High Ferritin!

[patez]

Hi again everyone.

As some of you already know, I am still "chasing" my health issues!

I took advice from those of you who very kindly responded, and ordered further blood tests for Vit D, ferritin, folate, TPOaB and TPGaB?

I have to wait another 7 days or so for the folate and antibody results, but I got the Vit D and ferritin results today.

Vit D was fine at 74.9 ng/mL (sufficiency 30-100 ng/mL)

Ferritin is 789.2 H ug/L (range 30-400)

Ferritin is obviously pretty high! Not high enough to require phlebotomy (from my research phlebotomy is usually only done if ferritin is above 1,000?), but that level is concerning nevertheless!

I know that high ferritin can be caused by many things, but I would like to ask if it is an indicator of being hypothyroid?

I have seen references that say that high ferritin is linked to hyperthyroid, but info is very sketchy about any link to hypothyroid!

I have discounted the main causes of high ferritin (liver disease or cancer) because I have had full liver function blood tests done, and a liver ultrasound done, with no abnormalities, apart from a very mild fatty liver detected. I suffer with trying to control my weight, so I do not have a weight loss problem associated with either cancer or liver disease!

As those of you who already know me, I am very symptomatic for hypothyroid, although my thyroid test results are "in range".

I will post them again, for anyone who may not have seen my previous posts.

FT3 2.62 pg/mL (range 1.40-4.18)

FT4 11.39 pg/mL (range 8.90-17.20)

TSH 1.55 mIU/L (range 0.30-4.5)

I am not taking any thyroid medication.

From what I understand, FT3 at 44% of range, FT4 at 30% of range, and TSH at 30% of range, is not "normal"? Or is it?

In conclusion, lowish FT3, FT4 and TSH, with high ferritin, what is your opinion?

Patez

[Foggyme]

Patez. I understand that you have just finished taking what you previously refer to as high dose iron supplements. This is the most likely cause of your extremely high ferritin levels.

Also - some time ago you were taking 750mg potassium tablets daily...this is a high dose unless you have a proven deficiency and know that you need it. Worth searching the internet to check on side-effects. Potassium levels are finely balanced and you may well be over-supplementing with potassium if you’re still taking these supplements.

I also note that you have previously been taking a high dose B complex (which may contain a potentially hugh dose of vitamin B6 - sometimes 300%+ of the RDA). In addition, if you are still injecting Neurobion as your form of B12, this also contains vitamin B6...so you may well be triple dosing (or above) on vitamin B6. Vitamin B6 is finely balanced in the body and even a small but regular over-supplement can result in neurotoxicity and potentially cause irreversible neurological damage.

I say this within the context of advice previously given on this forum which appears to lean towards you not having a hypo or hyperthyroid problem.

I make no claim to understand how vitamins and minerals pertain in thyroid issues but am saying this so that you can consider whether or not over-supplementation with various vitamins may be one potential cause of some of your symptoms (as per your excessively high ferritin levels due to over-supplementation with iron)....something that has been explored with you before on the PAS forum.

But of course please just ignore this if you no longer take large doses of various supplements 😉😀

Hope you find some answers.

P.s. It's also worth noting that most vitamins and minerals have the potential to interact with other medications, which I believe you do take. This is a good reference site if you want to check for potential interactions between your current medications and any vitamins and minerals that you may be taking:

drugs.com/drug_interactions...

👍

[patez in reply to Foggyme]

Hi.

I misread an article, which suggested that taking iron supplements would not effect ferritin levels, so I had discounted that as a reason? Apparently it does though! That could well be the reason for the very high ferritin!

I stopped taking the potassium a long time ago. I only took it when I was taking loading doses of B12 (on advice I received on here).

I only take the B complex occasionally, for short periods, mainly for the B1, just to be sure that my B vitamins are optimal. Yes I am aware of the fact that B6 can be overdosed on, which is why I do not take the B complex regularly.

I do carefully check possible interactions before taking any supplements or medication.

I am currently only taking the essential medicines I need and have been prescribed. 2 x 0.5 mg Clonazepam for the anxiety disorder and panic attacks, 1 x 40 mg propranolol to treat recently diagnosed essential tremor and unsteady gait, 1 x 0.4 mg Tamsulosin to treat recently diagnosed enlarged prostate.

