Husband has Sickle Cell gene and didn't tell me

[Anonymous]

Anonymous wrote:

Anonymous wrote:^ It will not let me quote you for some reason, but read the third link again. The third link did study the accuracy of peripheral blood smears on those with sickle cell disease (not just sickle cell trait). Peripheral blood smears were found to have diagnosed all cases of sickle cell disease accurately with 100% sensitivity and specificity.

https://www.rmj.org.pk/fulltext/27-1594051429.pdf

Because they were using special staining and then -- most importantly -- electrophoresis. That is not the same thing as just looking at morphology of cells; rather, that is specific for assessing the actual type of hemoglobin within the cell. You see the difference?

In the methodology:

Questionnaires were filled after interview and after all aseptic measures, 2 ml intravenous blood was collected in Ethylene Diamine Tetra Acetic Acid anticoagulated tubes (Purple Top). The samples were shifted to Dow Ishrat-ul-Ebad Khan Institute of Blood diseases (DDRRL) maintaining the cold chain and peripheral smears were prepared and stained using Leishman stain. Genio-S interlab (Italy) was utilized for hemoglobin electrophoresis at pH of 8.6 using cellulose acetate as a medium.

That's the only way you make it to 100% sensitivity, but that was not what we were discussing, I mean, it's great, but it's just not true that you will always find sickle cells in every sample from someone with SCA, much less SCT. However, you can do additional more complicated (and more expensive, more time-consuming) tests to do that -- but then we are back to not being able to rely on a simple peripheral smear viewed under a microscope. Because that isn't enough.

This is the electrophoresis process:

Test Details
What Is Hemoglobin Electrophoresis?
Hemoglobin electrophoresis is a test to check hemoglobin protein in your red blood cells. Hemoglobin is a protein in your red blood cells that helps cells carry oxygen throughout your body. A provider may do this test to diagnose blood disorders. It’s also one of several screening tests for newborns.

Advertisement


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Hemoglobin types
There are five hemoglobin types:

Type A (HgbA): Hemoglobin A accounts for most of the hemoglobin in your normal red blood cells.
Type A2 (HgbA2): This type accounts for about 2% to 3 % of your total hemoglobin.
Type F (HgbF): High levels are normal in fetuses, babies and children up to 3 years old. High type F levels in older children and adults may be signs of blood disorders or other health issues.
Type S (HgbS): This type is a sign of sickle cell anemia.
Type C (HgbC): This type C is a sign of hemolytic anemia.
Test Details
How does the test work?
A venous blood draw is the most common way providers get blood samples for analysis. Other procedures are:

Finger stick: Your healthcare provider pricks your fingertip to get a tiny sample of your blood. Your child’s healthcare provider may use a finger stick test to get a blood sample.
Heel stick: A provider gets a few drops of blood by pricking your baby’s heel with a needle. They do this test to check for sickle cell anemia.
You don’t need to prepare for this blood test.

What are the steps in hemoglobin electrophoresis?
This test uses electricity to separate hemoglobin types. That process involves the following steps:

1. A technician places dissolved red blood cells on a cellulose strip.
2. They put the strip into a machine that passes electricity through the red blood cells.
3. The hemoglobin types react to the current by separating into separate bands.
4. The technicians compare the test results with normal hemoglobin.

https://my.clevelandclinic.org/health/diagnostics/22420-hemoglobin-electrophoresis

Yes, they used stain to allow for identification of the various cell types. They need to be able to correctly differentiate and identify. This is a common practice when doing peripheral blood smears.

The electrophoresis was done because they were evaluating the accuracy of peripheral blood smears in diagnosing sickle cell by comparing the peripheral blood smear results with electrophoresis results.

Their objective says, “To evaluate the diagnostic accuracy of peripheral smear morphology as a screening tool for Sickle cell trait/disease by comparing its results with hemoglobin electrophoresis.”

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^ It will not let me quote you for some reason, but read the third link again. The third link did study the accuracy of peripheral blood smears on those with sickle cell disease (not just sickle cell trait). Peripheral blood smears were found to have diagnosed all cases of sickle cell disease accurately with 100% sensitivity and specificity.

https://www.rmj.org.pk/fulltext/27-1594051429.pdf

Because they were using special staining and then -- most importantly -- electrophoresis. That is not the same thing as just looking at morphology of cells; rather, that is specific for assessing the actual type of hemoglobin within the cell. You see the difference?

