If iron low but ferritin overloaded will thyroxine be utilised?

[cc120]

My B12, Vit D are in good/high range but iron level readings in:

Oct 2013:

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

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

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

Readings at present after supplementing with 210mg ferrous fumerate and vit c 1000mg a day for approx 3 months:

Sept 2014:

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

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

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

So does this mean that I am not utilising thyroxine from NDT I'm taking?

Any comments much appreciated : )

Full readings on healthunlocked.com/thyroidu....

I also had a test for: Thyroglobulin 8.6 ug/L

(Laboratory statement: Thyroglobulin is only useful in patients who have had a complete thyroidectomy for previous thyroid cancer. If this patient has not had a complete thyroidectomy then this result is uninterpretable.)

Thyroglobulin Antibodies <20.0 KU/L (0.00 - 20.00KU/L

[Clutter]

CC, your iron is mid range so it isn't low and shouldn't be inhibiting absorption of NDT. High ferritin, whether due to supplementing or other reasons, doesn't affect absorption as far as I'm aware. My ferritin was high last year without supplementing and I think it was due to inflammation and pain. It didn't affect absorption of my T4 or T4+T3.

Humanbean posted this useful link irondisorders.org/anemia-of...

[cc120 in reply to Clutter]

Hi Clutter, thank you, that is good to know, but I wonder then why I'm still so lacking in energy. Human beans link suggests inflammation, disease present in body which inhibits active iron. My GP (when pushed) also suggested inflammation might be present, and mumbled something about asking the laboratory, which I don't know if she did. What would be the tests for inflammation?

I might be trying T3 in addition to NDT in a few weeks?

[Clutter in reply to cc120]

CC, Full Blood Count (FBC) should show up if there is inflammation in the body although more drilling down will need be done to determine where in the body the inflammation is.

I'm not too good on these but I think elevated ESR in FBC is one pain/inflammatory marker but there are others.

It's likely your supplementing raised your ferritin though so you might need to retest 3/4 months after you stopped supplementing. It takes 120 days for red blood cells to die off and renew.

Labtestsonline and Patient.co.uk are useful resources for checking out blood labs.

[acc1 in reply to Clutter]

I think FBC just measures red and white blood count, and platelets. ESR is a separate test. C-reactive protein (CRP) is another inflammatory marker that is more commonly used these days.

It's useful to get a measurement of CRP and ferritin at the same time - if both ferritin and CRP are high, then ferritin is likely to be elevated due to inflammation, and is not a true measure of iron stores. If CRP is normal and ferritin is high, the ferritin result is a reliable marker for high levels of stored iron.

[Clutter in reply to acc1]

Thanks, Acc1. The tests I've had in the last couple of years measured all of those things and I assumed they came under the umbrella of FBC.

[cc120 in reply to acc1]

Thank you acc1, very helpful.

[cc120 in reply to Clutter]

Thank you Clutter, could it be that I'm not converting T4 to T3? As I said, I will probably try additional T3, just to try to get energy levels up to enable me to function and continue battling GP.

[Clutter in reply to cc120]

CC, If you have high FT4 and low FT3 that usually indicates you are not converting well.

[cc120 in reply to Clutter]

Thank you Clutter, I have no way of knowing for sure as GP said laboratory will not test FT3, however, judging by my lack of energy perhaps that is the case.

[Clutter in reply to cc120]

CC, you need to see your FT3 level to judge whether you are converting. I linked to private testing in my previous reply.

[cc120 in reply to Clutter]

Could skipping a dose of NDT cause fatigue? GP told me to reduce NDT dose as TSH suppressed below lower range, so skipped on dose?

[Clutter in reply to cc120]

CC, yes, you may be noticing the lack of T3. It would be better to reduce dose rather than skip doses so you still get regular T3. You are aware that T3 often suppresses TSH below range? Suppressed TSH is only indicative of over medication if FT4 and FT3 are over range.

[cc120 in reply to Clutter]

Hi Clutter, thank you. I think I confused myself, not knowing whether to follow GP's advice or not, so skipped instead of reducing. However, from what you say, GP should not have suggested I lower dose as my FT4 is not over range. Don't know about FT3 as GP said laboratory will not test this. Therefore I will continue on my present dosage, perhaps go up 30mg soon (if still lack of energy) and then add T3 later on.