I have just stopped taking the prescribed statins for now, to see if those are causing me problems.

Docs are at a loss as to why I am suffering badly with poor memory, fatigue, tiredness, insomnia, poor coordination, heat intolerance, weight gain, high cholesterol, balance problems, tinnitus, dry skin, depression, anxiety.

I will post my TPOaB and TGaB results when I get them in about 5 days time, if they show anything!

Thanks for your support and advice.

Patez

[Foggyme in reply to patez]

Just a thought...have you had autoantibodies screened for potential underlying autoimmune condition (other than PA and Hashimoto's). Autoimmune conditions tend to arrive in clusters so worth looking at if not done already.

Good luck Patez 👍

[patez in reply to Foggyme]

Hi.

Nope!

I doubt if the local hospital would even know what that is! LOL!

The local lab technician had never even heard of TPO and TGaB thyroid antibody tests, and had to phone around to find a hospital that could do those tests! That hospital is 1,000 kms away, but they did send the sample to that hospital.

At the moment I am taking it one step at a time, eliminating what it isn't that is making me so ill, and then move onto the next step, as and when finances allow!

Thanks again for the advice, and more importantly your support. Means a lot to me to have someone like you to keep my morale up.

Patez

[Foggyme in reply to patez]

Morale's a tricky thing when feeling so unwell and when medical help is scant. Keep it up Patez.

With your history of autoimmunity...May be a prime candidate and somewhere to look for answers (in the UK following initial autoimmune screen (ANA etc.) Investigations would be done by a rheumatologist - though understand this may be difficult where you are.

Very best of everything.

[patez in reply to Foggyme]

Hi.

I will tell you a story, something that happened very recently, which may explain how bad things are in the healthcare I have to put up with out here in Oman, probably doctors who do not even have any accreditation, or may not even be doctors at all?

2 weeks ago I sliced a finger quite badly (a little bit to do with my lack of coordination?), requiring stitches. Local doc seemed to be quite confused about which size/type of suture to use? Anyway! Stitches were removed (with an awful lot of pain, and I nearly fainted, and actually vomited). As the scar was healing, I noticed that "something" was "catching" my clothing, and on close inspection of the healing wound, there was still 1 suture sticking out! I pulled it out with a small pair of pliers! That hurt! LOL! That is just an example of the very minimal healthcare out here! Doc can't even remove sutures properly!

I have noted what a lot of people have said on here, and you are one who I have found that I can trust.

There are "trolls" on here, that is very obvious! One person suggesting that my health issues are because I cook with non stick pans!

Thyroid issues are complex! I know that my TSH, FT3 and FT4 are not conclusive of hypothyroid, but I will quote this from the endocrineweb.com website, who are reputable?

"In other words, some patients with very "mild" deviations in their thyroid laboratory test results will feel just fine while others will be quite symptomatic. The degree of thyroid hormone abnormalities often, but NOT ALWAYS will correlate with the degree of symptoms."

My personal opinion, and feel free to correct me if I am wrong? My TSH and T4 are both at 30% of range, but I see so many posts of the "optimal" levels of a lower TSH than mine, and T4 in the upper range?

I firmly believe that I am hypothyroid, from symptoms, and low T4 and low TSH, suggests the most probable cause being pituitary related?

And a pituitary and/or thyroid disorder can cause high ferritin?

All I really know is that I am feeling very poorly, and seeking solutions!

I will post my antibody results tomorrow.

Patez

[Foggyme in reply to patez]

Patez. Sorry about the finger.

Trolls - Admin here are usually very good at keeping them off and out.

No idea about the pans but some do think that coating is not good for some with sensitivities or intolerances...and some say cook with iron skillets to improve iron levels (that's true - on PAS website as advice - and look up 'iron fish' 😉).

Really sorry but I'm a thyroid dunce so can't comment about thyroid issues...just popped in to help with ferritin / potential supplement issues.

Your post is getting old and slipping down the page now so suggest a new post when you post your antibody results - more people will see it.

Good luck with the results 👍

[ShootingStars in reply to Foggyme]

Hi Foggyme. How do you know that he is not hypothyroid? He has the symptoms: poor memory, brain fog, weight gain, fatigue, tiredness, insomnia, poor coordination, heat intolerance, weight gain, high cholesterol, balance problems, tinnitus, dry skin, depression, anxiety. These are all hypothyroid symptoms.

