Iron normal but ferritin low question, could that be causing my symptoms?

[MelanieV]

Hello Folks, My iron came back at 130 but my ferritin is 35. I don't know why it went down as it is usually in the 63 range. Does this mean anything? Could this be responsible for my symptoms of weak,shaky, dizzy and off balance or no? I have had these symptoms for 2 years since it started and my ferritin was very recently higher always in the 63 to 65 range. Sometimes I think it is when they take the blood tests, to be honest, as I had a pharmacist tell me that blood tests are very inaccurate depending on the time of day you take them. Any advice would be appreciated.

[Foggyk]

I'm not sure if that's causing your symptoms but I also have normal iron but low ferritin. I take ferrograd c . It seems to help

[MelanieV in reply to Foggyk]

ok, thanks Foggy. Why is ferritin so important if our iron is normal?

[Foggyk in reply to MelanieV]

I'm no expert I'm afraid. Learning just like you

[MelanieV in reply to Foggyk]

ok, thanks.

[milkwoman]

Low ferritin level is the first sign of anemia. However, most doctors don’t know that and therefore won’t do anything when iron levels are “normal.”

Ferritin level is an indication of your energy/iron stores. A 35, your’s is low (even in the 60 range is still low, especially if you have an active lifestyle). So yes, if your energy stores are low, you will feel fatigued and dizzy and weak and off- balance.

You can try supplementing. Check out this post which has a tremendous amount of information about how best to raise levels quickly (scroll down and read the entries by Catania1). If supplements don’t work, you may have to have iron infusions.

healthunlocked.com/thyroidu...

[MelanieV in reply to milkwoman]

Hello Milkwoman, I am 61. Thanks for the info, however, I am quite scared of iron infusions as iron can be toxic and my level is already 130 which is pretty high. My doc said it was ok to try and iron supplement. Is it better to get a straight ferritin supplement?

[milkwoman in reply to MelanieV]

Iron infusions only fill up your stores. For example, prior to the infusions (blood result 3 weeks prior to first infusion), my Iron level was 143 ug/dL (50 - 170) and my ferritin level was 24 ng/mL (30 - 202). As you can see, my ferritin level was below normal and in my case, had fallen 34 points in 5 months despite supplementation. Obviously, something was very wrong.

1 week after my third infusion (I had 3 infusions, administered 2 weeks apart), my iron level was 102 ug/dL (50 - 170) and my ferritin level was 329 ng/mL (30 - 202). (Yes, 329 very HIGH and is expected after infusions).

I didn't feel the full effects of the infusions until 6-8 weeks after the last one. My sleep improved and I've had clearer thinking and more energy.

I will be tested again in 4 weeks. I have not been supplementing since I want to see what the effects are and how my body is using up the iron stores without outside influence. I suspect my levels are dropping again but I'm still feeling okay so far. If the blood test shows they have dropped significantly, I'm sure my next visit will be to Hematology to try to figure out why. I have lupus (SLE) and Sjogren's in addition to be HypoT so I'm a complicated case.

I used to take a ferritin supplement. This is the only one I know of:

Ferritin Bioavailable Iron

pureformulas.com/ferritin-b...

Can find it on several online stores.

[MelanieV in reply to milkwoman]

Hello Milkwoman, thanks for that response. I was wondering as what if your RBC and hemoglobin are normal as well as iron but ferritin is low?Would that still cause all my symptoms of weak and shaky and dizzy and off balance? It just seems like everything else is normal and wondering why ferritin could drop so suddenly from 63 to 35 unless blood test was wrong which can happen.

[milkwoman in reply to MelanieV]

Yes, RBC and Hemoglobin are normal. Ferritin is always on the low end - highest it ever has been is 58 and the lowest it's been is 18 (I've been tracking things since 2014 when I was diagnosed with Lupus).

Over the years, and much more recently, my % Sat has risen so that now I'm up at the high end of normal. With a high % Sat you would think I'd be bouncing off the walls with energy (this is what my GP said when we discussed) but I'm NOT so again, something is clearly wrong (and he agreed which is why he ordered the iron infusions). It's like my blood is doing everything it can to saturate itself with iron but for some reason, things get depleted very quickly and it shows in my stores.

There's no explanation why my ferritin level dropped from 56 to 24 in 6 months. I was supplementing like I normally do which had worked to raise things. I was working out, which I know plays a role for me, but the drop to below normal shocked both me and my doctor. BUT it did explain why I was feeling so drained all the time. It was getting to the point where I couldn't function normally. The infusions helped tremendously but I'm not out of the woods yet. I'd like to know WHY I have so much trouble keeping my iron stores full and more importantly, what can I do going forward to keep them full. This may mean I will have iron infusions on a regular basis in addition to supplementing. If you read the thread with information from Catania1 then you know there are different forms of iron as well as other supplements to take that can help absorption. I have to be careful with supplements because of side effects of various fillers. So for me, I really would prefer infusions since it is basically straight iron in a salt solution. Very safe and effective.

I'm very curious as to what the testing in a few weeks will show.....