In the methodology:

Questionnaires were filled after interview and after all aseptic measures, 2 ml intravenous blood was collected in Ethylene Diamine Tetra Acetic Acid anticoagulated tubes (Purple Top). The samples were shifted to Dow Ishrat-ul-Ebad Khan Institute of Blood diseases (DDRRL) maintaining the cold chain and peripheral smears were prepared and stained using Leishman stain. Genio-S interlab (Italy) was utilized for hemoglobin electrophoresis at pH of 8.6 using cellulose acetate as a medium.

That's the only way you make it to 100% sensitivity, but that was not what we were discussing, I mean, it's great, but it's just not true that you will always find sickle cells in every sample from someone with SCA, much less SCT. However, you can do additional more complicated (and more expensive, more time-consuming) tests to do that -- but then we are back to not being able to rely on a simple peripheral smear viewed under a microscope. Because that isn't enough.

This is the electrophoresis process:

Test Details
What Is Hemoglobin Electrophoresis?
Hemoglobin electrophoresis is a test to check hemoglobin protein in your red blood cells. Hemoglobin is a protein in your red blood cells that helps cells carry oxygen throughout your body. A provider may do this test to diagnose blood disorders. It’s also one of several screening tests for newborns.

Advertisement


Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Hemoglobin types
There are five hemoglobin types:

Type A (HgbA): Hemoglobin A accounts for most of the hemoglobin in your normal red blood cells.
Type A2 (HgbA2): This type accounts for about 2% to 3 % of your total hemoglobin.
Type F (HgbF): High levels are normal in fetuses, babies and children up to 3 years old. High type F levels in older children and adults may be signs of blood disorders or other health issues.
Type S (HgbS): This type is a sign of sickle cell anemia.
Type C (HgbC): This type C is a sign of hemolytic anemia.
Test Details
How does the test work?
A venous blood draw is the most common way providers get blood samples for analysis. Other procedures are:

Finger stick: Your healthcare provider pricks your fingertip to get a tiny sample of your blood. Your child’s healthcare provider may use a finger stick test to get a blood sample.
Heel stick: A provider gets a few drops of blood by pricking your baby’s heel with a needle. They do this test to check for sickle cell anemia.
You don’t need to prepare for this blood test.

What are the steps in hemoglobin electrophoresis?
This test uses electricity to separate hemoglobin types. That process involves the following steps:

1. A technician places dissolved red blood cells on a cellulose strip.
2. They put the strip into a machine that passes electricity through the red blood cells.
3. The hemoglobin types react to the current by separating into separate bands.
4. The technicians compare the test results with normal hemoglobin.

https://my.clevelandclinic.org/health/diagnostics/22420-hemoglobin-electrophoresis

Yes, they used stain to allow for identification of the various cell types. They need to be able to correctly differentiate and identify. This is a common practice when doing peripheral blood smears.

The electrophoresis was done because they were evaluating the accuracy of peripheral blood smears in diagnosing sickle cell by comparing the peripheral blood smear results with electrophoresis results.

Their objective says, “To evaluate the diagnostic accuracy of peripheral smear morphology as a screening tool for Sickle cell trait/disease by comparing its results with hemoglobin electrophoresis.”

Additionally, staining makes the cells easier to see. As it states on the first website, “To do a blood smear, a sample of blood is spread on a glass slide. The slide is treated with a special stain that makes the cells easier to see. Then a laboratory professional looks at the slide under a microscope to check the size, shape, and number of cells in your blood sample. Automatic computer programs may be used to help examine your blood smears.”

https://medlineplus.gov/lab-tests/blood-smear/

https://histology.siu.edu/intro/bldsmear.htm

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Being a sickle cell carrier lends an advantage - it's protective against malaria (that's why lots of black people have the gene -- the gene helped carriers survive in africa for a long time).

having sickle cell requires two parents, so your children will be fine (and will actually have an advantage).

https://www.reddit.com/r/DebateEvolution/comments/1gfav0r/the_argument_over_sickle_cell/

I don’t know about this based on personal experience. I am a sickle cell carrier and got malaria while traveling in the DR Congo. It was severe. I had to be hospitalized. It ruined my trip. Worst time of my life.