His FT3 is only at 44%, while his FT4 is at 30%. Both of these levels are below mid range and nowhere near optimal. I am not surprised he has all of his hypo symptoms with those lowish levels.

When I was first diagnosed, my FT3 was 36% and my FT4 was 31%. My TSH was 1.6. Would those numbers make you think that I was not hypothyroid either? I never had weight gain. At the time of diagnosis, I did not have brain fog either. I had fatigue, anxiety and an overall feeling that I was not well. That's it. Oh, and I also had my antibodies tested at the same time. My TPO came back at over 1000 (0-60). My at the time was an i.dio.t. He did not think my FT3 and FT4 were a problem. He had no idea why I had the symptoms that I had. He said that I didn't need medication.

Guess what happened. Within a month I became even more sick. Major brain fog, very low body temperature, cold intolerance, heat intolerance, fatigue beyond comprehension and I could not stay awake. At the second month, pain throughout my whole body started. By the third month, I could not move. My entire body ached to the point of making me very nauseated.

Five months after diagnosis, I finally got a new doctor who ran all my tests again. My FT3 was 31%, My FT4 was 1.5%, my TSH was almost 8 (0.40-4.00). My TPO went up to >6500. All that in only five months.

[Foggyme in reply to ShootingStars]

Hi ShootingStars. I don't.

Popped along to help with ferritin question and potential over-supplementation issues, together with possibility of underlying autoimmune condition (based on previous history / past discussions with Patez in another forum).

Couple of extracts from my replies above...

I say this within the context of advice previously given on this forum which appears to lean towards you not having a hypo or hyperthyroid problem.

In other words, the advice I’ve seen from others here in this forum, but not from me, because as stated to Patez, (as per above)...

Really sorry but I'm a thyroid dunce so can't comment about thyroid issues...just popped in to help with ferritin / potential supplement issues.

So...no advice about thyroid from me gov 😉😀. I'm a self-confesses thyroid know-nothing...🤷‍♀️😢😢...

The thought of thyroids sends shivers down my spine...terrifies the life out of me 😐😀

[ShootingStars in reply to Foggyme]

Hi Foggyme. Sorry, I read that as you'd given the previous advice. Thanks for the correction.

[Foggyme in reply to ShootingStars]

Not so much a correction ShootingStars...more of a hands in the air moment...a not wanting to step on thyroid toes (or into thyroid shoes)...'cause...grief...what a clod hopper I'd be 🤣🤣🤣🤣🤣🤣

[ShootingStars in reply to Foggyme]

Hey clodhopper! What out for thyroid nodules, too! You don't want to step on those either!

[Foggyme in reply to ShootingStars]

Oh grief...🤔🤔🥴...👀👀🥾🥾🥾🥾

[patez in reply to ShootingStars]

Hi.

I have just received my antibody test results today. Negative though!

I totally agree with you though that my percentage of "range" is "unusual", and suggests central hypothyroidism, possibly due to a pituitary problem?

Yeah! Symptoms! I totally agree with you!

I am currently being treated for some of those symptoms, but It is not really helping much!

For your info, I have been prescribed Propranolol, to treat the essential tremor, which is also a symptom of being Hypo?

I do not believe in the "in range" either!

Fine balance between very symptomatic and " in range" eh?

Patez

[ShootingStars in reply to patez]

Hi patez, That is wonderful! Lucky you! Can you post your numbers and the ranges? Some people on here have talked on about how people can have negative antibodies and still have Hashimoto's. For the people who believe in that possibility of antibody negative Hashimoto's, how do they make that diagnosis? I'm surprised that some of them with their knowledge about such a subject haven't suspected that this could be a possibility for you considering your symptoms and lowish in range thyroid hormone levels.

