What Does Thalassemia Have To Do With Gout?

Thalassemia is a group of blood disorders that are genetically inherited which seriously constricts the body’s ability to produce hemoglobin, a protein that carries the oxygen we breathe throughout our lungs and entire body. In addition, thalassemia patients have a lower than average count of red blood cells in their body, the red blood cells usually being too small in size. Hemoglobin is made from bone marrow by using the iron that our body takes from our food in order to create the hemoglobin.

So the bone marrow from thalassemia sufferers does not produce enough hemoglobin or red blood cells for that matter and this causes anemia and fatigue since the body is deprived of oxygen. People who suffer from mild thalassemia like myself may not require any treatment whatsoever. If it’s severe thalassemia, the patient will usually require blood transfusions to replenish hemoglobin and red blood cells. Exercise and diet does help deal with the symptoms of thalassemia, especially fatigue.

Tart Cherry Extract for Gout

Thalassemia mostly occurs to people from Italy, Greece, Middle East, Africa and Asia, so if you come from those regions and you suffer from slight to severe thalassemia, chances are you will eventually develop hyperuricemia in the blood. Uric acid may rise and you are at an increased risk of developing gout. The evidence is also seen in rheumatoid arthritis patients as well! Here is a good case report from the Journal Indian Academy of Clinical Medicine.

I know this touches only a small minority of gout patients but although I suffer from very mild thalassemia, perhaps this was the root cause of my gout development in my early 20s and can be another factor that can cause somebody to develop gout. If you do suffer from thalassemia, talk to your doctor and closely monitor your uric acid levels. Avoid any excess iron unless your doctor recommends it.

Make sure to eat a healthy diet that will help you feel better and keep your energy high. Your diet should contain adequate calcium and vitamin D in order to keep your bones healthy. You should also speak to your doctor about taking a folic acid supplement to help your body produce more new red blood cells. It’s also important to protect yourself from infections, so wash your hands frequently and avoid sick people.

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    16 replies to "Gout and Thalassemia"

    • […] Blood Disorders and Gout […]

      • Yan

        May i know Thalassemia minor beta can drink tart cherry juice everyday?

        • Spiro Koulouris

          I believe so Yan but make sure you speak to your doctor beforehand to make sure.

          If you can drink any type of juice then it should be fine.

          I would recommend a tart cherry extract supplement to avoid and limit your sugar intake.

    • Mannal Atwa

      Hello! I just stumbled across your article and from the sounds of it, I may be suffering from gout. It’s a guess. I do have thalasemia beta minor. I have been suffering since yesterday with a feeling I can’t describe just can’t handle the pain in my legs and hands and fingers. It’s happened before. All I know is I had spinach yesterday for dinner. Could that have triggered it? I’m always feeling heart burn too. I’m going to go to a doctor tomorrow, it’s just driving me mad. What ae your thoughts on spinach? And tea? Could those trigger this pain?

      • Spiro Koulouris


        Make sure to check it out but I remember also having lots of heartburn right before being diagnosed with gout. As for spinach, it could be. Write down all the foods you eat during the day and look for a pattern cause sometimes it could be the food before the one you think triggered it.

    • Paul

      Hi Spiro, I am a thalassemia beta minor case with a hemoglobin blood count that hovers around 8. I am 55 years old now and am starting to really feel the effects of gout throughout different parts of my body, especially where I have had broken or fractured bones in the past.

      Is it common to get gout in these areas since they were previously damaged earlier in my life? Also I have been taking fruit and vegetable supplements to boost my diet and the bouts of gout seem to get worse. Does that seem normal, or is it just a coincidence? Any suggestions would be appreciated. Thanks

      • Spiro Koulouris

        Yes uric acid crystals can lodge themselves where you previously damaged your joints. Fruit and vegetable supplements? It depends on what you are taking. Don’t think that is the reason, could be coincidence or I would write down everything you eat in a food diary and see if there is food that maybe triggers the bouts.

        Good luck!

    • Anna-Maria

      Hi Spiro!

      Your website is a great source of encouragement, and it’s really cool that you are a Canadian of Mediterranean descent.
      I’ve been having gout-like symptoms for two or three years now. I have the thalassemia trait that many Mediterranean people have.

