Suplemen & Vitamin Untuk Talasemia

Assalamualaikum...

Pertama sekali, NuNa cadangkan baca link ni dulu --> Thalassemia Major & Nutrition

Pastu klik la links yang related dengan masalah & treatment untuk talasemia…yang NuNa share kat sini sebahagian info jerk yaa…info suplemen yang related dengan talasemia…

Apa suplemen yang sesuai untuk pesakit thalassemia?? Yang perlu anda tahu adalah TIDAK BOLEH AMBIL IRON / ZAT BESI !!!

Yang lain??? Okeyh…NuNa ada jumpa sikit informasi tentang thalassemia nih…informasi tentang suplemen yang sesuai…actually dh lama tersimpan dalam pendrive…alang-alang dh jumpa, NuNa share la…NuNa ‘copy paste’ yang penting-penting ja…link asal NuNa tak copy…kalau jumpa, NuNa update okeyh…

These are basic recommendations for adults. Keep in mind that lower doses are most often recommended for children.

1. Vitamin E  400 iu.  Natural source preferred. d-alpha tocopherol (not dl-alpha). If possible, use mixed tocopherols. (Vitamin E is a blood thinner, which is a good thing for most people. However, if you are taking a blood thinner such as warfarin or coumadin, tell your doctor you are taking vitamin E as your dosage of the blood thinning drug may need to be adjusted downward).
2. Vitamin E is one of the most important nutrients that need to be supplemented in thalassemia. The iron overload that exists in major and intermedia causes tremendous oxidative stress to the cells and anti-oxidants can prevent oxidative stress from occurring.  
3. Folic Acid 1000-10,000 mcg (micrograms). 1000 = 1 mg This is recommended for all thal patients.
4. B-Complex. The B vitamins help protect the body against stress and are important for many basic functions. B vitamins are water soluble and do not last long in the body. It is important to replace them on a regular (daily) basis. Adequate amounts of vitamin B-12 are essential. B-12, as all B vitamins is water soluble and amounts ranging from 100-1500 mcg daily are advised.
5. Calcium  1000-1500 mg + 500-1000 mg magnesium + Vitamin D 1000-5000 iu (all work together to maintain bone growth and heart function). Calcium taken alone is inadequate and can also lead to problems affecting the heart. It must be balanced with magnesium, as they work together in the heart beat, and an imbalance can lead to heart palpitations. Vitamin D is necessary for the absorption of calcium.
6. Zinc 15-50 mg
7. Vitamin C 100-250 mg taken with desferal (helps more iron to be excreted). Do NOT take more than 250 mg daily if thal. Too much iron can be freed into the bloodstream where it can cause clumping in the heart, causing lowered heart function. Thals should NOT take vitamin C supplements, except when taking desferal and only 100-250 mg taken along with the start of the desferal. Vitamin C aids in the absorption of iron from food and should be avoided by anyone with iron overload. Citrus should only be eaten between meals so that the vitamin C in it does not increase the absorption of iron from the diet. 500 mg is far more than a thal should get daily.
8. IP6 (phytic acid) is a natural iron chelator and a member of the B family. IP6 is a powerful antioxidant, and patients using it have showed both some reduction in ferritin levels and also improvements in general health. 
9. Iron SHOULD NOT BE USE by thallasemics as it can lead to iron overload.

Paradoxically, oxygen is essential for life but is also lethal! This is because normal oxygen molecules can convert into different chemical forms known as “free radicals.” When the activity of free radicals is harnessed and controlled, they have important uses in the body. Uncontrolled free radicals, however, can do great damage and lead to disease.

Antioxidants are important in any diet, because as their name suggests, they prevent oxidative damage in the body. In doing so, they play an important role in the prevention of diseases such as coronary heart disease and cancer.

In thalassemia, because of the excess iron in the body, there is a higher risk of oxidative damage...Vitamin E is the most important dietary antioxidant. Several studies have found that many thalassemics have lower levels of vitamin E in their blood compared to non-thalassemics. This could be either because thalassemics do not take as much vitamin E in their diet or because their needs are higher. In many studies, when vitamin E was given as a supplement, vitamin E levels in the blood improved.

Fifteen beta-thalassemia intermedia patients, not requiring chronic transfusional therapy, were monitored in order to check their antioxidant status, and the lipid oxidation products in plasma, LDL, and erythrocytes before and during a 9-month oral treatment with 600 mg/day vitamin E. The low level of vitamin E, and high level of malondialdehyde in plasma clearly tended to normalize after three months (P < .001), and were quite similar to control after six months. The abnormally low level of vitamin E in LDL and the four times higher than control basal level of conjugated dienes (LDL-CD), were not modified after three months of treatment. Significant changes of LDL-VE (P < .05) and of the basal LDL-CD (P < .001) were evident after six months. LDL-VE was within the normal range after nine months, whereas LDL-CD still appeared twice as higher than control. Plasma vitamin A, ascorbate, beta-carotene, and lycopene increased markedly at the end of the trial (P < .005). The level of vitamin E in red blood cells was normalized after six months of supplementation. A decrease of the baseline value of conjugated dienes was observed after nine months, although it remained 1.4-fold higher than control. The RBC count and hematocrit appeared higher at the end of the trial (P < .05 and P < .001, respectively). The hemoglobin value did not show variations. A shift to normal of the resistance of erythrocytes to osmotic lysis was observed. Our findings provide evidence that an oral treatment with vitamin E improves the antioxidant/oxidant balance in plasma, LDL particles, and red blood cells, and counteracts lipid peroxidation processes in beta-thalassemia intermedia patients.

Osteoporosis is a serious problem in thalassemia that is becoming even more prevalent as the thal population ages. Since osteoporosis is also a major problem in the non-thal population, there are many studies done on prevention and reversal of bone loss. Several studies were summarized by Jean Carper in her column in the USA Weekend magazine,April 2, 2006.  

WHAT TO EAT FOR STRONG BONES??

Bones weaken and fractures soar with age. Today, about 10 million Americans have osteoporosis (brittle bones), and another 34 million have osteopenia (low bone mass). Potassium-packed fruit can help bones.

Here's the latest research on how to keep bones strong:

• Don't count on calcium alone. New research finds vitamin D as important. In fact, a daily 700 IU to 800 IU of D cuts hip fracture risk 26%, say Harvard investigators. Most women should take 500mg to 800mg calcium and 600 IU vitamin D each day.
• Beware animal fat. Eating high amounts of saturated fat in meat and dairy can weaken bones, finds a new Penn State study. In men under age 50, those who ate the most saturated fat had 4% less bone mineral density than men who ate the least.
• Eat fruits, vegetables. One reason: They're packed with potassium, which slows excretion of calcium. In animals, dried plums (prunes) even reversed bone loss.
• Cut salt. In women with a typical American diet, cutting back to 2,000mg sodium a day reduced their calcium and bone loss, says a University of Tennessee study.
• Get B vitamins. Low B12 levels in the blood signal lower bone mineral density in men's hips and women's spines, says recent Tufts University research. In Japanese research, high daily doses of B12 (1,500mcg) and folic acid (5mg) cut hip fractures 80% in stroke patients.
• Limit colas and candy. Higher consumption of these is linked to greater bone loss.

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