Thyroid/Iron Issues

[aggleflaggle1045]

Hello, all. I'm a 45 year-old woman new to this forum. I'm suffering from fatigue (I constantly have that feeling of needing a nap), extremely dry skin, anxiety, and in the last 3-4 weeks suddenly lost enough of my already thin hair that I'm now wearing a wig. I also have a history of post-partum hypothyroiditis which set in after the birth of my first child in 2006. At some point I decided I knew better than the endo and stopped taking the thyroid medication he prescribed because I'd read women sometimes recover from this type of thyroid issue. I thought I was in the clear because subsequent tests performed by my primary care doctor showed values in the "typical" range, as I've listed below.

The recent hair loss prompted me to go to my primary care doctor who tested me for thyroid and iron. The results were:

TSH: 3.27 uIU/mL (0.24 - 4.82) --my TSH has been around this number since at least 2015

Free T4: 0.72 ng/dL (0.59 - 1.61)

Free T3: 2.50 pg/mL (2.3 - 4.2)

Vit D,25-Hydroxy Tot: 40 ng/ML (20-80) --I've been taking 2000iU VitD for a while now due to testing at 10 in 2016

Ferritin: 14 ng/mL (12 - 252)

RBC: 3.82 M/uL (3.90 - 5.40)

Hemoglobin: 12.1 g/dL (12.0 - 15.5)

Hematocrit: 35.7% (35.0 - 47.0)

MCV: 94 fL (80 - 100)

MCH: 31.7 pg (27.0 - 33.0)

MCHC: 33.9 g/dL (31.0 - 36.0)

Lymphocyte %: 22% (26.0 - 46.0)

My doctor's only comment, made online, was that my iron's low and I should start taking an over the counter supplement once a day and see if things improve in three or four months. Not feeling satisfied with this response, I decided to go to another doctor who ordered many more tests for celiac, hormone issues, lupus, and vitamin deficiency. Most came back normal, but here are the ones I think might be pertinent:

Vitamin B12: 257 pg/mL (211 - 911) --tested at 284 in 2016

Thyroid Perox AutoAb: 891 IU/mL (standard range: <35)

Based on my reading, it looks like I have Hashimoto's and I think an argument could be made that I'm hypothyroid or at the very least, likely headed in that direction, and so should restart thyroid medication. I'm also trying to figure out how/whether my low ferritin might be related to the thyroid issues. How does one sort out whether the thyroid is making the iron issues worse or vice versa? And are there tests that would help to figure it out?

Thanks in advance for your thoughts!

[Surpresa]

Hi aggleflaggle1045, I am new here. Looks like hipothyroidism symptoms though test results look ok. Perhaps your hormone drug could be changed. I did recently and feel better. But I don't have Hashimoto, but had 3/4 of the gland removed 40 years ago.

Hope you get better soon.

[whispers]

You do have hashimotos and your levels are saying hypothyroid, you should really be on hormone replacement ideally your tsh should be around 1 and rt4 and ft3 should be abouve halfway/two thirds up in the range, you also need to address all the other low readings too, hair loss is a symptom of both hypo and low iron as is fatigue, will the second doctor not help you with these? The vit d you are taking us obviously not enough, and most people suggest taking vit K2 mk7 and magnesium whilst taking vit d. Please do get help

[Ruby1]

I was put on Levothyroxine when I was borderline within range, but like you, my antibodies were raised and my GP said I would head that way (he also had an underactive thyroid which helped). I was also low on iron - possibly iron tablets were the first thing that made me feel better.

I would head back to your GP and remind him of your symptoms, feeling tired, hair falling out etc and ask him if he could put you on levo even though you are still within range as your antibodies are raised and see if your symptoms improve.

My TSH these days is below the normal range and the doctor is happy with that.

Good luck!

[eeng]

It's an interesting question as to whether hypothryroidism causes low ferritin or vice versa. The received wisdom on this site is that hypothyroidism causes (or anyway is often associated with) low stomach acid, which prevents the gut from absorbing nutrients properly, so that hypo people typically become deficient in Folate, ferritin, b12, d and sometimes iron. (Low stomach acid can cause symptoms which are so similar to high stomach acid that people are often prescribed pills which lower stomach acid even further, exacerbating the situation).

You are unlikely to get a doctor to prescribe Levothyroxine again, although it's certainly worth a try. In the UK they don't prescribe until you get 2 TSH test results 3 months apart showing an over-range TSH, and many GPs won't prescribe until TSH is over 10. You could self medicate though - it's possible to buy thyroid medication online, but it does freak GPs out if people actually try to take control of their own health, so you may end up paying for private blood tests (up to £100 a time) to monitor your thyroid levels.

A Norwegian study showed that typically people without thyroid issues have a TSH between 0.5 and 1.5, so a TSH of 3.27 is high, and in some countries you would be treated. When you are taking enough thyroid hormones your TSH will be 1 or below and your FT3 and FT4 will be in the top half of their ranges. Your FT3 is currently near the bottom of the range and will be causing your fatigue. You could try taking a low dose of Natural Dessicated Thyroid (NDT), which contains both T4 and T3. There are several versions on the market, but if you start NDT and your GP does a blood test the results will probably really confuse him.