      I’ve had my uric acid levels checked, and had my kidneys X-rayed for kidney stones, but mysteriously, there was nothing unusual recorded.

      I wonder if people with thalassemia might experience symptoms at a lower level of uric acid than the general population, because of their smaller red blood cells.
      I notice that black coffee, celery and tart cherries all help with symptoms (joint pain after periods of stillness), and I was eating many of the offending foods like anchovies.
      I was also eating many high-oxalate foods. (The Italian diet is full of both types of offenders, and I spent four or five years on a pescatarian diet that included a great deal of spinach. I am back to meat again, but sparingly.)

      Do you know if uric acid crystal precipitation is related to oxalate crystal precipitation or vice versa?

      I note also that many modern wheat products now bring residual glyphosate into our bodies that exacerbate these issues.

      Any insights you might have would be helpful. I was sad to have to cut some foods out, but I have found some new foods, such as dino kales, that I enjoy as much if not more!

      • Spiro Koulouris

        Hi Anna-Maria!

        Thank you for your question.

        All we know is that any level of thalassemia can cause hyperuricemia which is a precursor to gout. As to the whole physiology behind it, I really don’t know how it works and all I could find was this study here–> http://medind.nic.in/jac/t10/i4/jact10i4p306.pdf

        If you ever find any more info please forward it to me!

        Thank you!

    • […] Thalassemia minor and Gout […]

    • Hairul

      I also have the same problem. Minor beta-thalessemia, mild anemia and automatically caused gout attack due to the release of uric acid from the burst of immature red blood cells.Consumption of allopurinol daily really help me and I can eat everything including high purine meals. Interestingly, I’ve found that eating chewing enzymes to help digestion really helpful as alternative to allopurinol. The enzymes play very important role in digesting our food and thus reducing the burden of our kidney, and our kidney can process the excess of uric acid…. Eating fruits with daily meals might also help in food digestion as well as preventing gout symptom for mild thallessemia patients.

      • Spiro Koulouris

        Very interesting Hairul! I will look into that “chewing enzymes to help digestion”. Thanks for your comment.

    • Morph

      My Thalassemia is also minor like yours! I just downloaded your book and I’m trying to read it from cover to cover right now. I live in the US and weather is terribly freezing right now. I am going to my doctor tomorrow to talk to her in starting me on allopurinol. I had my first attack in 2002 together with thalassemia minor diagnosis.

      This is going to be my first time to go on allopurinol if ever.
      Should I try your Gout diet first or combine it with allopurinol?

      Thank you for your help! I will try to follow what your books says and see what happens.

      • Spiro Koulouris

        Hi Morph!
        As for my gout diet, it won’t affect it with you taking your allopurinol and yes it can be combined, this is a health/lifestyle diet that a gout sufferer has to cut his protein and fat to 10% each of his/her daily calories and eat 80% of their daily calories as complex carbs, fruits, vegetables, whole grain breads and pastas, rice. You stick with foods as grown from the earth, you will quickly see by doing a simple blood test that your uric acid levels will drop and remain at healthy levels for you to avoid painful gout attacks. In addition, say goodbye to alcohol if you can cause it can get you into trouble, as well as sugary beverages like colas that have high fructose corn syrup in them, another culprit of gout. My ebook goes into more detail on the different kinds of foods and provide you with many tasty recipes, people think once you eat healthy that it’s supposed to be boring but that is far from the truth!

    • Morph

      Hi there! me and my brother both have thalassemia and we both are suffering with gout. You mentioned supplementation with folic acid, does this help you? Do you still get attacks? I just had the worst attack lasting about 2 weeks. This is just so frustrating!—Thanks! Morph

      • Spiro Koulouris

        Hi Morph! My thalassemia is very minor that I don’t need to do anything out of the ordinary to supplement it, so I don’t take any folic acid, if yours is more serious then talk to your doctor about supplementing with folic acid. I haven’t had a gout attack in a while although I may feel some flare ups when there is an abrupt change in weather here in Montreal or during the change of seasons. I follow a strict gout diet that you can find the details of in my ebook which mainly consists of 80% complex carbohydrates (foods that burn clean) and don’t raise your uric acid levels.

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