Lowish TSH and low FT3 and low FT4 usually mean Central Hypothyroidism, which can be caused by a pituitary or hypothalamus problem. You said in an earlier post that you don't have any pituitary signs. Yes, you possibly do. TSH is a pituitary hormone, not thyroid. If you had your current levels of FT3 and FT4 and your TSH was high in range, then people would be screaming hypothyroid. Central Hypothyroidism is commonly misunderstood. It confuses people to see a decent TSH level, and lowish FT3 and FT4. Yours are not super low, but they are low enough to cause symptoms in some people. If there is a pituitary problem, the body will think it's T4 and T3 levels are good, and will not send out a message (TSH) to make enough so that you don't have hypo symptoms. As a result, metabolism slows down. Your TSH is lowish and your thyroid hormones are nowhere near optimal. Top that off with the list of your hypo symptoms. Central Hypothyroidism is a possibility. Have you ever had any car accidents, sports accidents, or head or neck trauma? These can cause Central Hyothyroidism, or you can just have a faulty pituitary or hypothalamus.

I am hypothyroid, have Hashimoto's and Central Hypothyroidism. My TSH has been lowish my entire life. It ranged from I think as low as .6 and as high as 1.8. This is very confusing to doctors and patients who have such acceptable TSH and low thyroid hormones.

Tremors are not a symptom of hypothyroidism. Tremors and gait abnormalities are a symptom of Hashimoto's Encephalopathy, as well as other causes.

Do you have any swelling in your neck?

How many milligrams of iron were you taking every day? How long ago did you start and are you still taking it?

[patez in reply to ShootingStars]

Hi.

My antibody results are:

TPO 0.27 IU/mL (Range less than 5.6)

TPG <10.00 IU/mL (Range less than 115)

Folate was 14.01 ng/mL (range 4.6-18.7)

I was taking a total of 540 mg of ferrous sulphate daily (in 2 doses) for a period of 2 months, and stopped taking them just over a week ago.

No noticeable swelling in the neck.

The tremors and unsteady gait (Ataxia?) are much improved after starting taking the propranolol, but it comes and goes in "waves".

Still suffering badly with the poor memory and lack of coordination and the general "feeling unwell"! So fed up with the tiredness and my "disconnected" legs! Not to mention the really annoying tinnitus!

I have just started taking Thyroid-S, 1/4 grain in the morning (day 2 today), as a trial. Increase by 1/4 grain every 2 weeks until on 1 1/2 grains, and then get tested again. Why Thyroid-S? 2 reasons really. One reason is because I tried Merck Euthyrox but had a bad reaction to that after only 2 days (racing heart and BP all over the place)! The other reason is that I have read a lot of posts on here from people who have done very well on NDT, and it is faster acting? I have been advised to monitor my BP and temperature, which I am doing. As an aside, I have noticed that my basal temp is quite low (between 35.4-36.4 degrees C)?

I am leaning towards a pituitary problem, but can't afford the CT/MRI scan!

I am in total agreement with you that my thyroid function test results are a bit "unusual"! All 3 lowish in range!

Anyway, fingers crossed for the Thyroid-S!

Thanks again for your support.

Patez

[Fruitandnutcase]

Gosh, I thought mine was high at 175!

The doctor’s report that comes back when I get my blood test results suggest it could be inflammation of some sort which considering I have several autoimmune conditions is probably right. I’m in remission from Graves Disease which is hyper active thyroid with antibodies so I’m not sure about hypo.

Do you have autoimmune conditions of any sort that could be causing inflammation? Have you spoken to your doctor about your results and mentioned the possibilities of haemochromatosis? That can be a cause raised ferritin. I would have donated blood which would have reduced my ferritin but unfortunately I can’t because I take Hydroxychloroquine which is annoy8ng because I would like to have donated over the Christmas period when they were appealing for donors.

Once you get all of your results back post them on here and hopefully people will be able to help you.

[G2G2]

Agree with Fruitandnutcase it could be due to high inflammation. Mine's high & my doctor attributed it to inflammation. Have you had a CR-P lab?

[patez in reply to G2G2]

Hi.

Thanks for the advice.

No I have not had a CR-P done. Never heard of it until you suggested it, and it does seem to be a very relevant test to have done.

I will find out the cost and decide! Cost is a factor in my on-going diagnosis of what is wrong with me!

I have to pay out of my own pocket for tests! 200 km round trip to go to a hospital that can even do FT3 and ferritin! Local hospital can only test TSH and FT4, and cannot do antibody tests! Not easy!

May I ask what your inflammation was and how it was found? CR-P only shows that there is inflammation "somewhere" in the body!

Patez

[Foggyme in reply to patez]

Hi Patez. Based on our prior conversation about autoimmunity...CRP and ESR can be raised in inflammatory conditions, autoimmune conditions being some of the prime candidates.

