Thyroid UK

Iron help

!FERRITIN 21 (30 - 400)

TRANSFERRIN 15 (12 -45)

IRON 7.4 (6.0 - 30.0)

!MCV 77.8 (80 - 100)

!MCHC 385 (310 - 360)

MCH 28.2 (28 - 32)

HAEMOGLOBIN 121 (115 - 160)

RBC 4.41 (3.80 - 5.80)

WBC 7.13 (4.00 - 11.00)

TSH 1.87 (0.2 - 4.2)

FREE T4 14.6 (12 - 22)

FREE T3 4.0 (3.1 - 6.8)

!TPO ANTIBODY 3045 (<34)

Just wondering if bloods for iron ok? I am a new member and have Hashimotos as well. Thankyou

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Amandajade Just a quick reply, I'm running late.

No, your bloods for iron aren't OK. Your ferritin is too low (must be 70 for thyroid hormone to work, recommended is half way through range) and your low MCV/high MCHC suggest iron deficiency anaemia. You need to speak to your GP for the appropriate treatment - see NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines) cks.nice.org.uk/anaemia-iro...

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

Ideally you need an iron infusion for your below range ferritin so ask for one, it will raise your level within 24-48 hours. You can also help raise your 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...

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TSH 1.87 (0.2 - 4.2)

FREE T4 14.6 (12 - 22)

FREE T3 4.0 (3.1 - 6.8)

You don't say what your current thyroid meds are, but these results show undermedication. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo only. If you add T3 into the mix then you normally see a very low or suppressed TSH, FT4 can be low in range and FT3 should be near the top of it's range.

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TPO ANTIBODY 3045 (<34)

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

Gluten/thyroid connection: chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

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Taking 125mcg levothyroxine thanks

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You're undermedicated.

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Amandajade Ask for an increase in Levo and use this information is support of your request:

From thyroiduk.org.uk/tuk/about_... >Treatment Options

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

The booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It's published by the British Medical Association for patients. Avalable on Amazon and from pharmacies for £4.95 and might be worth buying to highlight the appropriate part and show your doctor.

Also -

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.

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