Hello, I have Hashimoto’s hypothyroidism, Addison’s disease (adrenal insufficiency) and low Ferritin. I have been battling these for a while although I was diagnosed with each of these separately over many years and therefore never felt like I had to distinguish the symptoms of each (this is hard since they overlap). My question is what is the optimum ferritin level for good thyroid and adrenal health? Currently I am taking an iron supplement to raise my ferritin / iron level but have had to have iron iv treatment in the past (prior to being diagnosed with Hashimoto’s and Adrenal Insufficiency). My ferritin level has raised a little by taking an iron supplement for over two months.It went from 17 to 31. I would appreciate any and all thoughts on this. Learning to deal/ manage my underactive thyroid (which i was diagnosed with last) has been difficult since I also have adrenal insufficiency. Thank you.
Help Please! Low Ferritin, Underactive Thyroid ... - Thyroid UK
Help Please! Low Ferritin, Underactive Thyroid and Adrenal Insufficiency
Higher! Get it over 50 / 60 and you’ll start to feel even better. Take the iron with OJ, or even better are oranges, and away from coffee or tea (and thyroid meds) to increase its uptake. I don’t know when you should stop, however. Anyone?
Good advice. I had to make sure my mum wasn't drinking tea at the same time as her iron tablets.
Thank you, now I have a good guideline to watch relating to my ferritin level.
The problem with iron tablets is that they are 'non heme' iron, which means that it takes a bit of effort to convert them into heme iron. It requires vitamin c at the very least plus some b vitamins, vitamin a and a harmonious blend of other minerals and amino acids. There are some expensive pre-blended iron formulas* out there that you may be able to emulate with additional supplements.
Alternatively, you may find you have greater success eating liver - if you are not veggie - (heme iron) twice a week for a while. Calves liver has the highest iron content (but I don't like the texture and prefer lamb's liver). Also black pudding is very good - there is a really nice gluten free one that I like.
Most importantly do your best to improve your gut biome. No amount of iron supplementation will work if you end up feeding a hungry bad bunch of pathogens**. The best advice on improving our guts I have read recently is in Dr Chaterjee's Four Pillars book.
*e.g. Ferrabsorb by Thorne
** Candida is iron-hungry and is a root cause of many autoimmune illnesses.
Great Advice . Most hypo/hyper patients have digestive issues and have leaky gut issues . Adding digestive enzymes are very helpful and going gluten dairy sugar free . Personally I found since having thyroid issues that my system became much more sensitive . Paying more attention to what I eat and omitting foods that I am allergic to has made a huge improvement + adding digestive enzymes with each meal .
Thank you. i will definitely start eating liver. I do have a sensitive stomach and try to eat healthy most of the time. I have noticed having various symptoms when I change this and eat foods that are not good for me, my thyroid, and adrenals. I plan to focus on a stricter healthy diet to help improve this.
Hi
I too have Hashimotos, low ferritin and had very low cortisol 68 (155-607). Ferritin could do with being up at 50/70 they say.
Have you had your T3 checked as well as T4 and TSH. I was only on T4 Levothyroxine and found out this year after countless collapses last year that I don’t convert very well T4 to T3. After a long hard battle I got T3 privately eventually. On the first day taking T3 I felt great. After 4 weeks I got my bloods done including cortisol at 9am. My thyroid levels were all in range but to my biggest surprise my cortisol recovered and was 311 at 9am. Latest bloods my Cortisol was 435. I have not been on any medication to improve my cortisol except a short spell of hydrocortisone last year which made me fall asleep. I past the synacthen test just within figures so it wasn’t Addison’s. It’s been amazing that T3 improved my thyroid and cortisol virtually overnight.
Sorry I know you asked about ferritin. But just wanted to share this news I have with you. It might just help you.
You can also get a DI02 gene test done to see if you have a faulty gene in converting T4 to T3.
It's so much of a struggke dealing with thyroid issues. I have low cortisol 100 lowest at 9 am. I am going private to see if I can get T3 . My T4 is 19 to 21 as an average to suppress TSH I am led to believe. I have had a total thyroidectamy due to cancer.
Oh my goodness. My sister had thyroid cancer also and her 9am cortisol was 100. And has been low quite often. She unbelievably past the synacthen test. Did you fail it? She is only on T4 Levothyroxine too. I have had the DI02 gene test done recently and it was positive. My sister too will be positive. Could I suggest to you to help your case that you get the Di02 gene test. It costs £150 and is worth every penny if it helps you to get the T3. NHS would not give T3 to me even though my T3 bloods was 3.9 (3.7-6.0) i was definitely having trouble converting. Without T3 you are very much comprised with so many things. My sister is going to have the test now that I’m positive to boost her chances of getting the T3 on the NHS
T3 is mega important to being able to function. It has been a miracle pill for me. Has turned my life around as I was in a dreadful state. For 12 years I struggled along in T4 until last year a hit a brick wall and couldn’t walk for months. All along I needed T3 as the gene test proves. How is your B12. I also had B12 deficiency as I’m a veggie which also effects iron/ ferritin levels.
Please try and get T3 checked if it’s low within the range and your T4 is high there is a strong case that you’re not converting very well. NHS ranges are too wide to keep people out of hospitals.
Di02 test is a good place to start. I wish I’d had mine done sooner rather than at the end of my situation I just didn’t realise. The report has just been scanned on to my health records by my GP who was very pleased I had this information.
