Can ferritin hugely impact ability to raise med... - Thyroid UK

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Can ferritin hugely impact ability to raise medication ?

owl87 profile image
26 Replies

I am currently on a reduced dose of T3 and still hypothyroid but despite having previously been on 10mcg T3 with absolutely no issues raising by 5mcg every couple weeks I cannot raise above 6.5mcg now without adrenaline rushes, faster heart rate and feeling very awake and anxious. All cofactors are ok - vit d, b12, folate all brilliant but ferritin is terrible - it was 22 and has raised to 33 after a month of supplements and 2 weeks of liver.

Back when I was on 10mcg t3 comfortably my ferritin was in the 90s and I had much better t3 levels back then which have now dropped. Can iron be the sole cause of an inability to raise?

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owl87
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26 Replies
pennyannie profile image
pennyannie

Hello Owl

Well it does for me - I know now through experience that my ferritin needs to be up and around 100 for my improved wellbeing.

Asda sell little tubs of frozen chicken livers - they are very clean and mild - 1 pot a week will help in your build up - flash fry in a little olive oil and then whizz down into a pate and store in the fridge. Take a spoonful each morning - and a little bit of mayo may help this medicine go down !!!

Your level is low, mine was at 22, have you been checked out with a full iron panel and know it's nothing other than a simple though slow build up the range.

I also took Solgar Gentle Iron and Spatone as I couldn't get on with the iron tablets.

owl87 profile image
owl87 in reply topennyannie

Thank you! I’m making sure to eat 200g liver weekly and I’ve now got some gentle iron as the nhs tablets do nothing for me! I feel a bit better now than I did a month ago but still can’t tolerate more increases so iron seems to really be impacting me!

pennyannie profile image
pennyannie in reply toowl87

Good, at least you have made a start - thinking back I was eating liver for breakfast everyday 'though I wouldn't have chosen to :

I found the Asda little pots purely by accident and now maintain my level this way. Now I hover at around 90 + so 1 pot every week/10 days seems to keep me topped up:

owl87 profile image
owl87 in reply topennyannie

Thank you! If I may ask when yours dropped had your thyroid levels also dropped? And do you find if you stop eating the liver now that your levels drop again? Thank you!

pennyannie profile image
pennyannie in reply toowl87

Yes, and yes :

I was very unwell this first time, with a very low T3 and a high T4 and on Levothyroxine.

The iron tablets prescribed gave me terrible diarrhea and I wasn't offered any alternatives so I built up my levels myself. I had had no problems with these iron tablets before my thyroid was ablated and believe I was now living with the known risks associated with this RAI treatment.

My whole digestive track seemed to be lacking it's mucus membrane, and it all started with my loosing all my mouth saliva and my body feeling as though it was totally drying up on me.

Anyway it took a good year to build up and now I try to aim for a ferritin of around 100 as that's where I know, through experience that I feel most well.

I am now two years into self medicating with NDT and run just a yearly blood test, and yes, on the same dose of NDT I have seen that when my ferritin level drops, so does my T3 and my T4 increases.

I think you need to know why this has happened to you - ferritin just doesn't drop through the range for no good reason - and would suggest you ask for a full iron panel just to be sure nothing else is going on.

owl87 profile image
owl87 in reply topennyannie

Thank you that’s incredibly helpful! Yes it was a bit concerning but definitely coincided with a big drop in ft3 and ft4 so they are linked I’m just not sure which dropped first! I think it may have been because I wasn’t supplementing. I will see about that full iron panel too. Thank you again!

Gemmab1982 profile image
Gemmab1982 in reply topennyannie

An u send me a link for these liver pots thanks

pennyannie profile image
pennyannie in reply toGemmab1982

I don't think Asda has these pots of chicken livers any longer.

I now buy frozen chicken livers from Waitrose - defrost 1 pack a week - flash fry and then whizz down into a pate which I store in a jar in the fridge and take a spoonful a day - and a dollop of Hellmans mayo helps this medicine go down.

SeasideSusie profile image
SeasideSusieRemembering

owl87

From nahypothyroidism.org/deiodi...

Iron deficiency

Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (238-242). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present.

Maybe get a full iron panel which tests Ferritin, Serum Iron, Transferrin Saturation % and Total Iron Binding Capacity.

When was your Ferritin in the 90s and do you know how/why it has reduced so much?

owl87 profile image
owl87 in reply toSeasideSusie

Thank you Susie I haven’t had a full iron panel - my endocrinologist just put me on iron medicine straight away but it didn’t do anything - as I expected - as I’ve had it before and it raised my ferritin from 3 to 20 over 3 months!

When my ferritin was in the 90s my thyroid levels specifically T3 were brilliant - T3 was around 70% through range around 6 weeks after starting T3. Unfortunately I wasn’t monitored correctly and my levels dropped and now my T3 had been around 43-6% since April. I assume this dropped my ferritin and the ferritin drop is subsequently why I’m suddenly unable to tolerate my old dose/any increase in thyroid medication.

SlowDragon profile image
SlowDragonAdministrator in reply toowl87

Would say your reduced ferritin level is directly linked to the fact T3 dose was reduced

Huskyy profile image
Huskyy in reply toSlowDragon

So, when ferritin rises, T3 rises?

SlowDragon profile image
SlowDragonAdministrator in reply toHuskyy

When hypothyroid low ferritin is common

So low ferritin DUE to low Ft3

Low ferritin then exacerbates hypothyroidism ...we need ferritin to carry thyroid hormones around the body

Huskyy profile image
Huskyy in reply toSlowDragon

Oh my, what a roller coaster.

