Both my Endo and GP do not see a cause for concern, but I thought a balanced ferritin level was essential for production of thyroid hormones? They say my stores are fine. Any thoughts would be much appreciated x
30 Apr
Serum ferritin 18 ug/l Range 13-150
Serum transferritin 3 g/l Range 2-3.6 g/L
Serum iron level 21.7 umol/L 10-30 umol/L
Transferritin saturation index 28.9% 0-50%
I had a private Thriva test in July, and my ferritin levels were 43.6 ug/L.
Warmest regards
HC x
HypoCrazy
What was the range for your Thriva ferritin test? It's not possible to say if your level has dropped as they can't be compared without the range.
However, this is very low
ferritin 18 ug/l Range 13-150
and for thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.
But we do have to be careful where iron is concerned. Optimal levels for an iron panel are
Serum iron: 55 to 70% of the range, higher end for men - yours is 58% so that is good.
Saturation: optimal is 35 to 45%, higher end for men - yours is 28.9%
Transferrin: Low in range indicates lack of capacity for additional iron, high in range indicates body's need for supplemental iron - yours is 3 (2-3.6) so slightly over half way through range.
So how you go about raising your ferritin level is a difficult question to answer. My suggestion would be to eat liver every week, I managed to raise my ferritin level that way without affecting the other results, but that might not be the case for everyone.
humanbean may have some suggestions if she is around as she is more knowledgeable about iron than I am.
Thank you Susie - you've been most helpful! Do you think Swanson's defatted Argentinian Beef Liver supplements would do the trick? Although if I'm honest, I'd been taking it for several months around the time of the test. I don't like liver! X
HypoCrazy
I don't know, it's not something I've used.
I sometimes take a supplement called Blood Builder which is from whole food. I have been taking 1 tablet a week and my levels are pretty stable.
And one member posted a link to this article the other day
stopthethyroidmadness.com/2...
Thank you for the wonderful link x
Thanks Susie! I will try the supplement you’ve recommended 
Any ideas for sleep? I’m exhausted during the day but when my head hits the pillow I’m completely wired!
HypoCrazy
My sleep is dire. I wish I knew what to do. I am tired, I go to bed, my mind then starts chattering away and I can't stop it. It takes at least 2 hours to get off to sleep, I need the loo once or twice during the night but I can usually manage to get back to sleep OK. I wake up as tired as when I went to bed. It's been like this for as long as I remember.
I've tried all sorts of different things but nothing seems to help.
My dear old dad used to say "sleep on the edge of the bed, you'll soon drop off" 
Sorry I can't help with this 
I’m sorry to hear this. Has this only been since having thyroid issues? Your sleep patterns sound identical to mine
HypoCrazy
I can't remember what I was like as a child.
I have been diagnosed Hypo since my mid-20s (now 70) and I can't remember a time when I haven't had sleep problems.
My late husband used to be able to drop off anytime, anywhere - the typical "sleep on a clothes line" type person. How envious of him I was!
Hello Seaside Suzie,
Thank you for the numerous posts - and references- they have helped me greatly in persuading my Gp to do some different tests to just TSH...
Re sleeping - so important for recovery and maintenance - I can only suggest something that never fails to work for me... headphones and a well read story off i-player or one of the book apps.... the quality of the voice makes a huge difference ( a bit like Stephen Fry reading the telephone directory ) - touch wood hasn't failed me yet. As I have a back injury I have to sleep on my back anyway, so no crushed ears....
I'm not keen on liver but buy some pate now and again - with as long a use by date as possible. Can't manage much at a time and often waste some but it's not that expensive
HypoCrazy
In someone whose body can metabolise iron correctly (and most people can), the body will transfer iron from the bloodstream (i.e. from serum iron) into storage (i.e. into ferritin) and back again as required.
If you aren't absorbing enough iron from your food then the body will do its best to maintain healthy levels in serum iron, while ferritin starts to suffer.
SeasideSusie refers to this process as ferritin being the pantry and serum iron being what you're about to use. In the April results your pantry is getting short of iron, but your bloodstream is doing well to maintain your serum iron levels.
What can happen to some people is that the body is poor at shuttling iron backwards and forwards between serum iron and ferritin and one of two things happens :
a) Too much of the available iron gets stored in ferritin, and there is not enough in serum iron.
OR
b) Too much of the iron gets stuck in serum iron and not enough is put in ferritin.
At the moment there is no evidence that you have either of the problems described in (a) or (b).
However your pantry has too little ferritin and needs more supplies, so you have to boost your iron intake.
If you do this it is essential to check iron levels fairly frequently (every 6 weeks to begin with) because with more iron available to your body, it is possible that problem (a) or (b) may occur and then you would have to stop supplementing and try and work out why the process of shifting iron from serum iron to ferritin is not working as well as it should.
