Hi, thank you for query The primary symptoms of thalassemia are a result of anemia, a decreased number of healthy red blood cells. The following are the most common symptoms of anemia. However, each child may experience symptoms differently. The symptoms may include, but are not limited to, the following: • pale skin, lips, hands or under the eyelids • increased heart rate (tachycardia) • breathlessness, or difficulty catching a breath (dyspnea) • lack of energy, or tiring easily (fatigue) • dizziness or vertigo, especially upon standing • headache • irritability • irregular menstruation cycles • absent or delayed menstruation (amenorrhea) • jaundice, or yellowing of skin, eyes, and mouth • enlarged spleen or liver (splenomegaly, hepatomegaly) • slow or delayed growth and development Children who carry a single thalassemia gene are said to have “thalassemia trait.” These children are generally healthy and do not require any treatment. Thalassemia intermedia causes less severe symptoms than thalassemia major. This can make it difficult to diagnose because it may resemble other forms of anemia. Thalassemia major causes the most severe anemia and requires ongoing treatment and regular blood transfusions.