Taking iron supplements but iron level lower an... - Thyroid UK

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Taking iron supplements but iron level lower and ferritin 100 over upper-range/overloaded, WHY?

cc120 profile image
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These were my iron level readings in:

Oct 2013

IRON – (SDB) – normal – no action

Serum iron level: 15 umol/L (6.60-26.00umol/L

Serum TIBC: 70 umol/L (40.80-76.60umol/L)

FERRITIN – (SDB) – normal – no action

Serum ferritin: 36ug/l (13.00 – 150.00ug/l)

And the following after supplementing with 210mg ferrous fumerate and vit c 1000mg a day for approx 3 months:

Sept 2014

IRON – (SDB) –

Serum iron level: 12 umol/L (6.60-26.00umol/L

Serum TIBC: 58 umol/L (40.80-76.60umol/L)

FERRITIN – (SDB) –

Serum ferritin: 251 ug/l (13.00 – 150.00ug/l)

Please find full blood test readings at:

healthunlocked.com/thyroidu....

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cc120
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humanbean profile image
humanbean

This article may explain what is going on :

irondisorders.org/anemia-of...

cc120 profile image
cc120 in reply to humanbean

Thank you humanbean. I'm finding it hard to take in, but will try again tomorrow when less brainfogged.

humanbean profile image
humanbean in reply to cc120

It would be a good idea to give the iron supplements a miss until you can sort out what is going on.

cc120 profile image
cc120 in reply to humanbean

Yes, I'm doing that humanbean. Will be seeing GP next Monday in regard to results.

cc120 profile image
cc120 in reply to humanbean

Hi humanbean, according to: irondisorders.org/anemia-of... :

'When the body senses a potential threat, iron gets shuttled to ferritin to be contained so that the harmful invader cannot get to the iron. Just enough iron is made available to make red blood cells but no surplus is left to nourish harmful pathogens.... . Inflammation triggers the release of chemicals that signal the iron regulation mechanism to adopt a defense mode. '

So a possibility my body is protecting me by storing iron instead of making it available to nourish present infection or disease?

gabkad profile image
gabkad

The inorganic phosphate is high. This is all I've found in regards to this:

The kidneys excrete phosphate. Therefore, the most common cause of increased phosphate levels (or hyperphosphatemia) is the kidney's inability to get rid of phosphate. Hyperphosphatemia is also seen in people who have:

Excessive dietary intake of phosphate (also from laxatives or enemas)

Your body may have a deficiency in calcium or magnesium, or it may have too much Vitamin D, resulting in hyperphosphatemia.

Severe infections can cause increased phosphate levels, resulting in hyperphosphatemia.

Cell destruction - from chemotherapy, when the tumor cells die at a fast rate. This can cause tumor lysis syndrome.

Problems with your breathing (respiratory acidosis)

You may have high phosphate levels from prolonged exercise, which causes muscle damage. Certain athletes and distance runners may get this, called rhabdomyolysis.

You may have problems with your thyroid, parathyroid gland, or other hormones, causing increased levels of phosphate in your blood and resulting in hyperphosphatemia

Kidney failure can cause hyperphosphatemia

cc120 profile image
cc120

Thank you gabkad, this has also risen since my supplements, previously in Oct 2013 was:

Serum inorganic phosphate: 0.94 mmol/L (0.87 – 1.45mmol/L), as opposed 1.68, which it is now. I will be seeing GP on Monday.

gabkad profile image
gabkad in reply to cc120

What is your hemoglobin? Normally, if you are taking iron (and 210mg ferrous fumarate once per day is not a huge dose) then your hemoglobin should also benefit from this. If you are post-menopausal, then iron loss is much reduced. Post menopausal women only need as much iron per day as men. You need the whole picture here to determine if you have been taking excess as a supplement or if there is something else going on.

If your hemoglobin is maxed out, then you can stop the iron. If you have low hemoglobin but high ferritin, then there is some other process going on.

You need good protein in the diet to make good blood. If the diet is protein deficient, then iron supplementation will not result in a good hemoglobin level but will be stored as ferritin instead.

Does that make sense? Get a complete blood count done and have this checked.

cc120 profile image
cc120 in reply to gabkad

Hi gabkad, I am post-menopausal. I have lots of yoghurt, did have few eggs a week, fair amount of cheese, so don't know if protien is deficient, though it could be. Probably in the last couple of weeks, my diet has been less good. Is there a 'protien' supplement? A complete blood count sounds like a good idea.

This was my full blood count in Oct 2013, but didn't get it done again in Sept 2014:

COMPLETE BLOOD COUNT – (SDB) – normal – no action

Haemoglobin estimation: 134 g/L (115-165)

Total white cell count: 5.6 (3.50-12.00)

Platelet count: 376 (140-400)

Mean corpuscular volume (MCV): 83.4 fL (78-98)

Red blood cell (RBC): 4.76 (3.80-5.80)

Haematocrit: 0.40 L/L (0.37-0.50)

Mean corpusc haemoglobin (MCH): 28.2 pg (27-32)

MCHC: 338 g/L (310-360)

Red blood cell distribut width: 14.4% (11.50-16.00%)

gabkad profile image
gabkad in reply to cc120

Yes, get the complete blood count done. Stop the iron. Because one way or the other, you don't want the ferritin that high.