Usually problem (a) or (b) becomes clear fairly quickly after starting to supplement - either ferritin shoots up massively or serum iron does. But assuming this doesn't happen, eventually your serum iron may rise, but not dramatically, and your ferritin will go up at a rate that is consistent with your ability to absorb the iron you take in.
To test iron this test is a good finger-prick test that can be done through the post :
medichecks.com/iron-tests/i...
Medichecks has fairly frequent special offers on, so watch out for those.
And a paper worth reading :
ncbi.nlm.nih.gov/pubmed/227... (Abstract only)
cmaj.ca/content/184/11/1247... (Full version of paper above)
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Edit : Please note that I'm not a doctor and have no medical training at all. So my interpretation of what happens with iron metabolism could be wrong.
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Thank you HB - you are sooooo much better at explaining iron than me
Thank you, SeasideSusie.
I should have made clear to HypoCrazy though, that I'm not a doctor and have no medical training at all! So my interpretation of what happens could be wrong. And in fact I'm going to edit my post to stick that on the end of it, for anyone who reads it later.
Dear humanbean
Thank you for such a thorough explanation of iron. I’ve never managed to find as good an explanation online or through any GP as yours! Much appreciated x
P.S. please let me know if you have any experience of using Beef Liver supplements!
I've never used Beef Liver supplements. I do eat liver occasionally.
I'm lucky in being able to tolerate ferrous fumarate 210mg and I take this as a way of maintaining my levels.
When I was actively trying to raise my iron and ferritin levels I was taking one tablet, three times a day, but it took a long, long time for me because I absorb iron so slowly. Now I take one tablet, three or four times a week to maintain my levels.
Did you find FF raised the two levels? So perhaps not a suitable supplement for those just wanting to raise their ferritin? 🤭
I have never heard of a way of dictating where supplemental iron goes.
If I was to take ferritin supplements it would raise my ferritin levels. But if my body decided it needed more serum iron it would just take it out of my ferritin.
If I take iron supplements of any kind it would end up in the bloodstream as serum iron, but wouldn't stay there very long at all if it was not required there. It would get transferred to ferritin very quickly.
The body is in control of determining the proportions of ferritin and serum iron someone has. If those proportions are not healthy i.e. very low serum iron with very high ferritin, or very high serum iron with very low ferritin, then things get more complicated. You'll have to cross that bridge if you come to it - but if it does look as though that situation is arising then don't keep supplementing. Stop, and try and fix the problem without poisoning yourself with iron.
People just have to experiment with different ways of getting iron into the body to find out what dose and what type they can tolerate. Some people may take ferrous fumarate (like I do), or eat liver (which I do sometimes as well), or take ferrous sulfate (which I can't tolerate at all but some people can), or take ferritin supplements (which I've never tried) or haem / heme supplements (which are very expensive and I've never tried either). I haven't listed all possible iron supplements, there are quite a few others.
Just as an example of what can happen... My body tends to keep serum iron too low and pushes a lot of the iron I supplement into ferritin. This is a fairly common problem and usually happens when people suffer with inflammation. The gut is a common place where inflammation can occur, and this is where I think my problem occurs. But years of trying to improve my gut health hasn't made much of a difference to the proportions of serum iron and ferritin I have.
I have decided to live with the problem by raising my ferritin to optimal and doing my best to keep it there (I haven't found it easy because it fluctuates quite a lot), and just living with rather low serum iron. My iron saturation is quite low too. I wouldn't want to raise my serum iron to optimal and live with very high ferritin because that causes damage of its own.
Thank you HB. You seem to be a guru on all things iron related
Do you know if ferrous fumarate raises serum iron? Or ferritin? Or both? As I'm just looking to raise the latter. Sorry for all the questions!
Iron supplements can't be classified as raising just ferritin, or just serum iron. Your body will do with it what it wants. You take iron and hope that your body sorts it out in the way that you want it to.
Person A could take iron in a certain form and it will raise their ferritin. Person B could take exactly the same supplement and it will raise their serum iron. Person C can take exactly the same supplement and it will raise serum iron by a small amount and ferritin by a lot. Person D could take exactly the same supplement and it will raise ferritin by a small amount and serum iron by a lot.
Your body decides what it will do with iron supplements of all kinds. It will shift any iron it has access to into and out of serum iron and ferritin as it pleases. It is this uncertainty that means iron must be tested frequently when supplementing, because you can't assume that it is going where you want it to.
Eating liver once a week should help improve levels
What about vitamin D, folate and B12 results?
Hey Slow
My Vitamin D levels in July were 96.0 nmol / L (Range 50-200)
Folate 25.1 (Range 8.83-60)
B12 536 pmol/L (Range 250-569) But this is often even higher.
