Results from GP - and advice on iron

Hello -

I managed to get an appointment with a locum at my surgery (hooray!) so managed to avoid the usual GPs (all three lack any knowledge regarding Hashimotos). I actually went to see him as I've been to the out of hours service and they suspect kidney stones, so something new to add to the list (Hashis, psoriasis, gastritis, hiatus hernia, reflux, 'functional neurological disorder' etc etc). I'm 44 and feel twenty years older.

Anyway, he did some blood tests and although they're not as in depth as the private ones, they're still interesting. He didn't say much when I said I was self treating with NDT but that was better than a lecture! No results for T3 obviously but I'm wondering if the fairly low T4 shows I need to up my dose - I'm currently on 2 grains a day and have been for a while now.

Iron, as usual, on the floor. He suggested iron tablets but I also have IBS so take Solgar's Gentle Iron (20mg) with their Ester-C. Clearly not helping much. I avoid red meat as it gives me stomach ache and I just cannot eat liver, the taste and texture make me feel sick. I do like pate though and eat a pack every week or two.

My magnesium's low despite supplementing for a good few years (previously citrate, currently glycinate 200mg). According to the pack that provides 50% of my RDA. Is it reasonable to increase dosage on iron and magnesium or not? It was the doctor who pointed the magnesium thing out...

He seemed happy as my iron's within range but of course, that's no use if it's so very low. We know that with doctors, it's all about the numbers and that symptoms don't mean much.

Anyway, a small selection of what I just collected - he actually printed out the results for me, whereas they normally try and avoid doing that and suggest I'm being unreasonable for asking. Small victories...

Magnesium 0.80 (0.70 - 1.00)

TSH 0.01 (0.55 - 4.78)

Free T4 12.9 (11.5 - 22.7)

B12 726 (>200) *active B12 not tested as far as I know*

Ferritin 26 (24 - 240)

I really need to get these sorted as I know it's important for thyroid hormones to be optimal, vitamins and ferritin need to be higher in the range and my iron is dismal. Heavy periods don't help matters much.

Any help would be much appreciated. Thanks!

[Jazzw]

He didn't say much when I said I was self treating with NDT but that was better than a lecture!

P’raps he didn’t know what NDT is... Did he show signs of knowing? Wouldn’t be the first time we’ve heard of doctors having no clue that there’s anything other than levothyroxine to treat hypothyroidism.

No results for T3 obviously but I'm wondering if the fairly low T4 shows I need to up my dose - I'm currently on 2 grains a day and have been for a while now.

As Lora7again says, you really need an FT3 result. FT4 is often low when you take NDT—if you think about it, that makes sense because the body uses the T3 in the NDT and doesn’t have as much use for the T4–so it gets rid of it. So don’t increase your NDT without getting an FT3 level. You could just do a finger prick test on FT3 alone.

Many years ago I read an article about how we may have it the wrong way around about anaemia and heavy periods. The author proposed that actually, iron deficiency causes heavy periods, because the blood can’t clot properly when you have anaemia—hence you bleed more. Wish I could find it again, because it made so much sense. So, you might find that addressing the anaemia actually lightens the flow. Either way, low ferritin causes all sorts of problems—it’s needed for conversion of T4 to T3, it has a role to play in your adrenaline / cortisol production etc.

Something perhaps to try—Vitamin C can help with ferritin absorption. Again, I’ve seen something here about a study that demonstrated that taking Vitamin C, even if you don’t supplement with additional iron, raises your iron levels—it presumably helps you absorb the iron in your food.

[Hidden in reply to Jazzw]

Hi, I think you might be right. He didn't look like he knew what I was talking about! I'll get my T3 tested privately in a couple of weeks. Interesting that T4 goes low on NDT, I didn't know that. Thanks 😊

[TSH110 in reply to Hidden]

I had a GP just undergoing the final assessment she didn’t know what NDT was but was quite intrigued to know more. She had never heard of grains and wanted a direct conversion rate to Levothyroxine so clearly knew zilch about T3. I gave her a rough approximation. I explained why it suppressed TSH and that I had phases of hyperthyroidism and could assure her I felt perfectly normal and was not hyperthyroid. I told her I had the DIO2 poor conversion gene combination so T4 alone could not make me feel well. She admitted I knew more about it than she did but good on her for listening to me and I hope she learned something from what I told her. She was as sharp as a needle - very bright indeed these are the ones who might have the brains to think for themselves. I hope yours is one that could help much needed change to occur.

[Jazzw]

Sorry—just spotted the Ester-C. So you already know about the Vit C thing. As you were.

[SeasideSusie Remembering]

Gosh, your ferritin level really is dire.

Have you had an iron panel and full blood count done to see if you have iron deficiency/iron deficiency anaemia? If not then ease ask for them. You shouldn't take iron tablets unless you know that because if you already have a good serum iron level then taking iron tablets may cause problems like iron overload.

