Low Ferritin & Iron with Hypothyroid

My last blood test showed my Ferritin is very low at 13 so I've been prescribed iron tablets. My doc said that could be the cause of my fatigue. I've been hypo for several years, on 100 of Levothyroxine & 1 grain of NDT daily, my thyroid labs are normal. Anyone here have something similar? I'm wondering what could have caused low ferritin, I eat iron rich foods & take multi vitamins which include iron, my B & D etc are fine. I wonder if it's blood loss as I get more frequent heavier periods (every 3 weeks.) I read also that it could be cos I have chronic indigestion but I take Lansoprazole & Levothyroxine which keeps that at bay. Anyway I just hope the iron tablets work & I get more energy...

35 Replies

  • Would be good to know your last blood results. Heavy periods can be a symptom of underactive thyroid, so (unless you know you're optimally treated) it's possible you're not on quite enough medication.

  • TSH 0.32 (0.27-4.20)

    T4 13.4 (12-22)

    T3 4.0 (3.1-6.8)

    Antibodies 6 (<34)

    B12 360 (180-900)

    Folate 5.2 (4.6-18.7)

    Ferritin 13 (30-400)

    D 75.4 (>75)

  • Vitamin D, B12 and folate levels would help as well.

    Also edit your post to put the ranges as different labs have different ranges.

  • Have done

  • I'm not a doctor, but I think your t3 could be higher. Your t4 and tsh may be a little low because you're taking in a small amount of t3, but it isn't quite enough to get your results nearer the top of the range. These aren't bad results, but I think you could do/feel better. Have you thought about swapping out some of your levo for a little more ndt?

  • The cause is your heavy periods. It is not rare to have iron issues due to heavy periods.

    If you are adequately medicated on levo your periods may get lighter and so after the course of tablets you won't need to continue on a maintenance dose. If however you are not adequately medicated or it makes no difference then you will need to take one tablet a day until you reach the menopause to prevent your ferritin and haemoglobin levels falling. (Some doctors don't believe in this while others do.)

    Low ferritin levels are often a precursor to iron deficiency anaemia which is why doctors who have done some reading up are aware that they need to prescribe supplements for them and try to reduce the heaviness of the woman's periods.

    However doctors are not very good at sorting out the causes of heavy periods as there is not lots of research done on it.

    BTW Multi-vitamins with iron are useless as virtually all of them contain calcium. Calcium reduces the absorption of iron a lot.

    Plus the amount of iron in a multi-vitamin is little so they can be sold over the counter in places like Boots and Superdrugs, this means you won't get a sufficient amount of iron from them if you have heavy periods. You are better of buying a separate iron supplement and taking a vitamin B complex instead of a multi-vitamin. If you are deficient or low in other vitamins and minerals then take them separately.

  • Thanks for that info. I did read that it could be due to blood loss from heavy periods. According to my thyroid labs I am adequately medicated but I still have symptoms. They didn't test my reverse T3 cos they don't do that. Calcium isn't listed in the ingredients of my multi vitamins (for hair, skin & nails) I have brittle nails, thinning hair & itchy skin. I know that calcium prevents absorption & I take my supplements several hours after meds. I also read that ferritin should be at least 70 if you are hypo. I have separate B & D.

  • That all sound like a combination of under medication, low b12 and low D3, as well as low iron. Taking a PPI will stop you absorbing B12 especially, and other nutrients from your food. I'd try to find out if you really have high acid (indigestion is more often from low acid, but GPs don't bother to test) with a view to gradually weaning off lanzoprazole - you can't just stop it, as it causes rebound symptoms (PPIs were designed to be used for up to 8 weeks). Generally multivitamins are a waste of money as they are made from poor quality ingredients and don't contain enough of the things we are usually deficient in to make a difference.

  • According to my labs I have enough B & D but I'm aware their ranges are questionable, especially if hypo as we need higher levels

  • B12 levels under 500 can cause permanent neurological damage apparently and D3 is usually considered optimum at about 100. .

  • best to be in the upper end of normal results if you want to feel well....i have found personally and other agree

  • also if you are bloated or constipated often it is bad digestion and you need to be on hci with betain b4 meals to help your body aborb nutrients or take 2tsp of braggs apple cidar unprocessed vinegar b4 every meal...i mix it with lemon juice , organic liquid stevia and take with a straw and chase with any liquid.....also caffeine block iron absorption and iron is best taken with lysine and vit c

  • I do get IBS & diarrhea. Someone else here mentioned those as well, think I will try that digestive aid supplement.

  • Lanzoprazole is a PPI which reduces your stomach acid, these should only be used for a short time, not long term. You may actually have low stomach acid as many of us have. You need stomach acid to digest food and keep everything moving. If you haven't enough you won't be absorbing vitamins and minerals properly.

    See this link


    Unfortunately the symptoms of low stomach acid can be similar to those of high stomach acid and doctors just assume it's high. Try the 'burp' test mentioned on Dr Myhill's page above.

  • OK thanks I'll have a look at that. I'll speak to my GP tomorrow about Lansoprazole, the thing is if I just go a couple of days without it my indigestion comes back with a vengeance

  • Very good advice from Anthea. My daughter had terrible indigestion and reflux but it's improved greatly since taking apple cider vinegar in water before food and this digestive enzyme with meals:


    20% discount with code: viridian20

    Improved breakdown of foods should also improve absorption of nutrients.

