A few weeks ago, I saw David who is seven and suffering from sickle-cell. First a primer about blood: blood contains red blood cells that transport oxygen around the body. The substance that carries the oxygen in the red blood cells is called haemoglobin. When someone has sickle cell, the haemoglobin becomes an abnormal shape, distorting the shape of the red blood cell – it becomes sickle shaped.
So unlike normal red blood cells, which travel easily through small blood vessels, sickle cells are stiff and pointy, making them likely to get stuck and block the flow of blood. Not only can this cause episodes of pain (known as “crises”) which often require hospitalisation, but the lack of oxygen can lead to organ damage too.
Furthermore, since sickle cells have a shorter-than-normal life span, the person develops anaemia (low RBC count). Whereas a normal red blood cell lives for about 120 days in circulation, a sickle cell lives for only 10 to 20 days.
The only known cure for sickle cell disease is a bone marrow transplant, but transplants are complex, expensive and risky and currently are an option only for certain patients with severe complications. Otherwise, children are given medicines to help manage the pain, and immunizations and daily doses of penicillin (an antibiotic) to help prevent infection.
So where would nutrition come in? First and foremost, patients with sickle cell disease require more vitamins and minerals. In order to ensure that the micronutrients are readily available in the body, I’d strongly recommend hearty, warming soups and daals (crush in a clove of garlic for an added immune-boosting punch). Most people forget about the importance of water, but adequate hydration ensures that the patient doesn’t require hospitalisation to receive intravenous fluids.
Vitamin and mineral supplementation is also required. Studies have shown that certain nutrients do seem to be able to help control the symptoms of sickle cell disease. Two that are particularly worth of mention are vitamin B6 and vitamin E.
Vitamin B6 appears to have the ability to actually stop the sickling of red blood cells, while Vitamin E has been documented to reduce the percentage of diseased cells.
One other supplement that may help, but has yet to undergo controlled trials, are omega-3 fatty acids. Preliminary studies show that it may improve the membranes of red blood cells and therefore may reduce flare–ups.
Yesterday, just three weeks later, I received a phone call from his parents to say that David was feeling much better. He was no longer as tired and hadn’t had a crisis since. I’m looking forward to seeing his blood tests in a few weeks. BY DAILY NATION