I’m also a sickle cell carrier who somehow managed to contract malaria twice on two SEPARATE trips to two DIFFERENT African countries (Ghana & Angola). 🙄 We’re out here!!

I swear I’m a malaria magnet. My kids and husband didn't contract it on either trip, thankfully.

This isn’t as uncommon as you’d expect. I’ve been to 9 countries in Africa. Out of those 9, I got malaria in Mali, Burkina Faso, Benin, Cameroon, and Equatorial Guinea. The only locations where I didn’t get malaria are Senegal, Botswana, Namibia, and Tanzania.

To the locals, malaria is often comparable to the flu because they have gotten it so many times throughout their lives starting in childhood.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Being a sickle cell carrier lends an advantage - it's protective against malaria (that's why lots of black people have the gene -- the gene helped carriers survive in africa for a long time).

having sickle cell requires two parents, so your children will be fine (and will actually have an advantage).

https://www.reddit.com/r/DebateEvolution/comments/1gfav0r/the_argument_over_sickle_cell/

I don’t know about this based on personal experience. I am a sickle cell carrier and got malaria while traveling in the DR Congo. It was severe. I had to be hospitalized. It ruined my trip. Worst time of my life.

I’m also a sickle cell carrier who somehow managed to contract malaria twice on two SEPARATE trips to two DIFFERENT African countries (Ghana & Angola). 🙄 We’re out here!!

I swear I’m a malaria magnet. My kids and husband didn't contract it on either trip, thankfully.

This isn’t as uncommon as you’d expect. I’ve been to 9 countries in Africa. Out of those 9, I got malaria in Mali, Burkina Faso, Benin, Cameroon, and Equatorial Guinea. The only locations where I didn’t get malaria are Senegal, Botswana, Namibia, and Tanzania.

To the locals, malaria is often comparable to the flu because they have gotten it so many times throughout their lives starting in childhood.

I’ve gone to Benin, Malawi, Uganda multiple times for work and have made it back malaria-free every single time. I have to wonder if the people who say this are taking the proper precautions.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shocked by these responses.
This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns.

No, it’s not even close to hiding infertility. It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life. SCD develops when inherited from both parents.

According to a previous poster, this is incorrect. See quote below.

"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."

This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. If you look at our blood under a microscope, you will see both shapes of red blood cells present. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. All of their red blood cells are sickle shaped.

No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis.

Sickle hemoglobin is not like normal hemoglobin. Under low oxygen conditions, hemoglobin S transforms into stiff strands within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow.

NIH webpage
https://www.nhlbi.nih.gov/health/sickle-cell-disease/

The red blood cells aren’t always sickled (as they have to undergo sickling), but there are always SOME sickled red blood cells that are present in the bodies of those with sickle cell disease at any given moment. If you looked at their blood under a microscope, you would always see SOME amount of sickled red blood cells (whether they’re in a crisis or not). The number of sickled red blood cells present in the body INCREASES under certain conditions (like low levels of oxygen in the body). A sickle cell crisis happens when those sickled red blood cells clump together. Those sickled red blood cells build up and become stuck in blood vessels as they’re attempting to travel throughout the body (as normal red blood cells do). This happening is what sets off a crisis.

“The sickle-shaped cells become more numerous when people have infections or low levels of oxygen in the blood.” - https://www.merckmanuals.com/home/blood-disorders/anemia/sickle-cell-disease

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shocked by these responses.
This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns.

No, it’s not even close to hiding infertility. It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life. SCD develops when inherited from both parents.

According to a previous poster, this is incorrect. See quote below.

"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."

This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. If you look at our blood under a microscope, you will see both shapes of red blood cells present. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. All of their red blood cells are sickle shaped.

No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis.

Sickle hemoglobin is not like normal hemoglobin. Under low oxygen conditions, hemoglobin S transforms into stiff strands within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow.

