Hi all. Can anyone please have a look and see what they think of my results, if I am possibly deficient in iron? To me it looks like my iron serum & transferrin saturation are on the low side. However my ferritin is in the normal range, so my doctor has said I'm fine. BUT I don't feel fine. I have major fatigue, have been having shortness of breath on and off the last few months (have had xray/scan etc) and nothing wrong. I do have a flare up of asthma, but I was feeling breathless before then. I also have endometriosis and coeliacs so those two together are known to affect iron levels. I just want to be able to pinpoint the reason for the shortness of breath. And it's not from anxiety/panic attacks (I get those, and it's not that). Thanks so much.
Serum Iron: 12 umol/L ( 10 - 30 )
Transferrin: 2.8 g/L ( 1.7 - 3.4 )
Transferrin Saturation: 0.17 ( 0.15 - 0.50 )
Ferritin: 66 ug/L ( 20 - 380 )
Free T4: 16.0 pmol/L ( 10.0 - 20.0 )
TSH: 1.4 mIU/L ( 0.30 - 4.00 )
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kingfisher51
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Those first results do NOT suggest hyperthyroid/Graves
More likely hypothyroid due to Hashimoto's
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
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)
Hi. No, no longer on carbimazole, however was changed to PTU instead. This is my latest and am due another check up soon to see whether to lower PTU.
Free T4: 16.0 pmol/L ( 10.0 - 20.0 )
TSH: 1.4 mIU/L ( 0.30 - 4.00 )
Comment: Consistent with euthyroidism.
I have heard about the early morning testing thanks My doctor will never agree to testing for all those extras, so will have to come out of my own pocket unfortunately. Is there a reason why my previous results would indicate hypothyroid and not hyperthyroid as the labs stated? Thanks.
Okay thank you. It's all so very confusing when you are trusting your doctor and they are going by what labs advise. And then I don't want to step on my doctors toes, it's a hard thing to approach. I will look into getting more bloods and then taking it from there.
I'm in NZ so don't use those lab places. But we can walk off the street to get testing if we pay. I'm actually seeing my GP today so will request for as much as I can get away with and follow up the rest myself! Thanks for your help.
On this forum members have found that a ferritin level in mid-range or slightly over is where they feel best. Note that ferritin is a measure of your iron stores.
Putting all this info together, your levels of iron and ferritin are too low for good health, and you should be aiming for :
Serum iron :
55 to 70% of the range, which for your test would be 21 - 24. For a woman you'd need a result somewhere around 21 or 22. For a man you'd need a result nearer to 23 or 24. This indicates your level of iron is too low, and you need more.
Transferrin :
Your result being in the upper half of the range suggests that your levels of iron may be too low.
Transferrin Saturation :
Optimal is 35 to 45% of the range, which for your test would be roughly 0.27 - 0.30. Your result is too low and indicates you need more iron.
Ferritin : Optimal for many of us is around mid-range or a little bit over. So your result is very low, and a level of around 200 - 230 would be a good level to aim for.
Please note my calculations are based specifically on the reference ranges that you supplied with your results. If you do a test with another lab and are provided with different reference ranges then the calculations would have to be redone.
Iron is poisonous at high levels, so care must be taken when supplementing not to overdo it and shoot over the desired result. Regular retesting is essential.
Another thing to be aware of is that some people can't get both ferritin and iron optimal at the same time. So, for example, ferritin may reach optimal before serum iron does. In this case people should err on the side of caution and should reduce supplementation levels to maintain ferritin at optimal levels, and just accept that their serum iron might be permanently too low. The same logic applies to reaching optimal with serum iron, while ferritin is still too low.
One way of improving iron levels is to eat more iron-rich foods in your diet. One thing that works for some people is eating 200g of liver once a week. For more info on foods containing iron, including non-meat options, see this website :
Once you've decided how you would like to supplement - IF you decide to supplement - then we can tell you where you can buy and what dosage you would need.
Thanks for all that break down of information, I really appreciate it. I always thought I was on the low side but because my doctor only ever refers to my ferritin even when it's normally lower but within range he won't suggest iron supplements, so then I keep doubting myself. But I just know I'm far from feeling optimal. I had thought I might supplement with floradix liquid so it would be easy to get down and one less supplement pill to take.
It contains 15mg of iron per dose. It also contains B vitamins and vitamin C.
Taking iron supplements reduces or stops absorption of most other nutrients and medicines taken at the same time or within a few hours, although vitamin C is an exception to that rule and apparently helps the body to absorb iron.
But the B vitamins in the liquid will probably not be absorbed very well.
Iron supplements should be taken 4 hours away from thyroid meds, other medicines, and any supplements.
Another issue is - when is the best time to take vitamins and minerals for best effect? I've read that vitamins should be taken early in the day and minerals (such as iron) should be taken later in the day. If you take a product which contains both you can't separate them.
Regarding dosage of iron...
I'll use myself as an example. I was very low in iron several years ago. I had to beg, but my doctor finally agreed to prescribe ferrous fumarate 210mg for me, one tablet to be taken three times a day. See this link for more info on the therapeutic dose for adults :
I discovered, purely by accident, that I could buy high dose iron supplements without a prescription. After my first prescription from my doctor I started buying my own, so I didn't have to beg any more.
A single tablet of ferrous fumarate 210mg contains 69mg of iron, so I was taking 207mg of iron per day. The dose of Floradix is very low in comparison.
It took me nearly two years to get my ferritin up to mid-range. My serum iron is still low in range, but I just live with it. If I stop taking iron supplements my ferritin levels drop rapidly. I maintain my ferritin now by taking one tablet, four times a week. It's taken lots of trial and error to find out what works for me now.
In the UK the iron supplements that doctors prescribe can be bought at pharmacies with the pharmacist's permission and without a prescription. I usually buy my supplies at either Lloyds or Tesco pharmacies - Boots can be awkward. They are available online too - try Ebay or Amazon.
These are the ones I usually get, but brand is not important :
There are 84 tablets per box. At full dose - one tablet, three times a day - they will last 28 days.
There are other choices, as outlined in Helvella's iron document that I linked in my previous answer.
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I can't stress enough that regular retesting of iron levels is essential because iron is poisonous in overdose. I would suggest that repeating testing every 4 - 8 weeks is a good idea. If you discover that you absorb iron poorly and slowly then you can reduce the frequency of testing by a little bit, but always, always be cautious.
Thanks again for all that information. Yes, that is the floradix liquid I have just got. I wasn't aware not to take iron close to take other medications, so that's good to know as I take thyroid meds. I'm in NZ but will see what other iron supplements are recommended here. I told my doctor I was looking at supplementing so he has also cautioned me to about raising my levels too much but he's more than happy to have my levels checked down the track.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
My doctor will never agree to testing for all those extras, so will have to come out of my own pocket unfortunately. Is there a reason why my previous results would indicate hypothyroid and not hyperthyroid as the labs stated? Thanks.
Iron blood levels
Iron Test
Iron overload
low iron and folate 
On iron supplements but my ferritin did not increase
