Hi @upndnglo, I’ve not heard of the term, Mediterranean Anemia, before. Thalassemia is an inherited blood disorder.
According to Mayo Clinic’s website, “ Thalassemia causes the body to have less of the protein hemoglobin than usual. Hemoglobin is present in red blood cells and allows the red blood cells to carry oxygen. Not having enough hemoglobin or red blood cells can lead to a condition called anemia. That can make you feel tired and weak.”

So that would explain your lack of energy with your anemia. Often people with Thalassemia require frequent blood transfusions. They can also have an overload of iron in their bodies which can cause some side effects to certain organs.
Did a doctor prescribe the iron pills for you?
Here’s the informational article from Mayo’s website:

Thalassemia
https://www.mayoclinic.org/diseases-conditions/thalassemia/symptoms-causes/syc-20354995
Have you been seen by a hematologist for this condition? Has there been any discussion for possible treatment for you?

In my 30-40’s my MD was stymied by my anemia. I took iron supplements but the side effects, diarrhea one day and constipation the next, were more than I could stand. MD told me he wanted me to see hematologist and I told him he was overreacting. Finally,he consulted a hematologist and told me he thought it was “Mediterranean” anemia (Italian on my father’s side). I told him it was my heavy periods. I don’t recall the specific but I do remember he told me it was a condition that affected “Italians and other people in and around the Mediterranean”, so genetic?
In my late 40’s I was diagnosed with fibroids and my uterine lining was removed. Problem solved. That “Mediterranean” anemia was really heavy, heavy periods. At 75 it’s obviously not that.
I know this sounds crazy, but two things did help me feel better. I started cooking about everything I made in a cast iron pan and I had a glass of red wine with dinner almost nightly! Now, I might go see a hematologist as my MD suggested years ago!
The real irony (pun intended) is that now I have PV. I have always been a woman of extremes!