    Maybe you could try this combo then wean off the Lansoprazole.

  • Yes I've heard good things about apple cider vinegar, I've recently started to take it again. That supplement looks good thanks, think I'll buy it. I was also looking at HCL tablets. I think first I need to test my acid levels before coming off Lansoprazole, there's an endoscopy clinic at my GP surgery so will try & get that done.

  • My daughter tried HCL for a few months but for her, the above combo works way better.

  • Hi Limbolass, I too have ferritin at similar levels but don't know the cause. I had a hysterectomy at 34 so it's not from heavy periods. My GP was going to send me for an endoscopy but has now decided against that but she does prescribe me ferrous fumarate. What you buy over the counter contains far less iron, I think prescribed contains 100 x more. I do have to remind her, she doesn't prescribe automatically, you may need to request it.

    Are you careful to avoid the foods that block absorption of iron? For instance both spinach and dried apricots, both well known for being iron rich, actually prevent the body from taking up iron. I think phytic acid in nuts also blocks it.

    Do you have plenty of vitamin C in your diet and do you have it at the same time as the iron? Iron needs the C to be absorbed.

    Apologies if you knew all that already and I hope you soon improve.

  • You can buy the prescription ferrous fumarate (mercury pharma) at Tescos pharmacy and independent chemists - they usually ask you to confirm that your doctor knows you are taking it. If you are getting free prescriptions it is obviously cheaper to get it from your GP. If you aren't, the box is about half the cost of a prescription.

  • You are right that you can buy ferrous fumarate and the other ferrous products but I really don't think you can buy without prescription the strength I am prescribed. If you have a box perhaps you could have a look and let us know, mine offers 140 mg (milligrams) iron, in a form that is easily delivered, per 5ml.

  • You can buy the mercury pharma 210mg x 84 tablets (69 mg elemental iron per tablet), which is what most GPs prescribe. I think there are only two products on the NHS list, that and Galfer.

    It sounds as though you have the syrup version which can be easier to take, but contains less iron than the tablets

  • Thanks Angel of the North and apologies for doubting you. I do have syrup not tablets because tablets are not vegan.

  • mine in menopause was from bad digestion,being bloated, and not slow elimanation......and i drank alot of caffeine which blocks iron- tea which i stopped and went to lemon water with organic liquid stevia by NOW brand

  • My iron's prescribed at the request of my Endo. My GP also told me to eat more spinach & funnily enough as I was walking home thru the churchyard I came across an unopened bag of spinach on a bench, no one was around so I nabbed it. I consider it a gift from the universe & am currently munching on it. I'm not sure what my vitamin C level is but I do eat plenty of vit c foods & drinks. Have you had your stomach acid tested? My GP is waiting for the results from my test for GERD & H. pylori then it will be the endoscopy for Hypochlorhydria.

  • Hi Limbolass, spinach blocks the body's ability to take up and use iron, as do dried apricots. Both are rich in iron but the effect on the body is the opposite of what you need. I think the phytic acid in some nuts does the same.

  • periods and bad digestion can be the cause or excessive blood testing

  • my stepson had bad ibs and was constantly in the bathroom.... i told him to start taking renew life probiotics b4bed every night at college and amazingly b4 the bottle was empty he quit and he has no longer had ibs and he had it for years .....he said he cant believe it....i told him he may have to take it again ....he must have had a very bad inbalance or absence of gut flora

  • Yes I've considered a probiotic supplement, I do eat live yogurt & fermented food like sauerkraut. I'm just so tired of pill popping, my bedroom looks like a pharmacy. My IBS tends to get worse with stress, bread & potatoes so I stick to sourdough bread. I suspect I'm gluten intolerant, my GP also wants to test me for Coeliac. Sigh.

  • the woman that created RENEW LIFE PROBIOTICS....had the same problem...so you can google about that..her story is amazing.....she said time released probotics is the key and she set out to help herself and then ended up making a product bec good ones were so hard to find that help....i saw her on a documentary

  • Lanzoprazole is the worst thing to take because it makes low stomach acid worse not better and blocks absorption of iron etc

    Hypothyroids have low stomach acid not high and need betaine or pepsin before meals

    You need to go glutenfree

  • I did talk about it with my GP but he wants to wait for my GERD & H pylori results first, then will book me an endoscopy to see my acid level. I saw that betaine was in that digestive aid someone here posted.

  • its the low stomach acid that occurs with hypothyroid that lets H pylori take hold and giving lanzoprazole simply allows it to flourish

  • Follow reallyfedup123 advice. I went gluten free and took a digestive enzyme with meals and IBS started to clear up.

    Best take a sublingual methylcobalamin B12 with a seperate methylfolate tablet for now as lansoprazole blocks absorption of B12 and folate helps B12 absorption.

    Some amino acids are great for IBS - glutamine powder dissolved in water is very soothing and n-acetyl-cysteine combats helicobactor by destroying their protective layer, but it's possibly safer with a sensitive stomach to start with the glutamine. N.B. Helicobactor and other bad bacteria thrive in low stomach acid, but I have a theory that eating less starchy food can help starve them out.

  • I'm about to buy B12 with folate. Will have a look at glutamine powder. I'm on a budget tho & all this will cost me a fortune.

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