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Thyroid UK
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Confused! Iron, B12, T3, T4 all low!


Hope someone can help! I tend to dose by symptoms rather than blood results. I am feeling hypo lately, mostly with Fibro type symptoms, lots of dizziness, brain fog etc.

Got some bloods back today, and Ferritin is 36 (not dure of range), B12 230 (again no range), FT3 is 3.7 (3.8-6.0) FT4 11.11 (9.9-20) TSH - 0.03. White blood cell count is low, but no number given. Doc is contacting endo.

So usually my TSH is around that number but the others much higher. I would expect my tsh to be around 5-6 with the other numbers on the lower end of the scale. Also not sure what low white blood cells might indicate and whether it is all connected.

I am on 30mcg T3 and 150mcg T4 after a TT 10 years ago.

Brain fog is making it hard to understand what I need to do first!! Please help!

Many thanks in advance


11 Replies


I recently had a major drop in white blood cell count within 4 week gap. When I mentioned to go he said this can happen if suffering infection.

Doing more bloods.

Hope you feel better soon.



My guess - but I'm sure others will know more - is that you need less T4 and more T3. Maybe T3 only. You're clearly not converting any T4 to T3 at all.

If your ferritin result uses the range we see most often here, then yes, you need more iron. T4 needs iron to convert to T3. Ideally ferritin should be at least 70. And your B12 is way too low.

I'm hoping you've got a decent endo?


Without the ranges its diffilcult but even on the lowest ranges your ferritin , folate and b12 are way too low

while they are all low and you take any T4 thyroid meds you will feel ill

you need to take iron plus at least 1000mg vitamin C at least 4 hours away from thyroid meds

and you need to take methylocoban form of b12

While you are trying to push up the levels you really should only take t3 because your body simply cannot convert the T4 into the t3 you desperately need

also after a TT your body needs a higher dose than might otherwise be normal because your body was so sensitised to very high levels when you had Graves and it cant cope on low levels ( very old Swedish research )

1 like

Yes I forgot to write the ranges down and then they disappeared from my sieve brain! It was the lower ones that were used though I think. I was told I had a conversion issue.. What sort of dose of T3 only would I be looking at? Currently upped to 30mcg but want to leave it there a week or 2 before increasing again. Also just ordered paul Robinson book. Thanks



well I can tell you my husband had TT and 350mcg thyroxine did him no good nor did 120mcg t3 .....................its only now he is on 5 grains of armour/NDT he is pretty good but his ferritin /folate/b12 have been fixed

my daughter who also has hashis was also on 120mcg t3 when her ferritin etc was low

but now she is on 4 grains of NDT

I doubt any endo or GP would dare prescribe that amount so you might need to source it yourself and CAREFULLY self medicate


What is your diet? Because it seems you are malnourished and you can take all the thyroid you want, but if the chemical infrastructure is not in place, the body has nothing to give. Not only the big four, but vitamin A, zinc are also needed. If these are not present in the diet, then they need to be supplemented. Quality protein is also a big necessity. At least 45 to 50 grams of quality, absorbed protein. Pulses (lentils, beans) have a certain amount of protein but only absorb 27% of the protein in lentils and I forget for beans. It's a bit higher. You need to analyze your diet with one of those on line tools and see where you need to improve. And it takes time to rehabilitate. Rebuilding the body takes time.

1 like

Thanks - I eat no Gluten or refined sugar, and am pretty much veggie most of the time, though eat some meat. I can't really tolerate pulses. Eat loads of veg, nuts, seeds, eggs, fruit. Got some Zinc today so thanks for the suggestion! I will look online to analyze diet as I want to be able to keep cycling and I'm starting to feel to rough to handle it!


A few years ago the South African coach of the Indian rugby team threatened to quit. He said that the vegetarian diet does not provide enough quality protein for the players to succeed in the sport. They had to eat 15 eggs per day.......LOL!

I don't know if they ended up winning any games after that though.


Do you have gut issues that are causing mal-absorption of VITAL vitamins and minerals ? It is important to heal the gut and address stomach issues if you have low acid too.

It is important to find out what is causing the LOW B12/Iron/Ferritin/Folate issues.

I would suggest a course of B12 injections and then dose with sprays/patches/lozenges to bring your levels up to around 800/900. Low B12 will cause many of the symptoms you are experiencing.


The above link will explain most of what you need to know about B12.



The new guidelines mentioned in the above link do state that clinical signs and symptoms should be taken into consideration ....


Thanks all..

I had gluten sensitivity but have been gluten free for 3 years, I do not eat pulses as my stomach cannot tolerate them. I used to take Methyl B12 but had stopped for a while. I have just got some more as well as zinc and Spatone for the Iron. I am trying to up my T3 but struggling a bit, and also not sure what sort of dose to aim for since I have lost weight.

My GP is excellent, and I am being referred back to the Endo who was ok, but humoured me really with the T3 I think!

Any Endo recommendations?

I am in Somerset. The doc has told me to wait for endo appt but I am going to continue trying to increase T3 as I cannot get any more hypo than this!! I do a lot of cycling when I'm healthy enough, but am not at the mo.

Marz - Thanks for the links - I have pins and needles in my hands and feet - so that's B12?! Will they give injections if it's within their (stupid) range?

Thanks again


Your results are very similar to mine, and recently had a fight with gp as she will not give me B12 injections, mine was 247 dropped an awful lot from May when they were in 600s. I am taking Iron and Vit D from Dr but would not give the B12 they have such fear why it is water soluble. Told her everything I know, so will find out what I can do for myself now. I am on T4 and T3 and I will not give in. I have learnt more from this site than anywhere else and the administrators are amazing. Read and learn as much as you can, I feel that I have been cheated of a decent life these last 20 years but I am determined to get better through self knowledge, I am quickly loosing all faith in drs and Endos. Good luck!


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