Alpha thalassemia major can be present in a patient who does not require blood transfusions. This form of the disorder can result in severe anemia, although it affects people differently. Some individuals may not need a transfusion at all. Signs and symptoms of alpha thalassemia may include fatigue, weakness, or paleness of skin. Treatment may consist of symptom management such as taking supplements or drugs that stimulate the production of more red blood cells within the body. Please consult a doctor for individualized advice.