Ferritin blood results - advice please! - Thyroid UK

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Ferritin blood results - advice please!

Cathrd
Cathrd

Hi all,

I visited my GP last week to request a blood test to check my iron levels as I have all the symptoms of low iron and very heavy periods. At the same time I asked her to check my B12 and thyroid levels (I’m hypothyroid and on thyroxine). I’m just fed up of feeling rubbish so trying to help myself.

I’ve just phoned for my results and whilst she wouldn’t give them all over the phone she told me they were all normal and no action is required.

However, I kept on about my ferritin levels and she has given me this. My result is 22 and the range is between 15-300! So because I’m within range they think that’s fine and don’t want to treat me but to me this is still very low and too close to the lower range border.

I was just wondering what others think? Surely I would feel better if I was mid range rather than at the bottom end?

Should I supplement myself if my GP won’t give me anything? I already take a multivitamin with iron in even before my blood test was done and have done for years.

If you think I should supplement to boost my levels, is there any particular brand that would be recommended?

Sorry for all the questions. Thanks in advance for any help/advice! 😊

Ps. I know this is a page for thyroid but I also know you are all so good with these other tests and results which go hand in hand with being hypothyroid. So thought this was the best place to ask.

11 Replies
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SlowDragon
SlowDragonAdministrator

For good conversion of Ft4 to Ft3 we need good vitamin levels

Ferritin at 22 is clearly too low

However iron and ferritin are complex. GP should do full iron panel test for anaemia

As you are warfarin there may be other factors at play

See page 32 chart on here

chelwest.nhs.uk/professiona...

Important to test vitamin D, folate too

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Do you have Hashimoto’s?

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 is in top third of range and FT3 at least half way through range

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)

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Cathrd
Cathrd in reply to SlowDragon

Thank you so much SlowDragon, I appreciate such a quick and detailed response.

I will be going to the surgery tomorrow to get my print out of results so will have a good look then. I don’t think my Vitamin D level was tested, I forgot about that one. I did ask about viewing my results online but unfortunately my surgery don’t offer this at present. Would be great if they did.

Interesting you say that low iron can affect the conversion of T4 to T3 as my T4 levels are always normal but T3 on the low side.

Thank you also for the link regarding warfarin and the new anticoagulants. Unfortunately for me as it’s for a mechanical heart valve I have no choice but to stay on warfarin.

It looks like a trip back to my GP to request more tests is needed armed with all this info. My free T3 and free T4 are always tested along with my TSH but I have never had thyroid antibodies tested before.

Thanks again, your advice is invaluable

Cath

SlowDragon
SlowDragonAdministrator in reply to Cathrd

I realise you have to stay on warfarin with mechanical heart valve

What was B12 result

GP would say result was normal if it was within very wide range....eg I’d result was 220 (200-650)

Many hypothyroid people need B12 optimal.....over 500

Suggest you get the actual result

Important to folate as it works with B12

NHS will only test thyroid antibodies once. If TPO antibodies are negative, they won’t test TG antibodies. Only having high TG antibodies is less common, but not rare...just rarely diagnosed

SeasideSusie
SeasideSusieAdministrator

Cathrd

Please ask the receptionist to arrange a print out of your results and say you'll pop along and pick them up when it suits, maybe within the next day or two. They can't refuse as we have a legal right to them here in the UK.

Ferritin: 22 (15-300)

Surely I would feel better if I was mid range rather than at the bottom end?

This is very low at just 2.46% through range and yes, you would feel better if it was mid-range which is the recommended level but, of course, doctors aren't taught nutrition so don't know this, they just think anywhere within the range is perfectly fine. You need to maybe suggest to your GP that the range is very wide and that she would say everything is fine if you were at any level up to 300 but you would most definitely feel different at the top end than you do at the bottom end.

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Do you have any of these? Point them out to your GP if you do.

Should I supplement myself if my GP won’t give me anything?

No, we should never supplement iron without an iron panel and full blood count being tested. Low ferritin can suggest iron deficiency anaemia. But an iron panel would show your level of serum iron, if this is high (or even a good level) then you wouldn't want to be taking iron supplements as it would probably raise the level even more, too much iron is as bad as too little.

An iron panel will show if you have iron deficiency.

A full blood count (which should include haemoglobin, MCV and MCH) will show if it's anaemia.

You can have iron deficiency without anaemia.

If you have iron deficiency or iron deficiency anaemia then your GP should treat. If it's just low ferritin then your GP should decide how it can be helped.

I already take a multivitamin with iron in even before my blood test was done and have done for years.

Why do you take a multivitamin? They are generally a waste of time and money. Multivitamins tend to contain the cheapest and least absorbable of active ingredients, often the wrong form, and usually too little of anything to help low levels and certainly wouldn't help deficiencies.

They also tend to contain things that we need to test before supplementing and should only be supplemented if levels are low or deficient, eg calcium, iodine, iron, Vit D.

Cathrd
Cathrd in reply to SeasideSusie

Thank you SeasideSusie, some more invaluable advice which I am very grateful for!

I will be getting a print out of my blood results from the surgery tomorrow and will find out exactly what I’ve been tested for. I know a full blood count was done but do not know the results as of yet.

As you have explained this I won’t start taking iron without seeing my GP, I just hope she requested a full iron panel for me as that is what I asked for - I will find out tomorrow!

As for the supplements, they are hair skin and nail tablets from Boots. I think I’ve just tried supplements out of desperation at times after being fed up of feeling rubbish. These definitely help my skin so I continued taking them. Whenever I stop I break out in spots.

Thanks again for your help, you are all so helpful on this forum!

Don't forget to stop taking the hair skin and nails supplement a week before a blood test as it will contain biotin which can give false blood test results

Iron and Ferritin levels are one of those Goldilocks minerals. You don’t want too much or too little.

My Ferritin when tested in December 2019 was 20. According to Dr Hedberg you want to aim between 70-150. As many will advise here eating liver is a good way to increase it. Plus a good dose of Vitamin C to help absorption.

drhedberg.com/the-ferritin-...

I also spoke to US doctor Dr Thomas Levy at the Get Well Show in London a few week ago. He’s an expert on Vitamin C and he advised that as long as your haemoglobin is in range you should be fine. The problem with iron supplements from the GP is that they aren’t food based and can cause side effects for many.

But no one seems to know what to do if you have bottom of range ferritin and high normal iron with low ferritin symptoms

I expect Dr Levy would say that if your haemoglobin is good then you don’t need to worry. I personally don’t know what my serum iron is but my Ferritin is 20. But what are your symptoms? Symptoms can often overlap.

Aphasia, fatigue, headache, dizziness, brittle nails, cold hands mostly. High (over range) transferrin saturation. Haemoglobin in range near top of range.

Apart from the aphasia, although I have brain fog I do have all the symptoms you’re describing. It’s a tricky one.

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