NIH webpage
https://www.nhlbi.nih.gov/health/sickle-cell-disease/

The red blood cells aren’t always sickled (as they have to undergo sickling), but there are always SOME sickled red blood cells that are present in the bodies of those with sickle cell disease at any given moment. If you looked at their blood under a microscope, you would always see SOME amount of sickled red blood cells (whether they’re in a crisis or not). The number of sickled red blood cells present in the body INCREASES under certain conditions (like low levels of oxygen in the body). A sickle cell crisis happens when those sickled red blood cells clump together. Those sickled red blood cells build up and become stuck in blood vessels as they’re attempting to travel throughout the body (as normal red blood cells do). This happening is what sets off a crisis.

“The sickle-shaped cells become more numerous when people have infections or low levels of oxygen in the blood.” - https://www.merckmanuals.com/home/blood-disorders/anemia/sickle-cell-disease

Yep. Medical examiners see some sickled RBC present in specimens taken from every person with sickle cell trait and sickle cell disease. This is one of the ways that they’re able to determine that someone had SCT or SCD (even if it didn’t contribute to the person’s death). You don’t need to be in a crisis or to have ever experienced a crisis (in the case of those with SCT) for sickled RBC to be present.

My apologies, but just to clarify -- are both of you claiming that you can rely on a peripheral blood smear to rule out sickle cell anemia and/or sickle cell trait, because there will always be visible sickle cells? Is that what you each are saying?

Sickle cell was actually first discovered and documented in Western medical literature using a peripheral blood smear. In the early 1900s, a student from Grenada presented to a hospital in the US because he had been experiencing medical issues. A physician performed a peripheral blood smear and noticed sickle-shaped red blood cells.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2947974/

https://www.sicklecellnewjersey.org/about-scanj/history-of-sickle-cell/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shocked by these responses.
This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns.

No, it’s not even close to hiding infertility. It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life. SCD develops when inherited from both parents.

According to a previous poster, this is incorrect. See quote below.

"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."

This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. If you look at our blood under a microscope, you will see both shapes of red blood cells present. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. All of their red blood cells are sickle shaped.

No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis.

Sickle hemoglobin is not like normal hemoglobin. Under low oxygen conditions, hemoglobin S transforms into stiff strands within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow.

NIH webpage
https://www.nhlbi.nih.gov/health/sickle-cell-disease/

The red blood cells aren’t always sickled (as they have to undergo sickling), but there are always SOME sickled red blood cells that are present in the bodies of those with sickle cell disease at any given moment. If you looked at their blood under a microscope, you would always see SOME amount of sickled red blood cells (whether they’re in a crisis or not). The number of sickled red blood cells present in the body INCREASES under certain conditions (like low levels of oxygen in the body). A sickle cell crisis happens when those sickled red blood cells clump together. Those sickled red blood cells build up and become stuck in blood vessels as they’re attempting to travel throughout the body (as normal red blood cells do). This happening is what sets off a crisis.

“The sickle-shaped cells become more numerous when people have infections or low levels of oxygen in the blood.” - https://www.merckmanuals.com/home/blood-disorders/anemia/sickle-cell-disease

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shocked by these responses.
This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns.

No, it’s not even close to hiding infertility. It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life. SCD develops when inherited from both parents.

According to a previous poster, this is incorrect. See quote below.

"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."

This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. If you look at our blood under a microscope, you will see both shapes of red blood cells present. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. All of their red blood cells are sickle shaped.

No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis.

Sickle hemoglobin is not like normal hemoglobin. Under low oxygen conditions, hemoglobin S transforms into stiff strands within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow.

NIH webpage
https://www.nhlbi.nih.gov/health/sickle-cell-disease/

The red blood cells aren’t always sickled (as they have to undergo sickling), but there are always SOME sickled red blood cells that are present in the bodies of those with sickle cell disease at any given moment. If you looked at their blood under a microscope, you would always see SOME amount of sickled red blood cells (whether they’re in a crisis or not). The number of sickled red blood cells present in the body INCREASES under certain conditions (like low levels of oxygen in the body). A sickle cell crisis happens when those sickled red blood cells clump together. Those sickled red blood cells build up and become stuck in blood vessels as they’re attempting to travel throughout the body (as normal red blood cells do). This happening is what sets off a crisis.

