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Thyroid UK
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Best way to increase Ferritin?

Does anyone have suggestions on how to increase my Ferritin levels? A recent blood test showed my iron levels to be at 101 (ref range 40 - 190mcg/dL). However, Ferritin is at 27 (ref range 10 - 232ng/mL). I read that Ferritin should be at least 70 for optimal thyroid function. I'm hypo. Are there suggestions on to increase Ferritin? My Iron level is ok. So don't want to overdo it with iron supplement. I'm also concerned about the disgestion issues. Anyone have experience with this? Recommendations? T

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Hi Abbysue, often with Hashimoto's your stomach doesn't have enough acid to break down minerals. You could add betaine HCL with meals and other digestive enzymes to get the nutrients you need. From Stop the thyroid Madness:

IRON RELATED (and you need all four, NOT just ferritin)

SERUM IRON (also called just Iron or Total iron): Measures the small amount of your circulating iron which is bound by the transferrin. You are looking for ‘close to’ 110 for women (or 109, or 108, or….), upper 130’s for men, based on what we’ve seen on hundreds of lab results. European or Australian lab ranges are something like this 7-27, and optimal is in the lower-to-mid 20s at the least for women and higher for men. If you are considerably higher than optimal, you could have the MTHFR mutation which will need testing and treatment. The MTHFR mutation also drives the ferritin low with normal or high iron is many of us, we’ve noted. If all three iron labs are high (serum iron, % saturation, and ferritin, you may have the genetic hemochromatosis and you can ask your doctor for testing for that.

PERCENT % SATURATION of IRON: Measures your serum iron divided by your TIBC. When iron is good, women tend to be “close to” 35% (or .35 for Canadian ranges), we have discovered, and men go from 38% to 40-45%. Like all iron labs, you should be off all iron for at least 12 hours before testing to see how your supplementation is doing, or up to 5 days to see what your natural levels are. The latter may be best. NOTE: % Saturation can look falsely good or high if your TIBC is too low!!

TIBC (Total iron binding capacity): measures whether a protein called transferrin, produced by the liver, is enough to carry iron in the blood. Used to determine anemia or low body iron. If your result is high in the range and in the absence of chronic disease, you may be anemic. When iron is optimal as explained above, TIBC will tend to be in the low 300’s (with a range of 250 – 450) or for other ranges, about 1/4th above the bottom number in the range provided. NOTE we do NOT treat the TIBC. We treat the iron and % Sat. The TIBC just gives us interesting information as explained.

FERRITIN: Measures your levels of storage iron. NOTE THAT WE DO NOT TREAT the FERRITIN LEVEL. A mistake. We treat iron and % saturation and let ferritin follow in its own accord. But ferritin is interesting to watch, and can also point to INFLAMMATION. Optimally, females often are around 70-90 with ferritin (Janie’s is 80 or less when her iron is good), though getting up to the 50’s has been good, too, when iron and % sat are OPTIMAL. Men tend to be slightly above 100, such as 110 – 120.

If your ferritin is low along with inadequate/lower levels of iron and % saturation, that usually points to simply low iron, which is common with those on T4-only meds, or undiagnosed, or under-treated. But we do NOT treat that low ferritin. We treat the inadequate iron and % saturation, and over time, the ferritin moves up by itself if it’s too low.

If your ferritin is low with very good or high iron, plus a TIBC in the middle 300’s or higher, that usually points to having high heavy metals and an active MTHFR mutation.

If your ferritin is much higher along with less than optimal iron, it can point to INFLAMMATION, i.e. inflammation causes iron to be thrust into storage, and inflammation is common with certain thyroid patients for a variety of reasons. In less common cases, higher ferritin can be from liver disease, alcoholism, diabetes, asthma, or some types of cancer. But for most of us, it’s just about inflammation from hypothyroidism, or gluten issues, or unknown. So we need to lower the inflammation before taking iron supplements.

If ferritin is high along with a high % Sat and Serum iron, you may have hemochromatosis, an inherited condition. Time to get tested in working with your doctor.

By the way, we learned that we should be off all iron supplementation for at least 12 hours before testing to see what supplementation is doing for us, but 5 days to see your true iron levels.


Thank you so very much for such detailed information!!! This is a great help to me and provides a better understanding of how it works. I've been struggling with fatigue for years! This gives me something to go back to doctors with. Will request testing for all four. THANK YOU!


I hope they will do the testing. You never know these days. If you have problems raising your levels you could also add a manganese supplement.

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I added a low dose iron biglycinate to my ferrous sulphate, & make sure I take both with citrus fruit for citric acid to improve digestion, & vitamin C to help absorption. I also make sure I take these well away from any foods containing calcium or other minerals that might hinder absorption.

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Thank you!

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