You need about 60 grams of quality protein per day. Eggs contain 13 grams each. 250 ml of milk contains about 8 grams.

Cereals and pulses contain protein but availability is low. We do not actually absorb 100% of the protein in lentils and beans, for example. But we do from sources such as eggs. If you eat a cup of lentils, you absorb maybe 30% of the protein. And the protein is not balanced in supplying all of our essential amino acids. That's why traditional vegetarian Indian food mixes grains and pulses i.e. roti/naan and daal. Plus traditional Indian diet contains dairy. Indians eat pulses every day in various dishes. It's not unusual to have more than one pulse dish per meal. (I just find consuming enough protein in this way makes for too much carbohydrate and puffy tummy. It's not enough for excellent skeletal muscle development.)

What you could do is write down everything you eat on a typical day and check the protein content with one of those nutrition data websites. If you find that chronically you do not consume enough protein, then you need to figure out how to increase it.

cc120 profile image
cc120 in reply to gabkad

Thank you for this info will definitely check it all out.

gabkad profile image
gabkad in reply to cc120

That was fine. Why did you take the iron then? Was ferritin low?

I guess if your hemoglobin is now up to 160, you'll have to lay off the iron for some months. It takes a long time to get the ferritin down if it's from taking iron. Normal body stores for a woman are about 2800 mg. You've got probably over 3500 right now. You lose 5 mg per day. So unless you are having some bleeding problem from the GI tract, it will take about 6 months at least to get the ferritin down to ideal range.

Don't worry about it though. It will go down predictably.

Make sure you are well hydrated before getting the blood taken. Dehydration artificially increases the hemoglobin test result (and other things with the CBC).

cc120 profile image
cc120 in reply to gabkad

Hi gabkad

Do you mean ferritin 168? I don't know what my hemoglobin is right now. Good to hear that 5mg is lost a day. I wonder if my GP will suggest blood letting to lower ferritin?

My iron was low in Oct 2013 at :

IRON – (SDB) – normal – no action

Serum iron level: 15 umol/L (6.60-26.00umol/L

Serum TIBC: 70 umol/L (40.80-76.60umol/L)

But is 3 down from that now?

I will make sure I drink a lot before the next test, thank you.

gabkad profile image
gabkad in reply to cc120

No ferritin tested?

You'd need to have ferritin sky high for blood letting. Yours is just high. If you donate blood a couple of times, that will get it down.

This is the 'thing' with post menopause: it's quite easy if our guts are absorbing normally to end up with high ferritin. Mine was 120 last year so I cut the liver eating. Replaced a majority of the meat with fish and seafood. My hemoglobin is also very high. Always has been even when pregnant. Doctors are always worried about it. Last time it was 161! But probably due to being dehydrated. When I've had blood taken after making sure I'm well hydrated it's 148. (It took consuming 2 litres of coconut water. Probably I don't drink enough fluids most of the day.)

cc120 profile image
cc120 in reply to gabkad

In Oct 2013:

FERRITIN – (SDB) – normal – no action

Serum ferritin: 36ug/l (13.00 – 150.00ug/l)

In Sept 2014:

FERRITIN – (SDB) –

Serum ferritin: 251 ug/l (13.00 – 150.00ug/l)

Perhaps GP will suggest a blood donation, or perhaps further blood test will take out enough.

Goodness knows what my heamoglobin will be now, if effected by high ferritin.

gabkad profile image
gabkad in reply to cc120

Don't stress about it. Just stop the iron supplement. Your ferritin was a bit low last year and probably taking 2 tablets per week would have done the trick. But alas, good thing you had another blood test done this year. We can overdo things can't we? Same with any supplement. There's a good place to reach and then not over-reach.

Do you not have blood donation in your area? If you qualify, you'll be a great candidate. LOL! Someone will get some supercharged blood!

Would you believe I am not able to donate blood here because I lived in England during the mad cow disease time? Ridiculous. You'd think there'd be all sorts of continuing problems in England these days from blood donations. If there is, they are sure not advertising it.

cc120 profile image
cc120 in reply to gabkad

Yes, looks like I overdid it.

gabkad profile image
gabkad in reply to cc120

Hm, interesting: dailymail.co.uk/health/arti...

cc120 profile image
cc120 in reply to gabkad

Looks like the problem could be worse then first thought!

gabkad profile image
gabkad in reply to cc120

What is your hemoglobin? Normally, if you are taking iron (and 210mg ferrous fumarate once per day is not a huge dose) then your hemoglobin should also benefit from this. If you are post-menopausal, then iron loss is much reduced. Post menopausal women only need as much iron per day as men. You need the whole picture here to determine if you have been taking excess as a supplement or if there is something else going on.

If your hemoglobin is maxed out, then you can stop the iron. If you have low hemoglobin but high ferritin, then there is some other process going on.

You need good protein in the diet to make good blood. If the diet is protein deficient, then iron supplementation will not result in a good hemoglobin level but will be stored as ferritin instead.