If CRP and / or ESR are raised, then whoever your doctor is should want to investigate...and at this point (under usual circumstances) autoantibody testing would be done...and then to rheumatologist for further investigations and tests if these are positive. Though goodness know how it works where you are 🤔.

👍

[ShootingStars in reply to Foggyme]

They can. Or you could be like me who has had some major autoimmune issues, very very high antibodies, joint swelling, major muscle recovery problems, but my CRP and ESR have always been normal low. ANA, RA, and many other tests negative. Go figure! My body has certainly felt like it had inflammation and of course had some edema before I got my meds and levels straightened out. I went to a rheumatologist once. I told her that I had inflammation. She asked me how I thought I had inflammation since my CRP and ESR were normal low. She was not too bright.

[Foggyme in reply to ShootingStars]

Yep...that’s me too...complex autoimmune issues. Trouble is general rheumatologists often not well versed in complex AI issues...many don't realise that active AI disease can be present, even if CRP, ESR and other bloods 'normal'.

As to sero-negative AI disease...😑😑...many not to bright on that either.

Pleased you got 'straightened-out' 😀

[G2G2 in reply to patez]

Yes, CR-P doesn't pinpoint where the inflammation is. So, you only know you've got high inflammation or not. It's good to know. What a pain you have to travel to get labs done & pay!

[patez in reply to G2G2]

Hi.

Yeah not easy out here in Oman!

I will be getting my thyroid antibody results tomorrow. I am very interested to see what they show. If high TPO, that will be Hashi's, which may probably cause a thyroid inflammation, which would also raise my ferritin!

I will post further when I get more info.

Thank you though for taking your time to respond.

It is appreciated.

Patez.

[Geetal]

I cant help you with the high ferretinn question as I also had high ferretin with my last tests but not as high as yours and my doctor was not concerned. But looking at the results youve shown you have not had free T3 tested. You may have difficulty converting from T4 to T3. I dont know your age but I understand conversion becomes more problematic with age and I am now on slow T3 as well as T4 and feel much more well(although still not consistently so). Hope this helps

[patez in reply to Geetal]

Hi.

Thanks for your reply.

I have posted the Free T3 (FT3).

I am not currently taking any thyroid medication, so I can't comment on conversion.

Patez

[ShootingStars]

Hi patez. I'm glad that you're getting more tests done. I stand by what I said before. I think you are hypothyroid. You have all of the symptoms, and you have lowish thyroid hormones.

Your numbers are very very close to what mine were when I was diagnosed. When I was diagnosed my FT3 was 36%, FT4 was 31% and TSH was 1.65. That is not a whole lot different than your FT3 44%, FT4 30%, TSH 1.55. My TPO started out at 1000 (0-60). My doctor said I was fine and had no reason for fatigue, anxiety and overall feeling of unwellness. I have never had any weight gain. I did not start medication because he said I was fine. I had an ultrasound of my thyroid which showed several small nodules. I had them biopsied right away and they were negative.

In the five months after diagnosis, I developed major brain fog, very low body temperature, cold intolerance, heat intolerance, horrible fatigue, and I could not stay awake. I also developed pain throughout my entire body. I got so bad that I couldn't move and the pain became high level and made me nauseated. Five months after diagnosis, I finally got a new doctor who ran all my tests again. My FT3 was 31%, My FT4 was 1.5%, my TSH was almost 8 (0.40-4.00). My TPO went up to >6500.

All of that developed in only five months. I had a follow up ultrasound and my nodules had grown due to not receiving medication. After starting medication the nodules reduced in size. I take T4 and T3. I try to keep both of my levels up at what is optimal for me: FT3 60-65%, FT4 60-65%. As a result, my TSH is well below bottom range (0.40-4.00). That is to be expected when you take T3 along with T4 and is how it has to be if I was to feel my best and keep my levels optimal. If my levels drop even to 50% I start to get hypo symptoms, so I never let it drop that low. What works for you might be different.

Even if you do not end up having positive antibodies, your thyroid hormones are lowish in range and you have a long list of hypothyroid symptoms. Oh, and in the years before I was diagnosed, my TSH was never higher than 1.8. FT4 was tested a few times, but FT3 was not. My FT4 was always around 40%.