Thalassemia intermedia; folic acid and vitamin B12 supplementation. What we know and what is needed?

This study presented a mini review on folic acid deficiency and recommendations for its supplementation in thalassemia intermedia (TI). TI is a clinical condition which lies between thalassemia major and thalassemia minor. Although TI patients may not need regular blood transfusion, precise diagnosis and management are critical for the prevention of clinical complications and quality of life improvement. Blood transfusion, iron chelation, and modulation of HbF are the main management strategies used for TI patients. High red blood cells turnover and nutritional deficiency in thalassemic patients lead to some vitamins and minerals deficiency as well as folic acid deficiency. Folic acid deficiency is more prevalent in TI patients compared with thalassemia major because of fewer blood transfusion which leads to higher red cells turnover. Therefore, Daily folic acid supplementation (1 mg/day) is recommended in these patients but the annual evaluation of vitamin B12 deficiency is also recommended in these patients for the prevention of its deficiency and complications