Does that make sense? Get a complete blood count done and have this checked.

cc120 profile image
cc120 in reply to gabkad

As I have explained though my serum iron level had decreased from (Oct 2013): Serum iron level: 15 umol/L (6.60-26.00umol/L to (Sept 2014): 12, my ferritin had (after supplementation) risen from Serum ferritin: 36 ug/l (13.00 – 150.00ug/l) to 251 in Sept 2014. She told me I had to stop iron supplements, but I had to push for a reason why I was storing so much iron but less had become available in the active form. She said other proteins binding iron, asked why, she said possible inflammation in body and mumbled something about she would ask the laboratory about it?

I forgot to ask about a full blood count test as she wasn't being very helpful overall, though finally agreed to refer me to an endocrinologist on Louise's list, but she's awaiting my full symptoms list that I suggested emailing her rather than sit there and have her type each one up on her PC.

Could I ask for a copy of the referral letter?

gabkad profile image
gabkad in reply to cc120

Someone else around here can answer that question. I don't know what a referral letter would contain. If your GP has not ordered a CBC recently then the endo should. (mine did before the first appointment).

cc120 profile image
cc120 in reply to gabkad

Thank you gabkad. Last CBC was Sept 2013. It didn't even occur to her to suggest it, and as I forgot as had a lot of issues to cover and she wasn't impressed about my self-medicating with NDT, she wasn't as helpful as I hoped she would be. She did say that the referral could take months. I asked could it be over 3 months, and she suggested it could be and to call the hospital that the endocrinologist worked at to ask how long his waiting list is.

gabkad profile image
gabkad in reply to cc120

Then I guess you'll need to infringe on her comfort zone and get the CBC done. I'm really surprised because it's a very basic thing. Budgets must be straining at the seams or ...maybe she needs some vitamin B12 to perk her up. ;)

cc120 profile image
cc120 in reply to gabkad

: ). Do you think the laboratory could use the same blood as for the last test, which could explain her asking the laboratory? I thought blood had to be quite fresh for any tests? I can see her being unhelpful about CBC, but will get the referral out of the way before I risk displeasing her again.

Clutter (on another thread) said I should request a copy of the referral letter when I email in my symptoms.

cc120 profile image
cc120 in reply to cc120

Also, she wanted me to decrease the amount I was taking as TSH 0.03 (suppressed) below lower range. I explained that I was only on 180mg and despite my T4 has doubling, I don’t feel the expected effects of that and could she test for T3 to see if I’m converting T4 to T3. She assured me the lab would not. I said I would probably start taking T3 if energy levels did not increase.

When I asked I asked for referral to an endocrinologist (specialist on Louise's list) and she said she would refer me but would I listen to him. I said as he is a specialist and would test me fully of course I would. She began to list my symptoms for the referral letter, but as there would be so many I offered to email them to her. She said it could be months for the referral appt.

gabkad profile image
gabkad in reply to cc120

Oh, got it. Yes, if you still have a thyroid, the TSH is low. You may be taking too much NDT. 180 mg is quite a lot. 1 grain is 30 mg. This is 6 grains. Most people taking full replacement with NDT are at 2 to 2.5. How long have you been on this dose?

Since she didn't do the fT3 it could be over range. NDT contains straight T3. At the amount you are taking that 9 times 6 = 54 mcg T3. That's an awful lot. You need to start another post about this.

cc120 profile image
cc120 in reply to gabkad

Hi gabkad, as you will see from conversion table:

nature-throid.com/images/RL...

That 65mg is equivalent to 1 grain, so I'm taking just under 3 grains, a dose I very gradually built up to over approx 5 months, starting on 15mg.

I believe Thiroyd (I was previously on Naturethroid) contains

T3 at 8.31 microgram; T4 at 35 microgram, which is 0.013% and 0.058% respectively. Please see: stopthethyroidmadness.com/a...

I have understood from other threads that it is not unusual and not dangerous to have a suppressed TSH when taking NDT?

gabkad profile image
gabkad in reply to cc120

My mistake. I was thinking each tablet was 30 mg = 1 grain. Thanks for clarifying.

cc120 profile image
cc120 in reply to gabkad

Hey no problem, thank you for all the information you have helped me with x.

gabkad profile image
gabkad in reply to cc120

Clutter would know more about this. But seriously, a CBC is routine stuff, nothing special, so she should not have a problem with ordering it. She sounds as stupid as my GP. How do these people even get into medical school?

Once you get the fT4 and fT3 results from your current dose, you'll know better what's what. You did not post anything about this. Or I missed it.

cc120 profile image
cc120 in reply to gabkad

Hehe, I'm sure she knows a lot about what she knows about, just not in depth on anything, certainly not anything that I needed help on.

Here is the link to my last blood test results, with my previous results below those:

healthunlocked.com/thyroidu....

She wanted me to decrease the amount of NDT I was taking as TSH 0.03 (suppressed) below lower range. I explained that I was only on 180mg and despite my T4 doubling, I don’t feel the expected effects of that and could she test for T3 to see if I’m converting T4 to T3. She assured me the lab would not. I said I would probably start taking T3 if energy levels did not increase.

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