Sometimes, people with mild thalassemia may be told to supplement with iron. Iron supplements are only appropriate for certain types of thalassemia, though, and can be dangerous for people with more severe types.

Thalassemia is an inherited blood disorder that causes decreased production of an important blood protein called hemoglobin. Hemoglobin carries oxygen to your tissues and organs.

When you have thalassemia, you may have low levels of hemoglobin and fewer healthy red blood cells, which is known as anemia.

Iron supplements are a common treatment for iron-deficiency anemia. However, anemia from thalassemia isn’t caused by a lack of iron, so supplements might actually cause more harm for people with the condition.

Anemia from thalassemia is mainly treated with blood transfusions. The frequency of transfusions depends on the type of thalassemia a person has and how severe their anemia symptoms are.

There are two types of thalassemia:

  • Beta thalassemia: This type refers to thalassemia that’s caused by mutations of the beta-globin gene, which causes a reduction in a part of hemoglobin called beta-globin.
  • Alpha thalassemia: This type is caused by mutations of the alpha-globin genes, which leads to low alpha-globin levels.

In addition to type, the following terms are used to describe how severe thalassemia is and what kind of treatment you may need, according to the Centers of Disease Control and Prevention (CDC):

  • “Trait” or “minor”: Most people with thalassemia trait or minor don’t need blood transfusions. It’s the most mild form and may not cause any symptoms.
  • “Intermedia”: People with thalassemia intermedia may need a blood transfusion once in a while, but not as frequently as someone with thalassemia major.
  • “Major”: People with thalassemia major can have severe, life threatening anemia. They usually need regular transfusions to make sure they have enough healthy red blood cells.

During a blood transfusion, donated blood is transferred to your body through a narrow tube placed in your vein. People with thalassemia are often also prescribed folic acid, a B vitamin, to support healthy blood cell production and help prevent anemia.

If you have more severe forms of thalassemia and receive blood infusions, you should never take iron supplements unless specifically recommended and monitored by your medical team. Doing so can result in a dangerous situation called iron overload, which can be fatal in some cases.

According to a 2020 case report, people with thalassemia who don’t depend on transfusions can also develop iron overload due to ineffective red blood cell production, which can lead to too much iron being absorbed into the digestive tract.

Because of this, people with thalassemia should avoid taking iron supplements and ask their doctor if it’s necessary to limit and monitor their intake of iron-rich foods to maintain safe iron levels, per the CDC.

Can people with alpha or beta thalassemia minor (thalassemia carriers) take iron supplements?

In some cases, iron supplements may be used to treat anemia in people with mild cases of thalassemia.

For example, a 2022 study found that iron supplements were effective and safe for treating iron-deficiency anemia in pregnant women with beta-thalassemia minor.

Another research report from 2022 had similar findings. The authors suggested that iron supplements should be considered for pregnant women with alpha or beta thalassemia minor, but only if they’re closely monitored by a doctor because of the risk for iron overload, especially in those with beta thalassemia minor.

If you have thalassemia trait or thalassemia minor and iron-deficiency anemia, your doctor may create a treatment plan that includes iron supplements.

Although iron overload is more rare in people with thalassemia minor, it’s still important to avoid taking an iron supplement unless prescribed by your doctor.

When extra iron begins to collect in the tissues of your vital organs, like the heart and liver, it’s referred to as iron overload. Iron overload is dangerous because it can damage these organs and cause them to work less effectively.

People with thalassemia are more at risk of developing iron overload due to blood transfusion treatments and increased iron absorption in the digestive tract.

If you have thalassemia, your healthcare team will use blood tests to regularly monitor your iron levels and ensure they’re within a safe range. If levels of an iron-storing blood protein called ferritin are greater than 150 to 200 ng/mL in menstruating females and 300 ng/mL in males, it could be a sign of iron overload.

Iron overload can be treated using certain methods, such as chelation treatment, which involves medication that increases the excretion of iron from the body.


Iron overload doesn’t show any symptoms in 75% of people. In some cases, people with iron overload may have symptoms like:

  • fatigue
  • abdominal pain
  • joint stiffness
  • an enlarged liver
  • irregular heartbeat
  • low sex hormones
  • decreased sex drive
  • high blood sugar levels
  • bronze-colored skin
  • depression


High iron levels in the body can damage organs like the heart, liver, and endocrine glands.

This damage can cause dangerous side effects like heart failure and liver failure.

When to see a doctor

If you’re experiencing any of the following anemia symptoms, it’s important to make an appointment with your doctor so that they can assess your iron levels and your overall health:

  • headache
  • lightheadedness
  • fatigue
  • pale skin
  • shortness of breath
  • cold intolerance

If you have anemia, your healthcare team will recommend the most appropriate treatment plan based on your diagnosis and overall health history.

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If you have thalassemia, your doctor will closely monitor your iron levels to make sure they’re within a healthy range.

Unless otherwise directed by your doctor, you should avoid using iron supplements if you have any form of thalassemia, especially if you’re receiving regular blood transfusions.

When you have thalassemia, a lack of iron isn’t the cause of anemia. Putting too much iron in your body can be dangerous, eventually leading to organ failure.