“The sickle-shaped cells become more numerous when people have infections or low levels of oxygen in the blood.” - https://www.merckmanuals.com/home/blood-disorders/anemia/sickle-cell-disease

Yep. Medical examiners see some sickled RBC present in specimens taken from every person with sickle cell trait and sickle cell disease. This is one of the ways that they’re able to determine that someone had SCT or SCD (even if it didn’t contribute to the person’s death). You don’t need to be in a crisis or to have ever experienced a crisis (in the case of those with SCT) for sickled RBC to be present.

My apologies, but just to clarify -- are both of you claiming that you can rely on a peripheral blood smear to rule out sickle cell anemia and/or sickle cell trait, because there will always be visible sickle cells? Is that what you each are saying?

https://www.tiktok.com/t/ZP89TUcp5/

The red blood cells of those with sickle cell do look abnormally shaped under a microscope. See video above.

[Anonymous]

Anonymous wrote:Man, eugenics is frightening.

You do not have the authority to determine and police the morality, beliefs, and feelings of other people. We all prioritize different things.

You say eugenics is frightening to you. You know what is frightening to me? The fact that sickle cell trait can cause sudden and unexpected death. The fact that sickle cell disease causes the blood inside of your veins to feel sharp (imagine the pain). The fact that the average life expectancy of those with sickle cell disease is 20 years shorter than those without.

I agree with OP. I’d worry about my daughter or son ending up with the trait, and I’d be terrified that my future grand babies would end up with sickle cell disease. I happen to consider potential long-term negative outcomes, though.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shocked by these responses.
This is a serious big deal. Just like it would be to hide infertility. This might not be a big deal for some but is for OP so one should be dismissing her concerns.

No, it’s not even close to hiding infertility. It should have been mentioned to make sure that the partner is not a carrier as well, but being a carrier doesn’t affect quality of life. SCD develops when inherited from both parents.

According to a previous poster, this is incorrect. See quote below.

"It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts."

This is true. Having the trait means that we inherited a normal allele from one of our parents and an abnormal (sickle cell) allele from the other parent. We have both normal (round) and abnormal (sickle-shaped) red blood cells in our bodies. If you look at our blood under a microscope, you will see both shapes of red blood cells present. The abnormally shaped red blood cells that are present can cause health issues for us. The trait is just considered less problematic than the disease because we do have some normal (round) red blood cells. People with sickle cell disease have NO normal red blood cells. All of their red blood cells are sickle shaped.

No. That is not how it works. The variant hemoglobin cells LOOK normal under the microscope UNLESS they are "sickled" -- it's not a default shape. They undergo "sickling" and change shape, which is what causes the crises in those that have them. Otherwise the blood flows normally. If they were always in sickled shape, people with SCA would always be in crisis.

Sickle hemoglobin is not like normal hemoglobin. Under low oxygen conditions, hemoglobin S transforms into stiff strands within red blood cells. These stiff strands change the shape of the cell, causing the “sickled,” or crescent-shaped, red blood cell that gives the disease its name. Sickled red blood cells are not flexible and can stick to vessel walls, which can block or slow blood flow.

NIH webpage
https://www.nhlbi.nih.gov/health/sickle-cell-disease/

What you’re saying is NOT true. I have sickle cell TRAIT. My Hemoglobin S quantitation report determined that 40% of my red blood cells were sickled (which is about average for someone with the trait). I also have congestion in some of my organs caused by sickled red blood cells getting trapped and building up. As I don’t have the disease, I have never had a crisis. We don’t need to be in a crisis for our cells to be sickled. If that were the case then none of my red blood cells would be sickled (since I have never experienced a crisis). Further, a percentage of your cells being sickled does not automatically mean that you will experience a crisis. Those of us with the trait know this.

People with sickle cell trait and sickle cell disease produce an abnormal type of hemoglobin (Hemoglobin S). This hemoglobin causes some of our red blood cells to become sickled. Hemoglobin S is always present in our bodies (as it’s genetically determined), so a percentage of sickled cells are always present.

[Anonymous]

Anonymous wrote:It's a widespread myth that sickle cell trait is always asymptomatic. Sickle cell trait is an intermediate phenotype, not a true asymptomatic carrier state. A proportion of individuals with SCT WILL have pain crises and other symptoms. Think of the trait as a less severe version of the disease. OP, I can't decide for you if you're in the right to be angry. I can only provide you with scientific facts.

