Iron and Folate

[Spangle15]

Hi all. Can anyone tell me if I should be taking iron and folate?

My last results were:

Ferritin - 24.2 (13-150 range)

Active B12 - 98.1 (>37.5 range)

Folate 24.8 (8.83-60.8 range)

I’ve been taking 100mg thyroxine and 5 mg T3 (previously prior to bloods 10mg) as my last thyroid results were:

T3 -7.8

TSH- 0.03

T4 - 18.8

But I’ve been feeling so tired that I’ve upped T3 to 7.5 mg daily as I felt a drop from 10 to 5 was too much as I was only just above the range.

[SeasideSusie Remembering]

Spangle15

Ferritin - 24.2 (13-150 range)

This is very low in range. Ferritin is recommended to be half way through range. No-one can tell you whether you need to supplement iron with just a ferritin result. To know if you have iron deficiency you would need an iron panel, to know if you have anaemia you would need a full blood count. It's not a good idea to supplement with iron if you haven't had those other tests. If you are not iron deficient and have a good serum iron level then taking iron could push it too high, and too much iron is as bad as too little.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

apjcn.nhri.org.tw/server/in...

Active B12 - 98.1 (>37.5 range)

Folate 24.8 (8.83-60.8 range)

Your B12 and Folate levels aren't too bad. Folate is recommended to be at least half way through range (so 35+ with that range). I would want my Active B12 over 100 so you're nearly there.

If those were my results I would take a good B Complex containing methylfolate and methylcobalamin, eg Thorne Basic B. I would take one capsule on alternate days and maybe retest in 5-6 months to see where your levels lie then. You need more of a maintenance dose than a dose to raise really low levels.

T3 -7.8

TSH- 0.03

T4 - 18.8

Do you have reference ranges for these results? Can you add them please.

Was this test done when you were taking 10mcg T3? I'm guessing FT3 is over range.

[Spangle15 in reply to SeasideSusie]

Hi

Thanks for your reply.

Iron was 23.2 (5.8-34.5), is that useful.

Yes those results were when I was on 10mcg of T3, I haven’t been tested since as that was just before lock down.

I don’t eat meat.

I’ve read that Ferritin below 50 can make you symptomatic even if iron levels are normal. I have been supplementing with iron (a brand that is 70% of daily recommended amount) but now I’m worried I shouldn’t be supplementing.

[Spangle15 in reply to SeasideSusie]

Also a couple more results:

Transferring saturation 45.1 (20-50)

TIBC 51.5 (45-72)

Vitamin b12 393 (145 - 570)

[SeasideSusie Remembering in reply to Spangle15]

Spangle15

Optimal results for an iron panel, according to web.archive.org/web/2018083...

Serum iron: 55 to 70% of the range, higher end for men - yours is 60.63%

Saturation: 35 to 45%, higher end for men - yours is 45.1 with a range of 20-50

TIBC: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 24.07% so lowish in range

Ferritin: Low level virtually always indicates need for iron supplementation - yours is low in range

So your iron panel doesn't show iron deficiency, you just have low ferritin, which suggests that you probably shouldn't be supplementing with iron tablets. However, were you supplementing at the time of the test? If so, did you leave iron off for 7 days and do the test after a 12 hour fast?

I’ve read that Ferritin below 50 can make you symptomatic even if iron levels are normal

You certainly can have symptoms of low ferritin with normal iron levels, symptoms of low ferritin according to drhedberg.com/ferritin-hypo...

◾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

Vitamin b12 393 (145 - 570)

Don't worry about this test, it's the Total B12 test and you've had the Active B12 test done as well which is a better test.

Yes those results were when I was on 10mcg of T3,

You haven't given the reference ranges but as mentioned I'm guessing FT3 is over range with that test, in which case reducing dose was the best thing to do and depending on how much over range it was then taking 7.5mcg might be than taking 5mcg. Fine tuning is the key with thyroid hormone replacement.

[Spangle15 in reply to SeasideSusie]

Thank you. Yes sorry, range for T3 was 3.1 to 6.8 so it was just over.

It’s tricky to know what to do with the iron, I wasn’t supplementing when I had the test so that hasn’t skewed the results.

I do have some symptoms, in fact probably 8 of those but if my iron levels are ok, I don’t know whether to supplement for the low ferritin.

Thank you so much for all your detailed responses.

[SeasideSusie Remembering in reply to Spangle15]

I don’t know whether to supplement for the low ferritin.

If you do then you risk raising your other levels and that wouldn't be a good idea.

[SlowDragon Administrator]

Have you had vitamin D tested?

[Spangle15 in reply to SlowDragon]

Yes. That was 96.7 (50-175 range). I have been supplementing since that test result.

[SlowDragon Administrator in reply to Spangle15]

How long ago was that test?

We typically need to supplement continuously at a maintenance dose to maintain optimal vitamin levels

Low Ferritin and iron will probably be making you feel exhausted

[Spangle15 in reply to SlowDragon]

It was the end of last year.

I have been supplementing more or less daily with Vitamin D since.

I am so confused by the ferritin/iron results. I am scared to supplement because of the transferrin saturation but at the same time, but ferritin is very low and it has decreased since my previous test when it was 28.

[SlowDragon Administrator in reply to Spangle15]

Iron and ferritin are complex...frequently it’s best to just improve iron rich diet