Thalassemia can cause many symptoms that interfere with a persons life. Firstly, almost everyone with thalassaemia major or other serious types will develop anaemia, which can be life threatening in severe cases. Generally anaemia will cause tiredness, heart palpitations and a general lack of energy, which will interfere with Elsas life physically in terms of completing daily tasks, but it will also impact her mental health if she is incapable of partaking in the general routine of her life due to lack of energy. Furthermore, due to the build-up of iron in the body, which usually comes with having thalassemia, her hormones and thyroid may be affected. Low levels of oestrogen in women can cause a range of issues such as low bone density- osteoporosis- resulting in easier breaking of the bones, delayed growth and puberty in children and young adults and reduced fertility which will affect her ability to have children. She may also suffer from stomach pain due to gallstone and cholecystitis. With all of these symptoms taken into account- including the impact on Elsa’s mental wellbeing, having to keep up with treatments and potential surgeries, transfusions or medications and the potential affect on Elsas future in terms of fertility- we can see why she would struggle, or fail, to thrive