Thyroid UK
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Can you have iron injections for anaemia if you are taking T4 levothyroxine and T3 liothyronine?

Have recently had a couple of dose reductions of levothyroxine due to having over suppressed TSH over the past year 0.02 (range 2.0 - 4.5) Four weeks in I'm suffering from exhaustion, breathlessness, brain fog plus speech slurring which has led to me taking this week off work. I'm normally just above borderline with my supplemented anaemia but believe this may be part of the problem. Can you have iron injections whilst taking T3 and T4 without it affecting their level of absorption?

7 Replies

Whats the problem with being suppressed? I've had a tsh of 0.02 for about 14 years.... And so long as free t3 isn't over range there isnt any fuss made. Certainly no medication change. Are your free t4 and free t3 in range? If they havent been done then your doctor is just working blind.

I think the iron affects the absorption of thyroid medication if its in the stomach at the same time. So having an injection shouldnt present a problem.

Xx. G


Hi Galathea

Thanks for responding.

My endocrinologist is monitoring all of my levels, T3 and T4 are both in range:

Serum free T4: 16 (range 12 - 22)

Serum free T3: 4.3 (range 3.1 - 6.8)

Apparently there's an increased risk cardiac related disorders if your TSH is oversupressed, hence trying a further reduction to see if I can tolerate and 4 weeks into this second reduction I'm struggling, but believe my anaemia may be contributing.

Have discussed potential increase of T3 to help overcome this, which we will be reviewing next week, but really keen to see if I could access the iron injections to give me a boost?

LilyBlue x


What on earth does 'over-suppressed' mean? TSH is either suppressed or it isn't. There's no over or under suppressed. Your endo is playing with words, like they all do, to scare patients. There is no risk of cardiac related disorders with a suppressed TSH, if your FT3 is in range. I don't care what anybody says. People who have had a TT for thyroid cancer, have to have their TSH suppressed to stop the cancer returning, but they aren't all dying like flies of heart attacks, are they? I think we would know about it, if they were. :)

The heart risk comes from long-term, well over-range FT3 - and it is only an increased risk, not a fatality. But endos don't understand this. Your endo is making you sick for no reason. You really should not stand for it. TSH is irrelevant once you are on thyroid hormone replacement.

Your FT3 isn't even mid-range. No wonder you're feeling tired. There's more danger to your heart from low T3, than there is from low TSH.


Hi grey goose,

Thank you for your response, my mistake saying over suppressed, they were my words, not my endo, my brain!

I had to call my consultant this week, due to feeling so terrible and he's told me to increase the levothyroxine again, my FT4 has dropped to 12 (range 12 - 22). He said that I'm clearly 'a patient that is suppressed and that function better that way' which is true. Im seeing him this week for a full review and we're discussing potentially raising T3 dose, which is what we'd discussed at my last appt 2 months ago.

When I have my latest blood results I'll post them, but think I've messed up the ferritin levels due to dosing myself heavily the few days before my tests, but I felt so terrible I had to do something and that helped as my last bloods showed:

Ferritin 14 (range 13 - 150.00 ug/L)

Haemoglobin estimation 128g/L (125 - 165)

My main query is my iron and could I receive iron injections to support my anaemia when taking daily T3 and T4

Thanks again for your response



There's no reason why you shouldn't receive iron injections when you're taking T3/T4. Lots of people do.


NEVER allow your doctor to reduce your meds based on blood tests alone. TSH becomes irrelevent when you are taking any form of thyroxine.


TSH is a useless measure if you are already on thyroxine of any sort.


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