Please could someone advise if my wife needs iron or not? She has underactive thyroid disease and has been told by endo she does not have Hashimotos. Her serum iron is not high and her transferrin saturation is not high either. She had iron deficiency diagnosed 2013 and she underwent iron infusion in 2016. Her ferritin has since dropped into double figures from triple figures. She is feeling unwell with increased thirst, dry skin, dizziness, hair loss, dry skin, muscle cramps, heavy menstrual bleeds, tiredness. A locum GP she spoke to thinks she might have coeliac disease. Below results done in Aug 2017.
Ferritin 53 (15 - 150)
Iron 10.3 (6 - 26)
Transferrin saturation 13 (10 - 30)
TSH 0.02 (0.27 - 4.20)
Free T4 20.8 (12 - 22)
Free T3 4.0 (3.1 - 6.8)
Thyroid peroxidase antibody 278 (<34)
Thyroglobulin antibody 253.5 (<115)
(175mcg levothyroxine, previously on T3 added to levothyroxine which she felt better on)
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She has Hashimoto's- only 5% have coeliac, over 80% are gluten intolerant.
As she is now under medicated, having had her T3 stopped, Hashimoto's will be badly affecting gut, hence low vitamins.
There have been many similar turn up recently.
Was it the same endo who started her on T3, that then stopped it?
To be fair, with Hashimoto's we do need all vitamins at good levels and most need to be gluten free for T3 to work well, because the gut is affected so badly with Hashimoto's, but this is something that endo's often don't consider.
Do you have blood test results from when on T3 ?
Essential to check vitamin D, folate and B12 too and supplement all and try strictly gluten free diet too
Then can consider trying adding T3 back
Can email Louise at Thyroud UK for list of recommended thyroid specialists- some are T3 friendly
Whenever I see that I want to go round to the surgery and smack some sense into the GP. What on earth do they think reference ranges are for? In range - fine (to an extent, it's where in range that's important), below range - a problem, above range - a problem. It's not rocket science!
This is folate deficiency with low B12. Check for signs of B12 deficiency here b12deficiency.info/signs-an... then post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc quoting these results, all the information about iron deficiency and ferritin, and any signs of B12 deficiency she may be experiencing. She may need testing for Pernicious Anaemia and may need B12 injections. See what they say and discuss with your GP.
**Vitamin D (25 OH) 49.2 (25 - 50 vitamin D deficiency) She only takes 800iu vitamin D for vitamin D deficiency diagnosed 2014.
Three years of supplementing and she's still in the deficiency category. 800iu D3 will never raise her level to that recommended by the Vit D Council which is 100-150nmol/L.
I suggest she buys some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 8-10 weeks then reduce to 5000iu alternate days, retest 3 months after starting them. When she's reached the recommended level she'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. She can help raise herr level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
After an iron infusion, it's not a good idea to just leave everything without any further monitoring or supplements, the level will most likely plummet again.
Has she been monitored, does she still have iron deficiency? Is her MCV low and MCHC high - this suggests iron deficiency? If so she needs further treatment.
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