[MelanieV in reply to milkwoman]

Hello Milkwoman, Would my low ferritin of 35 cause my weak and shakiness and off balance and lightheadedness? My doctor says I am not anemic when he looks at my tests. My hemocrit is high and my hemoglobin is normal as well as my rbc. Any advice would be appreciated.

[milkwoman in reply to MelanieV]

Not knowing all that is going on with you, I cannot say. Many things can cause the symptoms you list: low blood sugar, hormone imbalance to name a few. I’m sure low ferritin is playing a role as you clearly have something going on. Are you optimal on your thyroid meds?

[MelanieV in reply to milkwoman]

Yes, I was on nature throid for years but someone on this site suggested it might be my nature throid as they changed the formula, so I just switched to NP thyroid. If this does not solve the issue, I might try tirosent with cytomel instead. I am in range but my doctor said when you don't take your meds before the blood test, it is on the low end of the range which mine is-2.4. When I took my thyroid meds , it was on the upper range in the 4's. I said how do we know what my real thyroid levels are then? He said you don't, we just go by how you feel. Please let me know your thoughts.

[milkwoman in reply to MelanieV]

Your TSH is 2.4? Most people feel best when TSH is closer to 1.0. However, you really only know the whole picture when you also test FT3, FT4 and reverse T3.

Perhaps you are under medicated? Or, maybe you do need some T3 added in?

I follow Dr. Kenneth Blanchard’s protocol which is T4 (I take Tirosint) with a small amount of T3 (I take this in a custom compounded transdermal cream).

[MelanieV in reply to milkwoman]

no my free t3 is around 2,4 when i don't take thyroid med before blood test. When i take thyroid med before blood test my free t3 is around 4 somthing which is the higher end of the range. Sorry for the confursion. Let me know your thoughts.

[milkwoman in reply to MelanieV]

Do you have all your latest blood results, with ranges?

FWIW, I agree with others here and don’t take my thyroid meds prior to blood tests. That way you get the most accurate results. I’m thinking your FT3 is not high enough so you either need more Levo (if your conversion is good) or more T3.

Are you on HRT? Sex hormones need to also be balanced in order for thyroid hormones to be optimal.

[MelanieV in reply to milkwoman]

Hello Milk, yes i am on bio identical hormones. My doctor said my free t3 would not be high because i did not take the meds before the test. When you have hashimotos you have to keep replacing the hormone so your blood levels will always be low if you don't take the meds before the test. Let me know your thoughts again on this.

[milkwoman in reply to MelanieV]

I think you will need to ask that question in a new post so that others with more knowledge on the subject can answer. I’ve not heard what your doctor is telling you about T3 and FT3 to be true. I don’t apply my T3 cream prior to my blood test. That’s how I’ve always done it.

Your symptoms seem to be consistent to your not having enough Thyroid hormone (either T3 or T4, not sure which).

Again, posting your latest blood results with ranges would give a fuller picture.

[MelanieV in reply to milkwoman]

ok, thanks!

[milkwoman in reply to MelanieV]

One other thing that just occurred to me.

Optimal ferritin levels (along with optimal vitamin d levels, folate levels and vitamin b12 levels) are required for thyroid hormones to work properly.

If any are low in range they could be the cause of your fatigue. B12 is good mid-to-high in range, Folate and Ferritin mid-to-high in range and VitD at 100+.

So this kind of circles back to your original thoughts. The low ferritin is definitely a contributor, whether directly or indirectly, meaning, yes your low ferritin itself could be causing your symptoms OR the fact that your ferritin has dropped to a low level recently has put your thyroid hormones out of balance and therefore, you now have symptoms.

It is a puzzling condition, isn’t it?

[MelanieV in reply to milkwoman]

Hello Milk, and thanks so much for all your wonderful advice. I will try an iron supplement. It is so weird because all the docs say my blood tests are normal and I have been like this for 2 years after coming off of a short term medrol(steroid) pack for tendonitis. I think the steroid did this even though it was a short term pack. Also, the doctors say I am not anemic because of my red blood cell count. I wonder if that is true. Right now I am self injecting b12 every other day. My folate, vitamin d and b12 are all in normal to high range. My hemocrit is always high. I don't know if that means anything. Let me know your thoughts.

[milkwoman in reply to MelanieV]

I have no idea if a high hematocrit is of concern. That’s a question for your doctor.

Start a new thread and post your most recent thyroid blood results with ranges to see if you are actually at optimum levels. “Within normal range” from doctors means little as the “normal” ranges are inadequate for HypoT patients to function.

If you’ve been feeling poorly for the last two years then you are most likely not optimally medicated. If that trend continues, you will feel worse and worse as your body tries to compensate and function. Your low ferritin levels could simply be an indication of this. Your body isn’t getting enough thyroid hormones to function properly (ie, you are under medicated) so it is draining your energy stores in order to function. At some point, you will crash.

I would still pursue getting your ferritin levels up since ultimately that will help you overall. Typically, oral supplementation takes a long time to see results which is why I suggested iron infusions. However, Catania1 seems to have a hit upon a protocol that quickly worked for her so it might be worth a try?

[MelanieV in reply to milkwoman]

Ok thanks so much for all your wonderful advice!