Both low Ferritin and iron deficiency will cause symptoms independent of each other.

As for magnesium, most supplements suggest a serving dose of around 350-400mg.

Definitely get FT3 tested (with TSH and FT4) before increasing your NDT, it is the most important result when on NDT.

[Hidden in reply to SeasideSusie]

Yes, I'll do a Medichecks test again next month. I'll also up the magnesium, and when it's used up I'll go back to citrate as I preferred it.

There's no way they'll do an iron panel. The last time I mentioned it, the GP told me that plenty of women 'get by' with levels that low. And today the locum was sticking with the 'Yes, but you're in range' story. He actually said supplementing was obviously working for me because the numbers weren't below the minimum! He was really enthusiastic about the fact that I was in range by 2 points.

What am I supposed to do? It's like banging my head against a wall. 😬

[SeasideSusie Remembering in reply to Hidden]

I do an iron panel with Medichecks. My ferritin is on the low side (nowhere near as bad as yours) but my serum iron, TIBC and % saturation are good, so I don't need to supplement iron, just work on my Ferritin.

Have you had a full blood count with haemoglobin, haematocrit, MCV and MCH tested?

[Hidden in reply to SeasideSusie]

No, this latest one had lots of things like potassium and calcium but no more blood things... looks like I'm doing a big Medichecks order when we're back from holiday!

[SlowDragon Administrator in reply to Hidden]

Heavy periods suggests you may be still under treated

The cheapest option for just TSH, FT4 and FT3 £29 (via NHS private service )

monitormyhealth.org.uk/thyr...

Eating iron rich foods like liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

Helpful website

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

drhedberg.com/ferritin-hypo...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

[Hidden in reply to SlowDragon]

Thank you. It's such a minefield as I have reflux, gastritis and now kidney stones so have to avoid citrus and chocolate... it's just one thing after another, sadly.

I'll definitely look at these links and hopefully can try and improve things.

[SlowDragon Administrator in reply to Hidden]

Are you on strictly gluten free diet?

Frequently helps improve reflux and gut issues

Thousands of posts on here about low stomach acid.....using Betaine HCL, or slippery elm or apple cider vinegar

[Hidden in reply to SlowDragon]

Hi, yes - been strictly gluten free for going on 3 years now. I've actually been researching (as we all have to!) for a long time, and Dr Michael Ruscio has some great information on gut health. Although I have some absorption issues, the suggestion is that when gastritis is present it's probably an idea to use PPIs or similar for a short period to allow the stomach to heal before proceeding with dietary measures, supplementation etc. Of course, acid suppressants are routinely avoided in the functional medicine world and I was averse to this (and have been prescribed them on many occasions but not taken them) - Omeprazole and the like give me awful cramping and nausea. But I think I'm going to have to try it for a couple of months.

I've tested negative for H pylori twice in the past few years but my stomach lining is inflamed.

The gastritis means supplementing with HCL or ACV makes my stomach burn even more, so I do try and use slippery elm and DGL to try and soothe it. Anything acidic isn't an option really. I get very down about all this - whenever I find a possible solution, there's always something that means it's not an approach I can try.

But I can't just give up, tempting as it sometimes is. Between this, Hashis, neuro symptoms and now kidney stones (which apparently mean I can't take my just-prescribed Pantoprazole - yet again the GP didn't think about suitability - and Ranitidine has been recalled so I can't do H2 antagonists either until I try and get an alternative next week) it just feels as though doors are constantly slamming in my face! It's like a full time job.

[Hidden]

Hi, yes I'm planning on getting a Medichecks test once I'm back from holiday in a few weeks. I've done them before. I struggle getting enough blood out with the finger prick thing but can't get blood drawn as no private clinics within 150 miles!

I think I've got some tranexemic acid tablets stashed somewhere... better dig them out!

[Hidden]

Will do! To be honest I've felt rubbish for years. I genuinely don't know what it's like to feel well - warm, not tired, not having godawful stomach pains and headaches. I suppose you just get on with life, especially when you have young children 😕

[humanbean]

If you can afford to, you can get a finger-prick iron panel done privately without involving a doctor :

medichecks.com/iron-tests/i...

And you can get 10% off the price with the discount code mentioned on this link :

thyroiduk.org.uk/tuk/testin...

[Hidden in reply to humanbean]

Thanks. I'll buy this and the thyroid one I usually get... it's going to be an expensive month!

[SeasideSusie Remembering in reply to Hidden]

If you want to do them as fingerprick tests, make a separate order for each one, otherwise they will combine them and you will get a venous blood draw kit because more blood is needed for the two tests.

By making separate orders you will get two kits sent, each with their own return envelope so you could, if you wish, do them on separate days if you would struggle to fill 2 x microtainers at once.

[Hidden in reply to SeasideSusie]

That's great, thanks! I really struggle to get the blood out!