Yes, thank you for putting this out there. As someone with the trait, I feel uncertain and suspicious as to why so many people are quick to downplay and diminish the reality of sickle cell trait. As I mentioned in my post above, I have congestion in some of my organs caused by sickled red blood cells getting trapped and building up. How can we possibly be “asymptomatic carriers” when our bodies are quite literally affected by our “carrier” status?

https://www.theatlantic.com/health/2026/02/genetic-disease-carrier-symptoms/686014/

[Anonymous]

https://www.myamericannurse.com/sickle-cell-trait-can-take-a-sudden-deadly-turn/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Being a sickle cell carrier lends an advantage - it's protective against malaria (that's why lots of black people have the gene -- the gene helped carriers survive in africa for a long time).

having sickle cell requires two parents, so your children will be fine (and will actually have an advantage).

https://www.reddit.com/r/DebateEvolution/comments/1gfav0r/the_argument_over_sickle_cell/

I don’t know about this based on personal experience. I am a sickle cell carrier and got malaria while traveling in the DR Congo. It was severe. I had to be hospitalized. It ruined my trip. Worst time of my life.

It’s definitely not foolproof. It depends on what genotype you have. There’s different forms of sickle cell.

The AA genotype is the typical genotype (no sickle cell trait or disease). It offers no protection against malaria.

The AS (means you have sickle cell trait) and AC (means you have Hemoglobin C trait), and CC (means you have Hemoglobin C disease) genotypes are shown to be protective against malaria and have the lowest mortality (death) rates when infected with malaria.

The SS (means you have the extreme and most common form of sickle cell disease) and SC (means you have a milder and less common form of sickle cell disease) genotypes are shown to be somewhat protective but also have the highest mortality (death) rates when infected with malaria.

You forgot genotypes AD, SD, DD, AE, SE, EE, AO, SO, and OO. They’re way less common than the other genotypes (maybe even rare) but still exist.

[Anonymous]

Sickle cell trait is dangerous. It makes you more “fragile” or vulnerable than the average person. If a person with SCT gets slightly dehydrated, their life is in danger. If a person with SCT lives in or travels to a high altitude area or flies on a plane for an extended period of time, their life is in danger. If a person with SCT exercises too intensely, their life is in danger. They often don’t even realize that they can die from SCT.

I would say there’s an added layer of danger because medical professionals do not take sickle cell trait anywhere near as seriously as they take sickle cell disease. People with SCT don’t receive the same proactive and preventative healthcare that people with SCD do.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I am a carrier of the trait, as was my mom. My mom told me I was negative so I was totally surprised when I came up positive during my pregnancy labs. This is not a big deal and not worth you getting an amniocentesis over. Your child has a 50 percent chance of being a carrier. One of my kids is, the other isn't. We need to stay well hydrated and listen to our bodies, that is all. Please calm down. And not only black people can have it. This is misinformation.

Not everyone that has sickle cell trait is black, but everyone that has sickle cell trait has a black ancestor. They traced the origin of the gene back to one child that lived in Africa 7,300 years ago.

https://www.bbc.com/news/world-africa-43373247

https://www.the-independent.com/life-style/health-and-families/health-news/hidden-black-ancestry-linked-to-rise-in-sickle-cell-blood-disorder-738008.html

This is true. This is how there are people that physically appear to be fully European that have sickle cell trait or disease. The African ancestry decreases with each generation, but the sickle cell allele can keep getting passed down. The ancestry won't always show up on an ancestry DNA test either because those tests only go back 6-8 generations. I was taught that we are to screen every patient regardless of what they self-report their background as or what they physically appear to be for this exact reason. Not every medical professional is aware of this or follows this protocol though.

A “white” man found out (through an ancestry DNA test) that he has 18% African ancestry after his daughter tested positive for sickle cell trait at birth. All of those people that look white (or non-black) that have any type of sickle cell have some recent African ancestry (even if they don’t know it). There’s no question about it.

https://www.nytimes.com/2017/05/12/us/cleon-brown-black-lawsuit.html