[Clutter in reply to cc120]

CC, your TSH 0.03 and FT4 21 look good but don't show how well you are converting T4 to T3. Perhaps you could order a private FT3 test from Blue Horizon or Genova via thyroiduk.org.uk/tuk/testin... before increasing dose or adding T3.

[cc120 in reply to Clutter]

Hi Clutter, thank you. £19 plus £30 medical charge for FT3 which is a bit high for me right now, but will consider again in the future.

[shaws]

Hi cc1206

Are you taking iron or supplements 4 hours apart from your thyroid hormones?

[cc120 in reply to shaws]

Hi shaws, yes I am.

[Heloise]

cc, did you stop the iron supplement for five days before the test was done?

PERCENT % SATURATION of IRON: Measures your serum iron divided by your TIBC. Women want to be close to 35%, we have discovered, and men closer to 40-45%. Like all iron labs, you should be off all iron for at least 12 hours before testing to see how your supplementation is doing, or up to 5 days to see what your natural levels are. The latter is best!!

SERUM IRON: Measures the small amount of your circulating iron which is bound by the transferrin. You are looking for close to 110 for women, upper 130′s for men, based on what we’ve seen on hundreds of lab results. European or Australian lab ranges are something like this 7-27, and optimal is in the lower 20s at the least for women.

FERRITIN test: Measures your levels of storage iron, which can be chronically low in hypothyroid patients. If your Ferritin result is less than 50, your levels are too low and can be causing problems…as well as leading you into anemia as you fall lower, which will give you symptoms similar to hypo, such as depression, achiness, fatigue. If you are lower than the 50′s, you are scooting by. Optimally, females shoot for 70-90 at the minimum (Janie’s is 80 when her iron is good); men tend to be above 100 and optimally close to the 130′s. If your ferritin is much higher, you have INFLAMMATION–the latter causes iron to be thrust into storage and inflammation is common with thyroid patients for a variety of reasons. In less common cases, higher ferritin can be from liver disease, alcoholism, diabetes, asthma, or some types of cancer. Men are generally higher than women without having the above problems. If ferritin is high along with a high % Sat and Serum iron, you may have hemachromatosis or a MTHFR defect. Having heavy metals can push your ferritin low. You should be off all iron for at least 12 hours before testing to see what your body is hanging onto, and 5 days to see your true iron levels.

Folate works with B12 in the use and creation of proteins.

[cc120 in reply to Heloise]

Hi Heloise, I believe I stopped iron supplements a few days before testing. Thank you for such an informative reply.

So it seems that testing C-reactive protein (CRP) will be a marker for inflammation.

Before supplementing my Serum ferritin: 36ug/l (13.00 – 150.00ug/l) which you indicate was too low.

[Heloise in reply to cc120]

Hi cc, Your ferritin is now so high, from a low of 36 one year ago to way over range. Do they recommend doing something to lower it besides stopping the supplementing? I really don't know if it's dangerous or not and I guess it can be attributed to the supplements.

The CRP test is an important marker. In the states, it is used to determine heart risk. Did you have it tested, I can't find it? In the states, we use under 5 as optimal.

The comments come from Stop the Thyroid Madness Article:

stopthethyroidmadness.com/l...

[cc120 in reply to Heloise]

Hi Heloise, I had a test on 6 Oct 2014: QRISK2 cardiovascular disease 10 year risk score: 3.8% (estimated used as not all input date present or in range: Ethnicity: British)

GP simply stated I should stop supplements, only when pushed did she say that could be due to inflammation present, then mumbled she would ask laboratory!. Haven't had another appt to ask her.

I think it could be dangerous, to liver I think, another member suggested blood donation, but GP didn't seem so concerned, or knowledgeable.

[Heloise in reply to cc120]

That 3.8% score must be very good.

I know blood donation benefits you if you hemachromatosis but you don't have a high iron serum so I don't think that would help.

I don't know what to make of your TIBC since low seems to be better according to this:

TIBC (Total iron binding capacity) test: measures whether a protein called transferrin, produced by the liver, has the ability to carry iron in the blood. Used to determine anemia or low body iron. If your result is high, and in the absence of chronic disease, you may be anemic. With healthy amounts of iron, this test will be low in the range—about 1/4th above the bottom number.

[cc120 in reply to Heloise]

Hi Heloise - well the 3.8% was estimated so next to worthless I imagine.

That's very interesting regarding TIBC. Thank you.