Thank you. i take a combined natural thyroid medicine T3 and T4. My T3 I believe is good but on the low side. Am I correct? My doctor raised my Thyroid medicine but I have to watch this since my thyroid medicine can cause problems with my adrenal glands due to having Addison’s disease. I had a bad reaction to Levo and cannot take it at all. My cortisol levels are very low but I take 25 mg of hydocortisone daily.
T3 2.0 - range (2.0-4.4)
TSH 3.5- range (.450-4.5)
T4 .86-range (.82-1.77)
Ferritin 31-range(15-150)
My doctor also tested for the following vitamins which I believe came back fine.
Folate 6.2- range >3
vitamin B6, plasma 16.0-range (2-32)
Vitamin B1 106.4-range (66.5-200)
Vitamin B12 388-range(232-1245)
I would appreciate any thoughts on these test results.
I too had a bad reaction to Levothyroxine. Every time I took it within 2 hrs I’d be collapsing on the floor. No Dr would believe it was the Levothyroxine. What I did myself was to split my dose and not take it until the afternoon after the cortisol had peaked. I then introduced T3 in the mornings only 5mcg. I was getting discomfort in my back by my adrenals which worried me. But I did feel great overall. After 4 weeks the discomfort went away. I got bloods done. Thyroid levels were great and cortisol made a rise from 150 to 311 at 9am. Then recently I was switched to a NHS T3 brand. Next thing my skin was burning, stabbing pains and a rash. I thought it was shingles but Dr said it wasn’t. Bloods now cortisol was 455 maybe pushed too hard. I changed back to T3 I started on. Then started getting big drops in weakness at midday and around 6pm too. Yesterday was really bad. My blood pressure dropped 93/85 and was bad most of the day from 10am. Now I’m thinking has the change in T3 medication upset my adrenals. The NHS brand did feel much stronger although was same mcg. It’s a mine field. Today I’ll just have to wait and see how I go. I had to lay down quite a bit yesterday as wavering about and legs weak. So your Dr I believe is right in being careful with thyroid medication. I was fine until I swapped to an NHS brand called Sigma I’ve now switched back to ThyBon Henning but I think the damage has already been done. Where to go now I’m thinking.
Your levels seem quite low to me. Looks like you need more T3 and T4. But increase slowly!
Thanks for this helpful info McPammy , I’m in a similar situation with low T3, first test in April was 2.8 and recent test was 4.0 (3.9-6.8), been taking Levo 50mg for 3 months now, T4 increasing, was 11.8 and now its 16.0 (12-22 range) and TSH is now 0.27 (0.3-4.5). Also lowish cortisol at 9am was 295 (133-500). Have been thinking about getting the D102 gene test done as finally got an appointment with endocrinologist in August!
Hi
Your Cortisol doesn’t seem too low really. It only reaches the top of the range if you are stressed or ill. 295 is very good I’d say. You definitely haven’t got adrenal disease like Addison’s. Good that you’re increasing the Levothyroxine now and levels look better. I’d get your T3 checked again now you’re increasing your T4 before paying out for a gene test in your case as your TSH is improving. It might not be that you’re a poor converter, you just may need the T4 only. Not all are poor converters.
Hi McPammy thanks for your message. I had the morning cortisol blood test following a saliva test which showed low cortisol levels throughout the day, low DHEA with comments that established phase 3 HPA axis adrenal dysfunction. I thought that levels over 500 were normal but that if under 350 then may need to do other tests? My GP doesn't seem concerned anyway so probably just one of those things!
Oh that must be a puzzle off your mind. At least you know now what your levels are doing. I always think that that helps understand yourself and what course of action to follow. This week I had a 9am cortisol of 255. That’s s bit low for me now I’ve started T3 medication. I needed more T3. Today I’ve increased it so will be interesting to see what my cortisol is in a months time. I did feel unwell but now T3 increased today I feel great again. Such an instant recovery when on T3.
I hope you get sorted.
ShonaGreen
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This shows you needed dose increase in Levothyroxine. Did you get an increase?
Bloods should be retested 6-8 weeks after each dose (or brand) change of Levothyroxine
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).
FT4 is only half way in range
Have you had vitamin D tested?
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
Vitamin D, folate, B12 and ferritin need to be optimal
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
nhs.uk/medicines/levothyrox...
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
Like many on Levothyroxine, your TSH is very low, which is all GP will be looking at. But most important are FT3 and FT4
Hi SlowDragon , thanks for your message. I've been taking Levo 50mg one day and 75mg the next day and have been feeling better since doing it. However, I'm still getting tired very easily, getting blurry vision and my feet and hands are cold and very sensitive to the touch.
I would happily take 75mg every day as sure it would help, but I only have a prescription for 50mg. My GP would like to stop me taking Levo after he got advice from an endocrinologist who said that I don't have a thyroid problem, the Levo was probably just a placebo effect and I shouldn't be taking it.
I'm lucky at the moment as I have an extra month's supply from getting an early prescription when going on holiday. I'm seeing a private endocrinologist in August (a forum member suggested her, there isn't one on the Thyroid UK list that is near to me) so hoping they'll have a different opinion of my situation!
My last Vitamin D result was 57.9 (50-200) and Active B12 was 93.4 (37.5 - 188) so I've been taking the BetterYou sprays and Ingennus Super B Complex like you suggested. Folate was 6.12 (>3.89) and Ferritin was 162 (13-150).
Dessicated liver capsules (organic/grass fed) are an option if you can't tolerate eating liver.
Also, along with plenty of Vit C, taking extra (B5) Pantothenic Acid is good for adrenal health. (I take 500 mg per day.)
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