I've always had super low ferritin. Only now getting it into better numbers. Trying to understand how these two (ferritin & T3) "work together".

owl87 profile image
owl87 in reply toSlowDragon

It is difficult to know for certain as my endocrinologist hasn’t been great with blood tests and I’ve had to take matters into my own hands but back in February when ferritin was in the 90s and thyroid hormones were around 70% I was on 10mcg. My dose didn’t change but then by my April blood test t4 and t3 had both fallen dramatically to around 60% and 43% respectively. I became gradually less able to tolerate T3 and then any dose increase over months, then I had ferritin tested a month ago and it was 22 (15-250) along with a vitamin d deficiency again which was gone at my recent blood test. So I assume its drop is tied with my thyroid hormone levels drop. I was a little confused as to why my t3 and 4 levels dropped so much despite no change in dose but I wonder if it’s due to me not supplementing cofactors for long enough.

SlowDragon profile image
SlowDragonAdministrator in reply toowl87

Or as your metabolism improved you needed increase in dose

The trouble with T3 is it will suppress TSH, shuttling downtown thyroid output....even if not taking high enough dose

That’s why it’s so essential to test Ft3 and Ft4 and dose accordingly

Yes optimal vitamin levels usually essential

Huskyy profile image
Huskyy in reply toSlowDragon

IS it possible then that when ferritin rises high enough, person could decrease T3 dose? (if person is on combination treatment)

SlowDragon profile image
SlowDragonAdministrator in reply toHuskyy

Might be more likely need a dose increase

Huskyy profile image
Huskyy in reply toSlowDragon

Oh!

owl87 profile image
owl87 in reply toSlowDragon

Thank you slowdragon that’s a good point about the metabolism! I am now making sure I’m getting bloods done in time and with nutrients because the endocrinologist hasn’t been doing it himself!

I have noticed that at the last blood test my T3 level hadn’t moved at all despite a reduction in dose from 10mcg to 6mcg so I think supplements clearly make a big difference to my levels!

nellie237 profile image
nellie237 in reply toSeasideSusie

SeasideSusie I know this is an old post but it has been bugging me that I didn't understand why my last T4 had risen slightly & TSH levels dropped when anaemic due to Coeliac. Confused me completely "How had I managed to absorb the Levo, but not much else?" Now I'm thinking that higher T4 = there may be less /maybe not, but it's just floating around - and RT3 impacting on TSH?

I can't imagine adding T3 to my meds at the moment but wouldn't it be nice if we could see super dooper experts.

In however many months it takes to restore my depleted vits/mins - will my Levo requirement return to where it was - I don't think I'll get that answer because I'm on PPI's and have realised from this forum that I need to look at coming off them - a discussion I intend to have with Gastro.

SeasideSusie profile image
SeasideSusieRemembering in reply tonellie237

nellie237

Now I'm thinking that higher T4 = there may be less /maybe not, but it's just floating around - and RT3 impacting on TSH?

Don't get caught up in the RT3 thing, it's a red herring. High RT3 can be due to many, many reasons, only one of which is to do with the thyroid which is when there is an excess of unconverted T4, you will only know this if TSH, FT4 and FT3 are all tested at the same time and you have a high FT4 (usually well over range) and low FT3 showing poor conversion.

Other conditions that contribute to increased Reverse T3 levels include:

· Chronic fatigue

· Acute illness and injury

· Chronic disease

· Increased cortisol (stress)

· Low cortisol (adrenal fatigue)

· Low iron

· Lyme disease

· Chronic inflammation

Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.

Articles

thyroidpatients.ca/2019/01/...

zrtlab.com/blog/archive/rev...

verywellhealth.com/reverse-...

In however many months it takes to restore my depleted vits/mins - will my Levo requirement return to where it was

I really don't know, I think it's a case of just see how things go.

nellie237 profile image
nellie237 in reply toSeasideSusie

SeasideSusie Thank you for the articles, and sorry I got a bit over-excited didn't I. 🤐

humanbean profile image
humanbean

I think you might have an over-optimistic idea of how fast iron and ferritin might rise with iron supplements.

It took me 21 months to raise my ferritin from bottom of the range to mid-range. My serum iron was low too, and although it rose with supplements it has never reached optimal. I just live with that now because I don't want to go over optimal with any iron-related measures.

There are people who can never raise their iron and/or ferritin, some who do it like me and take ages over it, and there are people who absorb iron at an "ordinary" rate.

owl87 profile image
owl87 in reply tohumanbean

I definitely was not expecting it to be higher was just curious if it could be the reason behind the new intolerance. As it was previously in the 90s when my T3 levels were higher I assume I should be able to raise it though I know it will take a while!

in reply tohumanbean

Agree with you, humanbean.

I’ve never been treated for thyroid disease, only having slightly high thyroid readings in the past but have struggled with iron/ferritin lacks all my life.

Twenty three years ago I was firstly put on children’s liquid iron (due to malabsorption) and then progressing to slow-release iron (Maltofer=Iron polymaltose 370mg equivalent to 100mg of elemental iron per tablet), which I have to take to this day, otherwise levels drop.

Results of my iron supplementation for past 23 years:

Haemoglobin 26/07/1999 112 g/dl (115-165)

Haemoglobin 23/08/22 141 g/L (115-165)

Iron 07/03/13 12 (11-27)

Iron 23/08/22 7 umol/L (5-30) (Lowered due to not eating so much red meat for kidney disease)

Ferritin 14/2/2000 5 ug/L (10-200)

Ferritin 23/08/22 258 ug/L (30-500)

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