Hypothyroid and aneamic but not through iron deficiency

Hi I'm hypothyroid on thyroxine and had a full blood count done and the dr said I'm slightly anaemic but not through iron so im confused . My results are

B12 - 683 (170-730) so I'm thinking this is good?

Serum ferritin 17 ( 10-290) this seems low to me even tho she said it's not a shortage of iron.

Then red blood cell count

Haemoglobin 118 ( 120-156)

Packed cell volume 0.35 ( 0.36-0.46)

I'm googling it and worrying myself sick can anyone offer any advice?

27 Replies

  • I wonder if you have Pernicious Anaemia - I believe the blood looks 'different' and I had a test for the 'intrinsic factor' which confirms or not P.A. If you are positive you have B12 injections quarterly although some would like them more frequent.


  • I think my b12 looks quite high could I still be deficient in b12? X

  • It is now recommended that, to prevent neurological damage, that B12 be around 1,000. So your number is fine. B12 and Vit D are actually prohormones rather than vitamins as they have specific functions. This is about D D3 in particular (maybe a bit complicated as I think I'll have to re-read?2

    The following link is re B12.


  • low ferritin like that is classic in hypothyroid and very important

    its low stored iron and its vital thats its increased to at least 70

    incorporate liver into your diet even if you mince it in with minced beef ,lasagne etc

  • Oh no I really don't think I could eat liver 😱

  • It takes months and months of iron tablets to boost your ferritin

    wheras if you eat liver one way or another its much shorter

    all it needs is to be inventive and include it once a week for life to prevent re occurance of low ferritin which is so damaging for hypothyroids

  • Thanks I will try

  • I'd take iron supps if I were you. Your ferritin is very low. Eat liver as well if you like .. or you can buy it as pills and avoid the taste.

  • This gives food which can improve iron.


  • Hi rfu123. Went to buy some liver from a top butchers shop in town as we have done so in the past, (we buy it by the whole trayful) and were told that they had stopped selling it as no one wanted it anymore. How sad, liver is really good for us, vit B12 , iron and no doubt much more. :(

  • The World Health Organization defines anaemia as:[1]

    Haemoglobin (Hb) <13 g/dL in men over 15 years old.

    Hb <12 g/dL in non-pregnant women over 15 years old.

    Hb <12 g/dL in children aged 12-14 years.

    Source : patient.info/doctor/iron-de...

    Your Haemoglobin is 118 g/L (assuming the units are the same as the ones used on my own tests). When converted to g/dL your haemoglobin is 11.8 g/dL which is below the level set by the World Health Organisation for a diagnosis.

    I don't know why your doctor doesn't want to diagnose, but you really do need treatment for your iron deficiency, whether your doctor thinks you are anaemic or not.

    Your ferritin is only 2.5% of the way through the reference range and it needs to be around 50% of the way through the reference range (i.e. about 150 with your reference range, but if the reference range changes then the middle of the range will change too) for most of us to feel at our best. I can only guess your doctor doesn't want to treat you because your ferritin is still in range.

    You could ask for a second opinion on whether or not you need treatment. But you don't need your doctor's permission to treat yourself for iron deficiency.

    The BNF - the British National Formulary - is the book that doctors rely on to tell them what they can readily prescribe. It is available to look at for free on the internet. The link to the page on prescribing iron supplements is :


    I got my first two months worth of iron tablets from my doctor with a prescription, then started treating myself after that. It made life so much easier and I didn't have to beg any more.

    I was prescribed :

    Ferrous Fumarate 210mg, in a box of 84

    I got them from either Lloyds Pharmacy or Tesco Pharmacy. The last time I bought them they cost about £5 a box. It is up to the discretion of the pharmacist whether or not they sell them without a prescription. If you don't get them from one pharmacy try a different one from a different chain.

    I took 1 tablet, 3 times per day which is the maximum safe dose. I also took 500mg - 1000mg with each iron pill which helps to reduce constipation and improves absorption. You could obviously take fewer than 3 per day if you wanted.

