I have posted here once and had one reply but I still need advice about iron and would be grateful if anyone could help.
I now realise my ferritin has been consistently low since 2015. (Not looked at earlier results). I understand from various posts on here that this should be in the upper part of the range or it could affect thyroid hormones. Am I correct? If so, I want to address this before going further into T4 or T3 treatment (my previous post mentioned low FT4, FT3 and TSH)
My MCHC levels have always been below the range but. I don't know if this is important (I have read elsewhere that this relates to concentration of haemoglobin in blood cells but haven't seen this mentioned on this forum and my GP says they ignore it).
Could anyone advise on the best type of iron supplement and suggested dosage for addressing the low ferritin issue? Does anyone know about MCHC?
I suspect that the reason your doctor is ignoring the MCHC being low is because your haemoglobin is in range so you are not "officially" suffering from anaemia.
The World Health Organization defines anaemia as:[1]
Haemoglobin (Hb) <13 g/dL in men over 15 years old.
Hb <12 g/dL in non-pregnant women over 15 years old.
Your haemoglobin is 123 g/L which is equivalent to 12.3 g/dL.
Despite this it is acknowledged by some researchers that low levels of ferritin can cause fatigue even without anaemia. See this research paper on the subject :
Please note that, very annoyingly, the paper above doesn't give a reference range for ferritin (that I could find). There is a big difference between how the patients feel with the following levels. The two different reference ranges are both in common use in the UK :
Serum ferritin level 46 ug/L [15.0 - 150.0] (23% of the way through the range)
Serum ferritin level 46 ug/L [30.0 - 400.0] (4% of the way through the range)
Doctors often pay no attention to the reference range - they just care whether the patient is in or out of it - but even then some of them ignore ferritin when it is below range because the thought seems to be "that's close enough".
To increase ferritin you would need iron supplements. If your doctor was to prescribe, the options available to them are described on this page - look at the list of names down the right hand side and read the description - click on each name for further info, including dose - note you need the therapeutic or treatment dose, not the prophylactic dose :
Please note that it is the dose and iron content of the pills that you need to worry about, NOT the brand I've given a picture of above.
Ferrous sulfate 200mg has about 65mg iron per pill. Ferrous fumarate 210mg has about 69mg iron per pill. Ferrous gluconate 300mg has about 35mg iron per pill.
The most often prescribed form is ferrous fumarate 210mg. It comes in boxes of 84 tablets. At a maximum dose of 3 tablets per day (don't exceed this dose) this would last 28 days.
Ferrous gluconate is almost never mentioned on the forum, so I don't know how well it is tolerated. Personally I used ferrous fumarate 210mg, 1 tablet, 3 times per day. I had to take it with food in order to tolerate it. Some people do okay with ferrous sulfate.
All the supplements I've mentioned can be bought at pharmacies in the UK without a prescription, although it is up to the pharmacist whether they agree to sell it or not. (Just try another pharmacy chain if one refuses to sell to you. I've bought from Lloyds and Tesco Pharmacies in the past with no difficulty. It is also possible to buy these supplements online.
You really need to test iron and iron related levels regularly if you are supplementing. Overdosing on iron is poisonous, and the body has no way of getting rid of excess iron, and in some cases people with high levels of iron have to have blood taken (therapeutic phlebotomy) to get rid of it.
You can do your own finger-prick tests through the post. This is a good one and is not outrageously expensive :
Ferritin needs to be roughly mid-range or a little bit over.
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Ferritin/iron is often low in people who suffer from gluten intolerance, coeliac disease or other gut issues. If you aren't already eating a 100% gluten free diet then you could try it for 2 or 3 months to see if it improves your iron absorption.
It would be a good idea to get more info on your iron by doing the Medichecks test I mentioned in my previous post, before you think of supplementing iron. There is a possibility that your serum iron and/or transferrin saturation are already high, despite the low ferritin. If that is the case then supplementing iron isn't a good idea for various reasons, and you may have to treat other vitamin levels before treating your iron.
So, do the Medichecks test first, then post the results and ask for feedback.
You might find what I posted in this post useful :
Humanbean thanks so much for your informative replies and all the links. I’ve had a good read through it all today and will be doing as you suggest. It’s such a help to have some guidance.
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