Thyroid UK
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What's so important about ferritin?

Hi all, I'm trying to understand the exact mechanisms that make having a ferritin level of a least 70 so important for thyroid health? Is being anemic or having low ferritin levels to do with low levels of oxygen flowing around the body, essentially making a person hypoxic (oxygen deprived)? Or is there something else about the iron itself?

The reason I ask is that I've had a life-long problem with low ferritin (never over a 13 in the last 20 years) and anemic for much of that but can't really tolerate oral iron preparations. This is of course problematic as I have lots of hypo symptoms. The recent ultrasound of my throat descibed it as looking consistent with Hashimotos, so I'm about to get the anti-body test results which should confirm this diagnosis.

Anyway, even if I am diagnosed as having Hashi's, I won't get anywhere fast with such low iron (ferritin stores).

My point is that I've come across a treatment called EWOT (exercise with oxygen therapy) where you exercise as you breath (medical grade) oxygen and that encourages the oxygen to enter into your blood and cells at a deep level with some dramatic health benefits and results!

If I can get oxygen into my bloodstream and my cells, is that a 'substitute' for needing high ferritin levels??

thanks :)

17 Replies

Not sure about this therapy. Basically each red blood cell contains a molecule of haemoglobin which can carry 4 molecules of oxygen. So if your haemoglobin is below normal it may be 100 percent saturated with oxygen but because you don't have enough carrying capacity your muscles and organs are still short of oxygen. Increasing the amount of oxygen in your lungs makes no difference to the amount of oxygen being delivered to your tissues.

Have you investigated all forms of iron supplementation?

Hopefully someone more knowledgeable than I can comment on how ferritin and utilisation of t3 works.

Good luck on your search for good health.


It looks like iron is directly involved in conversion of T4 to T3, according to this study on rats:

"Thyroidectomized iron-deficient animals injected with T3 did not show hypothermia at 4 degrees C, whereas thyroidectomized iron-deficient animals injected with T4 showed hypothermia, increased catecholamines, and decreased T3 levels as compared to non-iron-deficient animals similarly treated."

Have you ever tried a haem iron supplement? I struggled for ages, tried ferrous sulphate, bisglycinate and gluconate, but even small doses gave me terrible cramps and stomach upsets. I now take Proferrin, which is a bit expensive but has no side effects for me, and is slowly raising my ferritin (now 34, up from 12, so a way to go yet...)

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Hi acc1, can you tell me if Proferrin makes you constipated? Also, where do yo get it? thank you x


I'm probably not the best person to advise on iron related constipation, as my usual response to most iron supplements is completely the opposite! Proferrin seems to have no side effects for me though, and I've seen plenty of other people online who say that iron salts cause constipation for them but Proferrin doesn't.

I've had to source it from America as I don't think there are any UK suppliers. I can't get access to my emails right now but will PM you later with the site I use.


Thankyou acc1, that would be great if you could pm the website, Its for my daughter who has extremely low Ferritin but refuses to anything because of their side effects .Your advice is very much appreciated.

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Hi could I also get a PM for the site to buy the Proferrin. Thanks x


Hi, I've just found a uk site. It sounds very effective but alas £159 for 2 bottles x 90 pills might be a bit out of my price range! Can I ask if you've found it cheaper directly from the US? Thanks


I paid about £115 for 3 bottles of 90 from the US, still a bit pricey but better than the UK site. PM sent.


Hi, ah that's great - thank you and yes, a much better price then I saw!

I don't eat much meat and only paid a passing interest in heme vs non heme sources of iron but heme sources do appear to be better absorbed so it's likely something I'll be exploring!