    Some people have problems tolerating iron supplements. If you can't tolerate the ferrous fumarate then there are other supplements you can try. A popular one on this forum is ferrous bisglycinate (also known as iron bisglycinate and also known as Gentle Iron). You can buy this on Amazon and on other supplement sites. It has a much lower dose of iron in than ferrous fumarate.

    It is important not to overdose on iron because it is poisonous if you take too much. It is vital to test regularly to be sure you aren't overdoing it. Get a test done after about three months. Healthy people with good absorption might fix low iron in 6 months, but it may take a long time. It took me nearly 2 years to get my levels up to optimal. But you should assume you absorb iron well and test regularly for safety.

    You could use this test if you want to check privately rather than involve your GP :


  • Thanks for your reply don't they say it's dangerous to take iron for certain types of aneamia? Like if it's chronic disease aneamia X

  • Have you got more results that you haven't told us about? Because I can't see how you can decide you have anaemia of chronic disease with the results you've given us.

  • If you have some reason to think you have Anaemia of Chronic Disease then you might be interested in these two links :



    And don't forget it is possible to have more than one kind of anaemia. If that happens then you can have difficulty in disentangling what is going on.

  • It's not dangerous with ferritin that low and low haemoglobin. You need that iron desperately.

  • Hi, that was what the dr said to me. I asked if I need iron suppliments she said no it's not through iron, she said its could be through chronic disease. So Then I started googling and realised that can happen because of the thyroid and thought it might be that. But my iron is low really so I don't know why she thinks that isn't the problem?

    What results would indicate it? I do have more results but too many to post, but if you tell me what to look at ill post it and see what you think? X

  • So I only thought ACD because the dr said its not through iron deficiency and could be ACD so I've been worried. But in reality it probably is the iron still as its very low

  • Your doctor needs to decide if you have ACD, not just leave you hanging like she has. With the results you've quoted there is no evidence of it.

    Do you have results for CRP? It would generally tend to be high in cases of ACD but there is no guarantee.

    Look at this link I gave you earlier :


    There is a table at the bottom showing you the things you would need testing to know if you had ACD and whether you could expect the result to be high or low. But as I said previously, if you had two different types of anaemia you could get some very muddled results indeed. But that isn't a reason to leave you untreated. Your doctor needs to pull her finger out!

  • Hi Crp was 2 (0.10-6.00m/gl) so that seems ok??

  • hashimotos is a chronic disease and it virtually always causes low ferritin which in turn prevents you utilising levothyroxine t4

    liver is absorbed better by the body than iron pills and NDT seems to overcome the utilisation of t4 and conversion into t3 in the experience of my husband

  • similar situation, ferritin was 20 (13-150), taking iron supplements now. Iron rich-food would be great; any alternatives for liver? (I'm pescetarian)

  • Haem (also spelled heme) and ferritin supplements are available online. However they are based on meat.

    Some fish have more iron than others. Have a look here:


  • Thanks Helvella!

    Jeez how iron-dense clams are!! Also Just about the only sea food I dislike :) :D

  • spinach and watercress iron content are minimal

    afraid lambs liver still best source

  • The dr upped my thyroxine from 100 to 125 as I was tired and she said that might sort the aneamia out if it was chronic disease and now my tsh has gone from 2.52 to 0.19 . I mount back this week to have a chat about it and hopefully get some more tests done X

  • Thanks I will do that. However we did increase them and now I'm guessing when I see her tomorrow she will reduce it again as my tsh is now 0.19 is this too low now ?

  • Hi went to Drs she said my iron is now 10 so she can give me iron tablets so I'm on those for 3 months now!! I asked her to check back to March when I last had a blood test and it was 14 back then so it's been low for a long time I'd say!! She left my thyroxine as its for another month but said we may need to reduce it. She didn't listen to me about testing t3 she said we don't need to as I'm on thyroxine?? X

You may also like...