As for iron supplements - Ferrous fumarate is much better absorbed than Ferrous sulphate. Amazon is good for supplements and superdrug sell ferrous fumarate 210mg over the counter. You can take up to 3 a day, and it's good to take it with vitamin C to aid absorption and prevent constipation.

SeasideSusie has posted very thorough information about supplements including B12, which should be much higher than your current levels. (aim for at least 500)

Hope this helps.

[thyroidrose]

Good question Aggle. I also had low iron and hashimotos hypothyroidism and decided to tackle one thing at a time. First I tackled the iron issue by using supplements, eating clams as much as I could, and getting a Mirena fitted which stopped my monthly cycles, and I went from a ferritin of 6 to a ferritin of 40 in about three months. Then I tackled the hashimotos issue although that has taken longer to correct. It’s just now being controlled for the most part by alternating Tirosint 88 mcgs one day with 75 mcgs the next. Hitting this combination took about a year and a half of tinkering.

By doing it this way, I did learn what was caused by low iron - charley horses/restless legs and some fatigue - and what was being caused by thyroid issues.

Not everyone would want to solve 1 issue at a time but for me it did work to keep things a little clearer.

[greygoose]

Given that you have Hashi's, I very much doubt that low iron caused your hypothyroidism. It's the immune system attacking, and slowly destroying your thyroid that is causing your to be hypo. Low iron didn't cause Hashi's.

Self-treating is a solution - but obviously not the best solution, because it means that you will not be recognised as hypo by the NHS. You will forgo your free prescriptions, and have to pay for your thyroid hormone replacement, yourself. This could cause all sorts of problems in the future.

Given that your TSH is almost certain to rise in the future, it might be best to wait, and keep an eye on things with regular testing. In the meantime, you could try a gluten-free diet, which could make you feel better - Hashi's people are often sensitive to gluten - and take some selenium.

[Heloise]

This is probably why you are hypothyroid. You understand this better than your doctor!

youtube.com/watch?v=3_uaUXi...(Not working as expected?)

[Heloise]

Dr. Kaslow explains some of your blood cell results. drkaslow.com/html/blood_cel...

Often this all starts in the gut and there are autoimmune diets you could follow until you heal. Taking digestive enzymes with some meals and Betaine HCL at other meals will help you get the nutrients you need. B12 and vitamin D should probably be supplemented immediately.

[MariLiz]

I think low B12 could be part of your problem, and it will definitely cause extreme tiredness. If we have a thyroid problem we need our B12 to be at the upper end of the scale. As your ferritin and VitD are also low, then it sounds as though you might have problems with absorption.

If you can, get your GP to re-test for B12, ferritin, folate and VitD. Have you been checked out for coeliac disease, as this might explain the poor vitamin levels?

My own B12 was found to be low, and once that was treated I began to feel much better. I was less tired and my energy increased.

Best wishes

MariLiz

[sunflower25]

Hi i also suffered post partum thyroid problems where I had no energy extremely tired all the time and painful l muscles. I continued like this with my third child. After 2.1\2 months i was very unwell, my waist looked like a massive tree trunk with no shape. I used to be a size 12, my weight shot up even tho i hardly ate. I was walking around confused all the time and walked and after like I was extremely drunk even tho i don't drink. I would walk my children home from school each day. 2 month old in pram , 2 year old and 4 year old. I would put tv on for them and I would literally collapse on sofa and was good for nothing I always made sure my babies were ok first. I would do dinner when I came round. I went to my doctor with this problem my hair was calling out with bald patches and my eye brows thinned right out and my skin looked thick and puffy round round my eyebrows ,I was put on 50mcg of thyroid immediately and blood tests taken. My doctor knew my symptoms were dangerous and I could of go e into a thyroid coma at any time. For which there is no coming back from he told me 24 years ago. Luckily he did as I had hashimoto thyroid disease and may not have survived the 10 days of room to wait for blood results. As soon as they were back he increase thyroid to 100 mcg. It took at least 6 seems to start feeling normal again . Plz go asap to your go you need thyroid as thyroid supports so many functions in our bodies. My children started being tested at 12 years old every year and still do now they are grown up as it can be inherited from mother. I wish you well and a speedy recovery. Do Not Leave It To Now To Gp.

[Katherine123]

If it was me...I would get my iron, vitamin D up to a 100 and B12 up to a 1000 and iron mid range and see how I felt after that (took me 4 or 5 months to get these up), yours are all very low which would creates fatigue and lots of other symptoms, hair falling etc, then get thyroid and anti-bodies re-tested again, sometimes after you get iron and B12 up the tsh can return to normal, it happened to me and a few others I know of. xX

[Marz]

Are you now receiving treatment for your thyroid ?

Have tagged a couple of people who can support you with information ...

SlowDragon SeasideSusie