Iron, Ferritin, transferrin and transferrin saturation index

[jbthyro]

Could someone please explain the differences between these and which ones are important to achieve optimum levels to support good thyroid function?

My Ferritin is 41 (20-150)

Iron 18.8 (6.6-26)

Transferrin is 2.2 (2-3.6)

Transferrin saturation index 0.34 (15-50%)

thank you

jbthyro x

[humanbean]

Some good links :

labtestsonline.org.uk/under...

irondisorders.org/Websites/...

rt3-adrenals.org/iron.html

rt3-adrenals.org/Iron_test_...

In your shoes I would be supplementing iron because your ferritin is below optimal. But you would need to test very regularly because your serum iron is already mid-range. Ferritin is optimal for most people around mid-range or a smidgen over.

The problem with iron supplementation is that until you've had a few tests done you won't have a clue how quickly you absorb it. And it is very important not to over-do it because excessive iron is poisonous. So test very regularly.

[jbthyro in reply to humanbean]

thank you humanbean, they are brill links.

Thanks for the advice too, I will keep that all in mind. I am sure I can ask my GP to test the iron sooner in October then I will get a BH blood test done in about December then.

[bluebug]

One test you have missed out is your haemoglobin level.

If your haemoglobin is over 13g/dL then you need to be more cautious in supplementing iron as it is unlikely your body will decide that it needs to move more iron from ferritin to haemoglobin.

If it is near or under 12g/dL and you start supplementing iron you will likely see your haemoglobin level increase before your ferritin level gets to an optimal level.

There are some exceptions to the latter the most common one is inflammation where your body keeps the iron in storage e.g. ferritin instead of allowing it to be used by the red blood cells e.g. haemoglobin.

If your level is under 12g/dL then the Word Health Organisation classifies you as having iron deficiency anaemia though some NHS labs won't, and if you are taking iron supplements so you are taking 200mg or more of elemental iron daily without your haemoglobin level increasing you should be referred to a specialist.

The start of this tutorial explains the link between haemoglobin and ferritin - chemistry.wustl.edu/~edudev...

[jbthyro in reply to bluebug]

thanks bluebug,

that's brilliant! Very useful information!

just looked at bloods when haemoglobin was checked, April 2015 last time and Haemoglobin concentration was 135g/L (115-160)

Mean cell haemoglobin level 30.3pg (27-3)

jbthyro

[bluebug in reply to jbthyro]

You level is 13.5g/dL and you have an NHS lab who thinks it is normal for people to be slightly anaemic as the lower boundary is 11.5g/dL. (Yes I'm just dividing by 10)

Anyway you need to be careful then when supplementing iron.

Standard treatment for low ferritin levels is one ferrous fumerate twice a day with vitamin C and water. Take 4 hours away from thyroid meds and 2 hours away from other food, drink and other supplements to avoid interaction. Iron interacts with lots of things.

You should buy 84 tablets from a pharmacist - not the one you pick up your prescriptions from - as you need to say to them when they ask why you want the tablets something like "I have low iron and the doctor told me to get iron tablets as it is cheaper off prescription". It is up to the pharmacist whether they give them to you or not. Some people have had issues with Boots but generally find the busier supermarket pharmacists more receptive. Alternatively buy them from Amazon and confirm the seller is a pharmacist. The tablets are about £3.80 After the course wait a week and get your ferritin level tested. This is very important.

Be aware if you ask a doctor to do a ferritin test they will often ignore you and just do a full blood count. Many doctors do not know or understand the importance of maintaining good ferritin levels. In addition ferritin tests are more expensive than a full blood count. However if the doctor agrees to do one tell them they only need to test your haemoglobin and ferritin not the full load of tests to save the NHS money.

If you have bowel issues e.g. constipation, diarrhoea with the iron tablets go down to one a day. If you still have issues post a new thread and people will recommend other but more expensive iron salts.

If you have any other issues that are not bowel related stop taking them immediately and post a new thread for advice.

More information here on non-anaemic iron deficiency that you can show your doctor if they realise you have been supplementing - patient.info/doctor/non-ana...

[jbthyro in reply to jbthyro]

It seems that when my sons had blood tests in March this year (a year later than I had them done) the path lab have changed their 'ranges' to 135-175) for haemoglobin concentration!

[jbthyro]

Amazing bluebug, Cant thank you enough for all of that, incredibly interesting.

And how totally ridiculous that we have to learn all of this ourselves!

This forum is so totally invaluable, thank you xx