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Thyroid UK
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Iron deficiency, how to treat?

Dec 2017

Ferritin 28 (15 - 150)

Iron 7.2 (6.0 - 26.0)

Transferrin saturation 13 (12 - 45)

RBC 4.41 (3.8 - 5.8)

WBC 7.13 (4 - 11)

Haemoglobin 116 (115 - 150)

Haematocrit 0.41 (0.37 - 0.47)

MCV 80.2 (83 - 98)

MCHC 378 (310 - 350)

I can't tolerate tranexamic acid for my heavy periods. The tablets make me feel sick. Does the anaemia need treating or is it ok not to?


8 Replies

Your MCV is under range. You need to go back to your GP and point this out as it is microcytic anaemia and they should give you iron tablets.

However if your TSH isn't under 1 plus you have hashimotos but aren't completely gluten free and taking selenium supplements you are going to have ongoing problems. So get your thyroid hormones sorted out.

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TSH 5.1 (0.2 - 4.2)

TPO 1500 (<34)

FT4 14.2 (12 - 22)

FT3 3.0 (3.1 - 6.8)


Is your thyroid being treated at all? As your TSH is too high. It is above the range.

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Was taking 50mcg levo but had symptoms of nausea and stomach feeling empty


The reason you felt sick was probably due to your dose not being high enough. The dose should have been increased every 6-8 weeks until your TSH was under 1. This takes time.

In addition you need to try going completely gluten free - this means you make your own food from scratch buying processed gluten free food to eat rarely. And take up to 200mcg of selenium per day.

If you leave it then you are going to have period problems that can't be dealt with and if you want to get pregnant you are going to have difficulty.


You are extremely under medicated

TSH should be around one and FT4 towards top of range

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

You iron is low because you are under medicated for Hashimoto's

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ask GP for coeliac blood test first







Typical post of Low vitamins due to under medication


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You are aware that untreated hypothyroidism can lead to:

- Myxedema, a condition that causes swelling of tissues, increased fluid around the heart and lungs, slowed muscle reflexes, and a slowed ability to think.

- Myxedema coma, a rare, life-threatening condition.

-- Sleep apnea, which causes you to stop breathing for 10 seconds or longer while sleeping.

- Forgetfulness and dementia.

So not taking your levo is actually very serious. (I've missed other things out like your heavy periods.)


I don’t think you have microcytic anemia because your MCHC is above range and not below. MCHC can be elevated by being dehydrated at the time of your blood draw so you may have had a falsely elevated level. However anemia also requires low red cells and hemoglobin.

I have iron deficiency but not anemia. My iron and ferritin are way below range and my saturation is slightly below range. But my hemoglobin and red blood count remain just inside normal limits like yours. I am not anemic, just deficient. Nonetheless my hematologist gives me iron infusions monthly now to keep me from becoming anemic. You may want to ask about them, although your ferritin is almost double the low end of the range and where I live it must be below 15 for infusions.

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