Cheers x


Hello, Have you tried liquid iron from Spatone? Iron pills give me constapation, but this liquid form of iron doesn't. I'm nore or less like you with my low ferritin level, constantly low if I don't supplement, and Spatone seem to work. I do need to take 2-3 sachets a day, so it's a pit pricey, but maybe its worth trying?


the most likely reason you have trouble tolerating iron is low stomach acid .............when hashimotos /hypothyroid starts it trashes


vit B

vit C


these in turn affect every system of the body and the low stomach acid leaves you vulnerable to

helicobactor pylori and salmonella

so you might as a start benefit from getting the correct supplemental acid to correct your stomach and then take iron plus at least 500mg of vit c together with it

you will also need to take a really good multivitamin each night before bed

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I was advised to take iron supplements with vit c as this helps absorption and combat constipation.

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This e tract from STTM might help clarify the need for optimum levels:

"Why is having low iron levels a problem for hypothyroid patients and what are symptoms? First, though the slide into low iron can be symptomless, it eventually becomes the precursor to being anemic, revealed by the other iron labs–saturation and serum iron. And once the latter occurs, you can then have symptoms which mimic hypothyroid–depression, achiness, easy fatigue, weakness, faster heartrate, palpitations, loss of sex drive, hair loss and/or foggy thinking, etc, causing a patient to think they are not on enough desiccated thyroid, or that desiccated thyroid is not working. Excessively low Ferritin as well as low iron can also make it difficult to continue raising your desiccated thyroid, resulting in hyper symptoms when raising desiccated thyroid.

In turn, having low iron levels decreases deiodinase activity, i.e. it slows down the conversion of T4 to T3. Biologically, insufficient iron levels may be affecting the first two of three steps of thyroid hormone synthesis by reducing the activity of the enzyme “thyroid peroxidase”, which is dependent on iron. Thyroid peroxidase brings about the chemical reactions of adding iodine to tyrosine (amino acid), which then produces T4 and T3. Insufficient iron levels alter and reduces the conversion of T4 to T3, besides binding T3. Additionally, low iron levels can increase circulating concentrations of TSH (thyroid stimulating hormone).

Even worse, good iron levels are needed in the production of cortisol via the adrenal cortex. This study reveals that an iron-containing protein is present in high amounts in the adrenal cortex and is involved in the synthesis of corticosterone. So by having low iron, you can potentially lower your cortisol levels.

Iron, in addition to iodine, selenium and zinc, are essential for normal thyroid hormone metabolism."


Hi, I'm taking hemaplex for iron and took it for 10 days before it seemed hard on my stomach. I also take ground flax on my cereal and that keeps my digestion going well enough to take the iron. Good luck. A.


Thanks guys, all your feedback is useful and totally appreciated!

My doc is 'exploring' IV iron with the local hospital so we'll see how that proceeds? Ultimately I'll have to decide if it's a good idea to do it as its so invasive but you know what they say about desperate times...

There are good suggestions regardng some iron preparations I haven't tried and it does make sense that I probably have leaky gut/ gut permeability issues and low stomach acid as I have other autoimmune conditions (which apparently all start in the gut) so it might be that I'm having trouble uptaking and assimilating the iron once swallowed. That and the constipation, stomach aches etc when I have taken them in the past. And as my throat it pretty inflammed and bulging, with Hashi's, I have challenges swallowing pills.

I might explore Dr. Myhills spray on vitamin/mineral formula as another way of getting these essentials in me therefore bypassing the stomach? And see if there is any sublingual preparations that are effective. (Spatone and Flordix(?) never worked for me)

Sigh :/ We all have our own versions of woes related to this multi-faceted condition!! But thank god for this community!! x


i too had a very low ferritin for years. i took ferrous gluconate 3x daily but nothing helped. my ferritin was hair was falling out ,nails dreadful had achy joints and rstless legs. i had 2 iron infusions at hospital only took 1/2 each my ferritin went to 206 and 6months later is still183 and full bloods 13.8. im absorbing levo much better now and symptons have stopped. i had a tt 8months ago for a goitre. i would have the infusion without hesitation if i needed it again


Wow that sounds very promising! Do you remember which iron preparation was infused? Did you have any allergic reactions and did they give you any Benadryl beforehand? And finally, how long was it before you felt any energy from the treatment. Thaaaanks!


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