Thyroid UK
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Low-ish Ferritin & high Serum Iron

From last week's lab work, my Ferritin was 25 (15-150 range) and my serum Iron was 184 (27-159 range). I know that the iron is really high. My ferritin has always been been around that number, but my iron has previously been normal. My Hemoglobin was 12.5 (11.1-15.9 range).

I'm 27 and have been on Synthroid since 2010. I got my lab work done last week as I was concerned about recent symptoms. I've had a lot of hair loss and some weight gain. More importantly, I've had really late periods. I used to be able to set my calendar on ~30 day cycles, except when my med levels needed to be adjusted, but the last couple of months, it's been 2-3 weeks late. My TSH came back normal, so my endo pretty much said that I must be stressed as my hypothyroidism is being properly treated.

How exactly do I proceed? I'm not sure what exactly the excess iron means. I would appreciate any advice as I'm pretty perplexed. I'm not even sure what additional blood work I should request to figure out the problem.

Additional results:

Free T3: 5.68 pmol/mL (normal 3.07-6.76)

Free T4: 22.66 pmol/L (normal 10.55-22.78)

TSH: .527 uIU/mL (normal .45-4.5)

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Do you have Hashimoto's (high thyroid antibodies)?

Have you tested vitamin D, folate and ferritin too. If so can you post these results

Someone with iron and ferritin expertise should be along shortly

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I don't know actually. When I was first diagnosed based on my TSH, my endo put me on levothyroxine, and pretty much adjusted the dosage based on TSH/free T3/free T4. I don't think my antibodies were tested in the beginning. I definitely know they weren't tested any time in the last five years.

Re. Vitamin D: It used to be really low (~25), but I take a daily supplement, so my recent levels have been around 51.

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I assume you are not in UK?

Vitamin D units vary country to country. I think your would be ng/ml - range typically 30-100

50 ng/ml is good

endmemo.com/medical/unitcon...

If you have raised antibodies, then often gluten free diet can help

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

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Actually, I travel quite a bit. And I didn't get my vitamin D tested last week because it was tested a couple of months ago when I was in Asia, which is where it was 51 ng/mL.

Thank you for the info on antibodies! I asked her once if going gluten free would help, but she just told me not to believe everything I read on the internet. Figures my endo never mentioned them. I'm going to get them tested privately. You mean TPO and TAA right?

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TPO and TG here in UK

TPO is main one

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Thanks! I'll get those tested.

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Nushie,

Your thyroid results are indeed very good. FT4 top of the range and FT3 are approaching the top quarter levels which starts at 5.83, according to the range provided within your post.

If you are still not feeling very well, checking the antibodies, as SlowDragon mentioned, is a very good idea and will either confirm or eliminate an autoimmunity within the thyroid.

No need to change your dose of Syndroid but adding Selenium may boost the conversion a bit more and may help to increase T3. As long as they don't go over the top range.

Do you take any iron supplements? any other supplements?

Your iron profile is incomplete to ascertain what's happening. You may need to repeat and to ask for TIBC and transferrin saturation to be included. Transferrin saturation is the ratio of serum iron and TIBC (serum iron/TIBC). If the transferrin saturation comes also as high typically > 45% and sometimes >55%, then you may need more investigations about hemochromatosis which may point towards a genetic disposition for iron overload with certain ethnic backgrounds to be more prone to than others.

Iron is a metal complex and considerable variation occurs within a day in individuals.

Ferritin, a protein, stores iron and provides a balance between iron overload and deficiency.

Your serum iron is elevated as you have said but your ferritin is within the range and your Hemoglobin is pointing towards the lowest end which indicates you may be lacking other essential ingredients to make it.

To make hemoglobin, and in addition to iron and you need copper and you need Vitamins B6, B9 (folate) and B12, and Vitamin A. Vitamin A helps stems cells develop into red blood cells, ensuring that your body can produce enough red blood cells to replace those that die due to age. It also makes sure your developing red blood cells have access to the iron needed for hemoglobin.

If you are taking any iron supplements, best to stop them and perhaps you need to consider testing for b12 and folate and accordingly add a good b-complex with additional b12, depending on your levels.

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I don't take an iron supplement. I do take a vitamin D supplement daily. I take a biotin supplement as well as multivitamin gummies, but I'm pretty inconsistent with both. I only take vitD without ever skipping.

I did get my B12 tested, and it was 414 pmol/L. As per your suggestion, I'll get a complete iron test, as well get the other vitamins checked.

You mentioned that my ferritin is within range, but I have a question about that. One of my issues is hair loss, and I have seen on here that ferritin below 70 is linked to hair loss. Is that not the case?

Thank you for your suggestions.

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Trichologists say that as hair and nails aren't essential organs you need a ferritin level of 70-90 for them to grow healthily. On the other hand you will find medical doctors saying that ferritin levels need to be over 30 or around 50 to be in good health. If you have iron overload problems e.g. genetic hemochromatosis you want it to be around 50 that way you know the iron isn't settling in your other organs.

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Ferritin levels fluctuate and as much as the recommendation for Ferritin levels to be around 70 might be acceptable, it is best to be cautious when serum iron is high and without knowing your transferrin saturation. So, it is best to accept the lowish levels at the moment and don't push with any iron supplementation at the moment and until you get a complete iron profile and discuss it with your doctor.

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Thanks for explaining. I'll wait for the complete profile, and then see about getting everything in line.

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You are welcome, Nushie!

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