Iron issues puzzling

[JennaShi]

So I have been pondering two questions lately and this may not be the right group at ask in but I think that everything works together so if one thing is off chances are other are off or will be.

My periods have mostly been heavy and painful and recently I’ve found my iron and ferritin to be low and get even lower during/after my period.

So my primary physician put me on birth control to see if it helped. It did after a month of oure nauseation and sickness. However it was only temporary and ended up having to up the dose due to bleeding sometimes randomly, which im told is normal.

I stopped the birth control and have been eating alot more meat and greens (both previously and currently).

So I am curious if this issue with my iron is in relation to my thyroid issues (previously Graves and currently Hashimotos) and or due to leaky gut (i am taking enzymes after each meal to help break things down), and or could it be an even further issue with something such as pernicious anemia? I have only tested b12 once and will be doing so tomorrow as well as testing for the intrinsic factor and vit D.

[Nanaedake]

Good idea to get vitamins tested, B12, folate, ferritin and vitamin D and rule out intrinsic factor test for antibodies. You might consider tests to rule out coeliac disease. What were your last iron test results and also thyroid test results? What dose of levothyroxine are you taking?

[JennaShi in reply to Nanaedake]

I agree, can’t hurt to know more information, right?

My last iron test results were: 44 range: 37-145

Tsh: 2.260 Range: 0.400- 4.410

T3 Free: 2.1 range: 2.2-4.2

T4 Free: 1.38 range: 0.80-1.90

I did get and IgE basic panel done and everything including wheat was less than 0.10

On my IgG gluten and wheat in class 1 so I dont think its celiac, thank you for checking though :).

I am taking 100 mcg of Levo and was taking 5 mcg of t3 before I got these results back. Now have upped to 20mcg t3

[Nanaedake in reply to JennaShi]

The antibodies tests for coeliac are not conclusive. Have you had thyroid antibodies tested? If positive, then you might consider going gluten free in any case as gut dysfunction is often associated with thyroid disease.

[JennaShi in reply to Nanaedake]

Oh ok, I may asked to get it checked. I have a friend who has celiac and although I havent looked into it, I dont seem to have a completely similar experience as she. I understand we are all different though.

Yes I have had antibodies checked. >900 tpo and 22.50 I believe it is for TSI. Yes, have also been gluten free for about 6 months with occasional slip up. I completely agree, didnt realize how messed up ones gut can be with standard diet. I have recently been taking alot of supplements to support and hopefully heal my gut under supervision of a functional doctor.

[Nanaedake in reply to JennaShi]

Ok, well check the supplements don't contain iodine as you've got elevated TPO antibodies.

[JennaShi in reply to Nanaedake]

Thats a good idea, thank you!

[Gambit62]

article on thyrogastric syndrome

ncbi.nlm.nih.gov/pmc/articl...

[Nanaedake in reply to Gambit62]

Wow, Gambit62 what an interesting bit of research!

[Gambit62 in reply to Nanaedake]

interesting in as much as it really highlights what isn't known.

[Nanaedake in reply to Gambit62]

The bit about the connection with low iron confirms what is apparent from postings on this forum.

[JennaShi in reply to Gambit62]

Gambit, thank you for sharing this article, I have also found it to be interesting although I can't say that I completely understand it. Is it basically saying that there is a commonality between auto immune disease (hashimotos, graves, addisons etc.) and auto immune disease targeting stomach lining? Causing the cells that help to grab the nutrients, such as Iron and b12 to die off? And one way to see if this is the issue for the person may be a b12 deficiency and showing of intrinsic factor on blood test?

I can say that I got a hair analysis test and it confirmed that my gut is not in good shape and nutrients aren't getting absorbed. My functional med doc explained it as there being gaps in my stomach and food, such as meat is falling through and being attacked instead of absorbed.

Please correct me if I am wrong, I have not slept well in a few days and this has left me feeling tired and short attention span.

[Gambit62 in reply to JennaShi]

basically right - the auto-immune condition is PA (pernicious anaemia) - so called because it was first identified as a type of anaemia that lead to madness and death - about 200 years + before people actually identified that the causal link was actually B12 deficiency at the cell level caused by an auto-immune condition in which your body attacks the mechanism by which you absorb 99% (on average) of your B12.

It works both ways round - I started off with PA and later developed Hashi's.

However, there are a number of ways in which hypothyroidism could cause problems absorbing nutrients and it could be that different ones are involved in different individuals.

[JennaShi in reply to Gambit62]

With your PA, did you test first for b12 then for intrnisic factor? Is the intrinsic factor the one that attacks b12? Have you also tested for the autoimmune gastritus? It looks like this attacks the parietal cells. I see they mention that there is a relationship, does one cause the other or mainly immune system?

I have it printed out so I will be going over it again to better understand

[Gambit62 in reply to JennaShi]

the reason for the high crossover isn't understood though I quite like the theory that because the cells in the gut and the cells in the endocrine system come from a common source (embryonically speaking) anti-bodies for one have a high probability to adjust to being the antibodies for the other.

IF is the test for PA as a specific cause of a B12 deficiency. IF is a protein that binds to B12 allowing it to be absorbed in the ileum. It is produced by parietal cells.

The test is notoriously prone to false negatives. To my knowledge I've never been tested. My low B12 was discovered when I was hospitalised with a broken ankle - think my creatinine was very high so they checked my MMA which was also very high, and that then lead to testing B12 levels which came out as low.

[JennaShi in reply to Gambit62]

That would make more sense, I think that is another reason why so many people end up with more than one auto immune disease. However I do have a question, i was reading more on it in other places and found that often people who have the auto immune gastritus, have antibodies for the parietal cells but then, no IF. How would be so if someone were to have PA and AG or thyro gastritis? Maybe its a dfference in opinion or a process? Have you tested for thyrogastritis or for the antibodies for parietal cells? Or do you think this is your case?

I did look back at previous labs and I do have one previous b12 test and folate from a year ago and both were in range, although towards the bottom end. Also my red blood cells have been both low and normal. I would be curious to see if this is what is hapoening with my health. I have yet to get my results back from yesterdays blood tests

[Gambit62 in reply to JennaShi]

thyrogastric syndrome is the name for the observable phenomenon of PA and hashis occuring together - it's just a label.

Can't quite follow what you were saying about parietal cells and IF. The test for IFA (Intrinsic Factor Antibodies) isn't very sensitive - suspect this is because it is difficult to distinguish between the antibodies and other chemicals - so it often doesn't detect antibodies accurately enough.

[JennaShi in reply to Gambit62]

Oh ok, I got it.

My question is regarding auto immune gastritis. Where the immune system attacks the parietal cells that make the IF. I was curious if you had tested for it. I think it says something about it in the article that you sent. And as I googled it, this also came up so I was curious.

[Gambit62 in reply to JennaShi]

I've not had any tests for PA as a specific cause of B12 deficiency but my stomach acidity is chronically low which points to PA as the cause - suspect my gastrin levels would be very high.

Both GPA and IFA tests have extreme limitations which means there isn't a good test for diagnosis of PA at the present.

[JennaShi in reply to Gambit62]

Thank you for clearing that up for me :). I did get my test results back and it my b12 is in range and it says negative for intrinsic factor antibodies. Thank you for help, I appreciate that you have taken the time to help me understand.