Low ferritin?

[StrangeKoala]

I am continuing my quest for a diagnoses and/or treatment for my hypothyroid-like symptoms (fatigue, weight gain, feeling the cold etc). I was finally sent to an endocrinologist (due to higher than normal cortisol levels, they then discounted Cushing's through a normal low-dose dexamethasone suppression test). He immediately told me I had nothing endocrine related and discharged me but gave me some more tests for 'piece of mind' which I got back today. He said they are all normal.

They helpfully didn't include any reference ranges so it's hard to know for sure (I'll try to get them next week) but you all seem very good at interpreting results like this.

Haemoglobin - 135 g/l

Folate - 14.4 mcg/l

Ferritin - 28 mcg/l

TSH - 2.9 mU/l

Free T4 - 14.7 pmol/l

Free T3 - 5.3 pmol/l

calcium - 2.39 mmol/l

Vitamin D - 53 nmol/l

Now correct me if I'm wrong but even with different reference ranges that level of ferritin is pretty low, right? According to an NHS site <40 is considered borderline, could this account for some of my symptoms or at least be making them worse?

My Free T4 has previously been only just in range (previously 13.3 with a range of 12-22 pmol/l) so it would have been useful to have the reference range for this to see if it's any different. Would a decent ferritin level improve this as well?

What is the recommendation for improving ferritin levels?

Thank you!

[SeasideSusie Remembering]

StrangeKoala

This article lists symptoms of low ferritin

restartmed.com/low-ferritin/

Most Ferritin ranges start at around 13 or 15, and low Ferritin can suggest iron deficiency anaemia, so it would be worth having a full blood count, see where MCV and MCH lie, also an iron panel.

Vit D at 53nmol/L is low. The Vit D Council recommends a level of 125nmol and the Vit D Society recommends 100-150nmol. If you're not already supplementing then taking 4000iu D3 for 3 months should help raise your level, retest at that point. Once you've reached the recommended level then you'll need to find your maintenance dose by trial and error. D3 has important cofactors - magnesium whi h helps the body convert Vit D into the active form, and Vit K2-mk7 which directs the extra uptake of calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems.

Your TSH indicates that your thyroid is struggling but you need the reference ranges to properly interpret all your tests.

[StrangeKoala in reply to SeasideSusie]

Hopefully they'll give me the reference ranges when I phone them next week (I don't know why they didn't include them in the letter!) Thank you for replying and for the information. It does make me paranoid when doctors say everything is fine and it's actually far from optimal. Even worse when they blame it on depression, when you aren't even depressed!

Do you think my thyroid will struggle less if I sort out my vit D and ferritin? Or should I continue to monitor it anyway?

[SeasideSusie Remembering in reply to StrangeKoala]

It's impossible to predict. Optimising nutrient levels would be a good first move. It's said that Ferritin needs to be 70 for thyroid hormone to work properly (our own as well as replacement hormone) so it would be a good idea to aim for that. Low levels and deficiencies bring their own symptoms, some of which can overlap with symptoms of hypothyroidism.

Was B12 tested as well?

What about thyroid antibodies?

[StrangeKoala in reply to SeasideSusie]

I don't think my B12 has been tested recently so I'll look into that. I had my thyroid antibodies tested privately last year and they were low/none, so I'm happy with that side of things.

I will get my levels up and then retest them and thyroid etc again in a couple of months, I think.

I find it so weird that the drs I've seen are so happy to jump on a diagnoses of CFS/depression/stress (even when I don't fit the symptoms) but don't bother advising on nutrients that could be improved!

Thank you so much, you have been very helpful!

[Poniesrfun in reply to StrangeKoala]

But don’t you know - nutrition is woo medicine, very unscientific while depression is a made to fit very scientific diagnosis that drug companies can profit from. Aside from the endocrine system is totally separate from the rest of your parts. And women are hysterical anyway.

Seriously - my oncology nutritionist is awesome but even she wasn’t really up on thyroid/nutrition connections.

Patti in AZ

[anne1483]

On the same path. Followed Seaside Susie's advice and preparing to book a GP appointment to ask for more blood tests.