Hypothyroid - low serum iron and saturation, bu... - Thyroid UK

Thyroid UK

130,644 members153,951 posts

Hypothyroid - low serum iron and saturation, but normal Ferritin

ak_83 profile image
6 Replies

I am hypothyroid and already have a post about what I'm doing:


In this post I would like to ask a separate question around my iron panel.

My iron panel and optimal results as suggested by Stop The Thyroid Madness (STTM)



Serum Iron: 12 umol/L ( 10 - 30 ) - Should be 25+

Ferritin: 101 ug/L ( 30 - 500 ) - 110 - 120

Transferrin: 2.5 g/L ( 2.0 - 3.2 ) - unsure

Transferrin Saturation: 19 % ( 16 - 45 ) - Should be 38% to 45% for men

My doctor does not want me to go on the iron supplementation as my Ferritin is near the top end of healthy range. According to STTM, the low iron panel, but high/normal Ferritin means inflammation, which is most likely due to being in hypo state for quite some time (decades).

My question is, do people here support the view of my doctor and that of STTM? Do you think I should exhaust other treatment options and then retest the iron panel again to see where I am.

So for example, if my Serum iron and % Saturation are still low as above AND my Ferritin goes down to say 60 (like it was several years ago), then I could try supplementing with Iron? In this example I would have enough Ferritin room to play with.

Another view could be that I ignore Ferritin and just try to lift the Serum iron etc and hope that it makes me feel better overall and eventually this would actually correct my inflammation and hence lower the Ferritin?

6 Replies
Heloise profile image

You are finding out just how complicated this condition can be. It is all about the inflammation which can be caused by infections, parasites, gluten, dairy or anything that irritates your gastrointestinal system. Iron is tricky. Implicated in cancers for sure and one doctor said if you can't get enough from food you would have the same problem with supplementing. I don't even know if you can be in a sympathetic state (fight or flight) if you don't have cortisol but usually that is the case when we have an autoimmune condition. Is that you? If only there were functional doctors who understand all the nuances of a perplexed immune system.

You could go to a basic check of your metabolism by taking your temperature and pulse three or four times per day. I think it's the best indicator .

Baobabs profile image
Baobabs in reply to Heloise

It never ceases to amaze me the quality of advice and support given on this forum! So much superior to most of the twaddle dished our by Endos and GPs. Well done Heloise.

Heloise profile image
Heloise in reply to Baobabs

Thank you, Bb. The more I learn the more complicated it becomes. I wish there were better tests and more of them but it always seems out of reach. The human body is remarkable though and carries on in spite of it. I have to say the research is amazing. I'm working on this right now. ncbi.nlm.nih.gov/pmc/articl...


humanbean profile image

Serum Iron: 12 umol/L ( 10 - 30 ) - Should be 25+

Ferritin: 101 ug/L ( 30 - 500 ) - 110 - 120

Transferrin: 2.5 g/L ( 2.0 - 3.2 ) - unsure

Transferrin Saturation: 19 % ( 16 - 45 ) - Should be 38% to 45% for men

Your ferritin is currently 15% of the way through the reference range. If I've understood you correctly, you think the healthy range for ferritin is 110 - 120 (17% - 19% of the way through the range you've been supplied with i.e. 30 - 500), based on information from STTM.

STTM annoys me immensely when it refers to "optimal" levels or healthy levels of various things. The site often doesn't mention units of measurement and it also doesn't state which reference ranges are being used when stating absolute numbers which are allegedly "optimal".

Supposing we do tests for substance X. The result is 10. The units of measurement aren't stated, and neither is the reference range. Let's suppose that the ref range is actually 1 - 8. Then the result is over the range. You would come to different conclusions if the reference range was 8 - 20 or 8 - 50 or 5 - 100 or 5 - 15 or 20 - 40. The reference range always matters! Somebody can't say the optimal range is (for our mysterious substance X) 12 - 15 and not tell you anything else!

There is a huge difference in how people will feel with a ferritin level which is 2% of the way through the range, or 98% of the way through the range, or 50% of the way through the range.

I find it almost impossible to believe that the healthy range for ferritin in males is only 17% - 19% of the way through the reference range you've been given. This is suggesting that 81% of males whose results fall in the reference range have unhealthy levels - and I simply don't believe it.

When people ask about optimal levels for iron and iron-related measures I give this link :


I can't remember where the number came from, but on this forum there are many people (including me) who believe that ferritin should be mid-range or slightly higher. But these numbers are usually suggested for women. The medical profession is quite happy to keep menstruating women a bit anaemic. For men and post-menopausal women an optimal level of ferritin may be a bit higher. But whether that decision has been reached just because men and post-menopausal women have higher ferritin levels than menstruating women, I simply don't have a clue.

According to the link above, an optimal level of serum iron for you would be 55% - 70% of the way through the range, which comes out as an optimal level of 21 - 24, with the best result for men being closer to 24 than 21.

So, I think you are hoping to get your serum iron too high in range for good health. And I think your aim should be to get ferritin closer to mid-range which is 265 for the range you've supplied.

My personal, and untrained, opinion is that you need to get your ferritin higher than it is, and your serum iron. Your transferrin saturation is way too low. But you don't want any of these numbers to go over the optimal.

I have iron problems. I aim to keep my ferritin at mid-range or slightly higher. When I reach this level my serum iron and transferrin saturation are still too low for comfort. But I'm not prepared to push my ferritin over optimal to get my serum iron and/or transferrin saturation to the optimal. I would also say that if I got my serum iron to optimal and my ferritin was still too low I wouldn't push my serum iron above optimal to improve my ferritin.

Heloise profile image

I had a phone call and was interrupted but just wanted to add that Broda Barnes was a man who taught us a lot about metabolism. His take on thyroid hormone and prednisone:

Barnes treated hypothyroidism by prescribing patients a daily dose of thyroid hormone. He recommended starting with a small dose, and then slowly increasing the dosage in monthly intervals until symptoms resolved and waking body temperature was between 97.8F and 98.2F. He also recommended never surpassing 3 grains of desiccated thyroid. For most patients, he recommended continuing thyroid medication for life at that optimal dose, though some could be slowly weaned off.[5] Barnes used a desiccated thyroid extract, Armour Thyroid, almost exclusively, based on his anecdotal observation that it was superior to synthetic hormones.[5]

During his years of practice, Barnes also began to believe that virtually all his hypothyroid patients had concomitant undiagnosed adrenal insufficiency. Based on this speculation, he routinely prescribed an accompanying dose of the synthetic corticosteroid prednisone. Barnes argued that it was mandatory to give prednisone to patients with a systolic blood pressure below 100.[3][5]

I don't know if autoimmune disease was as well known back then.

jgelliss profile image


WOW !!!! THANK YOU For Sharing !!! Always Great Informative Information's .

You may also like...