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  • 2015-2016 Thalassemia Outreach Intern Team
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  • New multidisciplinary center for Alpha Thalassemia Major
  • Twin girls from China reunited at our thalassemia center
  • View the slide presentations from the 2015 Seattle thalassemia patient and family conference
  • My Experience iwth Gene Therapy
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  • Focus on Alpha Thalassemia, by Ash Lal MD
  • Painted Turtle Camp July 17-22
  • Thalassemia Fact Sheet
  • Thalassemia: The Passion to Help Others
  • Thank you, Italian Catholic Federation (ICF)!
2015-2016 Thalassemia Outreach Intern Team1 Sign up for our newsletter2 New multidisciplinary center for Alpha Thalassemia Major4 Twin girls from China reunited at our thalassemia center5 Slides: Seattle thalassemia patient and family conference6 My Experience iwth Gene Therapy7 How you can help8 Visit our Facebook page9 Focus on Alpha Thalassemia, by Ash Lal MD10 Painted Turtle Camp July 17-2211 Thalassemia Fact Sheet12 Thalassemia: The Passion to Help Others13 14 Thank you, Italian Catholic Federation (ICF)!14 slideshow jquery by WOWSlider.com v8.2

Living with Thalassemia

Living with Thalassemia
▶ Life Stages:
  1. Infancy
  2. Toddler
  3. School Years
  4. Adolescence
  5. Adulthood
Transition
▶ Nutrition
▶ Immunization
▶ Fertility/Pregnancy
▶ Patient Stories
▶ Resources and Support:

Nutrition and Diet

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Nutritional deficiencies are common in thalassemia, due to hemolytic anemia, increased nutritional requirements, and morbidities such as iron overload, diabetes, and chelator use.

Patients should be evaluated annually by a registered dietitian regarding adequate dietary intake of calcium, vitamin D, folate, trace minerals (copper, zinc, and selenium) and antioxidant vitamins (E and C). Annual nutritional laboratory testing should include albumin, 25-hydroxy vitamin D, fasting glucose, fasting plasma zinc, serum copper, ceruloplasmin, serum selenium, alpha and gamma tocopherol, plasma ascorbate, and serum folate. (See nutrition table below.)

Recommendations for dietary supplementation should be made as indicated by nutritional history, complications of the disease, and, in children, growth status. Typically multivitamin supplementation without iron is suggested (e.g., Centrum Silver in tablet or chewable form is now available).

For nontransfused thalassemia patients, folate supplementation (1 mg daily) is recommended, and consuming a moderately low-iron diet is encouraged—that is, avoiding iron-fortified cereals and other products and excessive consumption of red meat. Drinking black tea with meals is recommended to reduce iron absorption from food.

For transfused patients on chelation therapy, a low-iron diet is unnecessary and may decrease the quality of life for some patients. The amount of iron obtained from just one unit of packed red cells (200 mg) far outweighs the amount of iron obtained from a 3-ounce steak (5 mg).

Vitamin D supplementation (50,000 IU once a week until levels normalize) is recommended for patients with a 25-hydroxy vitamin D less than 20 ng/dL. Calcium supplementation should be encouraged if dietary intake is insufficient.

Counseling should be offered for patients with special dietary needs. These include patients with diabetes or lactose intolerance, those who practice vegetarianism, those who are pregnant, or those on oral chelators or bisphosphonate medications.

Alcohol consumption and cigarette smoking are to be discouraged. Alcohol potentiates the oxidative damage of iron and aggravates the effect of hepatitis B and C on liver tissue. Cigarette smoking affects bone remodeling and is associated with osteoporosis.


Northern California Comprehensive Thalassemia Center
UCSF Benioff Children's Hospital Oakland
747 52nd Street, Oakland CA 94609   •   Phone: (510) 428-3651   •   Fax: (510) 450-5647
© 2003-2012 Children's Hospital & Research Center Oakland
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