 p.m.! Granted, the alarm goes off at 5 a.m., and I'm gone 12 hours a day, but regardless of amount of sleep, I'm always tired. Just rest when you can and exercise when you can, even if it's three times a week.

I have a lot going on and hate slowing down. I have literally not gone out with friends on work nights because I know I'll be exhausted by 10 p.m.

By anon278074 — On Jul 04, 2012

Recently my husband has been diagnosed with Mediterranean Blood Disorder. I am very concerned with his lifestyle and diet. He is a smoker and a regular drinker. He also has high blood pressure and his level of fats is too high. I have been preparing him oat porridge every morning hoping that it will cut down his fats and bring down his weight. Please advise me what I can do for him to assist his health and get him to be more concerned with his own diet.

By anon259405 — On Apr 06, 2012

I have the minor trait of Mediterranean Anemia and was diagnosed with it when I was seven years old. As a child, I was always ill and, as a teen, it got worse when I started my menstrual cycle. I'm now in my twenties and, as a high drive person, it gets frustrating having to slow down and coddle the anemia, but it's what I have to do. A healthy, balanced diet has been a great help to me, as well as making sure I get enough sleep at night. I also get the flu shot every year and stay away from sick people as much as possible.

One thing that is extremely frustrating: I've had a number of doctors tell me the minor trait has no symptoms, even though I have struggled with clear immune system issues, am always extremely pale with scary dark circles under my eyes even with ten hours of sleep a night (especially around my period), get dizzy and lightheaded regularly, am always tired (I feel the same, whether I've had four hours of sleep or whether I've had ten and, for a while, gave up on sleeping eight hours a night and just slept four because what's the point) and am extremely moody.

Everyone in my family who has been diagnosed with the minor trait complains of the same symptoms and it's not depression. I am hyper and happy most of the time, even during the mood swings. I don't understand why doctors are in such denial over the minor symptoms.

By anon129773 — On Nov 25, 2010

This disease seems to affect anyone from any part of the Mediterranean.

@119931: My mother’s side is from Italy, and several of my family members have this condition. The most important thing is for your husband to keep it stable, to stay active but rest when he needs to, to eat a healthy diet, and to see the doctor regularly. Also, if some one with this disorder does not take any recreational drugs, they should be just fine.

Also, heart health is important, just so there’s no extra bodily strain.

My grandfather has this and he is going to turn ninety soon. He has lived through hell and back, being a Holocaust survivor, and then the father of many children. It all depends on the person and how well they’re willing to take care of themselves, as well as how much love they have to live for. I hope I could be of help to you. I wish you both the best, and will say a prayer for you two for health.

By anon119931 — On Oct 19, 2010

My husband has been diagnosed with Mediterranean Blood Disorder. I'm very concerned with his quality of life as he approaches his later years and what his life expectancy is with this diagnosis. I would like to talk with anyone who has experience with this disease.

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