Do they sound ok? x
Folate is on low side. Supplementing a good quality vitamin B complex may be of benefit. One with folate in not folic acid
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Thanks Slow.... I sincerely appreciate your advice Let me know if you have any advice for sleep - I am exhausted by day but when my head hits the pillow I am wired and cannot sleep until 2am!
Magnesium is important, especially when supplementing vitamin D
Good B vitamins. A good quality daily vitamin B complex
Good levels of FT3 as well
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. If also on T3 or NDT make sure to take last dose 12 hours prior to test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
Is this how you do your tests?
What are your TSH, FT4 and FT3 results ?
Gluten free diet essential for me too (I have Hashimoto's)
Hey Slow
Is TSH lower or higher at lunchtime than in the morning? My last bloods were done at midday this week and I did fast however. They were:
Vitamin D 132
T3 4.1
T4 18.9
TSH 2.5
I’m not sure of the range as I got my results over the phone GP says vitamin D is too high and asked if I was supplementing (I am).
Let me know your thoughts. Much appreciated x
Are you in the UK?
Usually in UK range is
Under 25 deficient
25-50 insufficient
50-75 adequate
75-200 good
Aim on here is around 100nmol
So yes you probably want to reduce to maintenance dose (trial and error what that is)
GP will probably think anything over 75 is high
You need ranges - ask for printed copy with ranges on
TSH likely too high
FT3 looks low
TSH would be higher early morning
Yes I'm in the UK
Thanks SD. I've been told my T3 is 'in range' but the UK range for T3 only starts at 4.0 so I'm perceiving this to be very low...
Yes, then FT3 is too low.
What is top of range? If range is say 4-6.5 likely to need FT3 near 6
TSH is too high.
How much Levothyroxine are you currently taking?
Perhaps push for 25mcg dose increase in Levothyroxine
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
See box
Thyroxine replacement in primary hypothyroidism
pathology.leedsth.nhs.uk/pa...
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Thank you Slow. I’m on Levo 75 but I’ve got 100 ready to start, I’m currently 5 weeks in to the 75s.
I’m not sure of the range as it’s not stated on my printouts from the doctor Is the NHS range standard? I am in Northern Ireland.
No you have to assume every lab has slightly different ranges
Ask for print out of results including ranges
Hey Slow
I popped into my GP so I could get the ranges for you. I am curious to know your opinion
T3
August 4.1 pmol/L (3.1-6.8)
July 4.0
May 4.2
Warm regards
HC X
Most people would find that far too low
Many need it at least above 5, or near 5.5
Slow do you know any ways for those of us who are poor converters (Hashi's) to raise T3, besides taking T3?
Getting Vitamin levels all optimal
Selenium supplements can help improve conversion
Strictly gluten free diet
Soya free diet including soya lecithin
Get Levothyroxine dose high enough to bring TSH down to around one and FT4 towards top of range
If, after all that FT3 is still low, then look at adding small dose of T3
DIO2 gene test may help at this point in getting NHS prescription
(See my profile)
Thank you Slow!
I have found magnesium Glycinate to be very very good for my sleep, as well as other things.
Went on holiday without it, first week did not sleep well (& had other problems). I ordered it & my second weeks sleep (& other probs were) was so much better. Really don't know what I'd do without it. I use Pure Encapsulations Mag Glycinate.
Thanks Paula. For some reason when I took magnesium (citrate) my sleep was dreadful Is this common for those with problems absorbing vitamins and minerals? X
I know citrate is supposed to help with sleep, I've never tried that form. I tried malate but found glycinate suits me the best thus far. The Pure Encapsulations isn't stuffed full of fillers. People are known to react to fillers. It's more expensive but more pure and it works for me. There are other great brands such as Jarrows, Bio-calm, Now Foods, Thorne, Better You, Cytoplan (which I know Seaside Susie likes🙂)
With regards absorption you need to heal the gut from leaky gut (literally holes in the gut) particularly if you have Hashimotos (which a lot of hypos do have ).
I take a pro & prebiotic blend that's combined with enzymes and the all important L-glutamine which actually helps repair the gut. I use kefir (contains probiotics) on my cereal but you can drink it, I buy mine from Sainsbury's. I gone gluten free, which I have felt better from.
Hashi sufferers benefit from spray vitamins as they bypass the gut thus absorbed into bloodstream. I use Better You B12 spray and used their spray Vit D combined with Vit K2-Mk7. It's important to use VitD's co-factors.
Plug those leaks and absorption issues will be vastly improved. Vitamins, minerals and hormone treatments will get to where they need to and you'll start to feel better.
It all takes time & research. I've found the search bar really helpful and any links that people send to me.
I can't send links unfortunately! I hope that helps 😊
Blood test results
Low ferritin help
Back to feeling awful : < - do these blood tests mean anything?
Results help please
Iron results 
