Iron panel results and trouble raising T4 medic... - Thyroid UK

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Iron panel results and trouble raising T4 medication?

owl87 profile image
14 Replies

I recently had an iron panel and just got the results:

TIBC: 55 (range 0-100) (normal 41-77)

UIBC: 35.4 (range 0-125) (normal 24.2-70.1)

Ferritin: 43 (range 0-400) (optimal 44-150)

Iron: 19.2 (range 0-60) (normal 5.8-34.5)

I am also trying to raise my T4 medication as last blood test showed a T4 of 13.5 (10-20) and a T3 5.1 (3.5-6.5) last blood test T4 was higher and T3 lower on the same dose. I initially before my blood test had tried a small T3 increase but got very unwell and looking at my results I want to increase T4. I started on just 1/4 of a 25mcg tablet plus my usual 75 two days ago and yesterday had a higher heart rate and anxiety again. Last night I had an adrenaline surge at 3.30am out of the blue and then was in and out of sleep all night panicky. I woke up with a fast pulse of 84 and anxious this morning. My question is could that tiny T4 increase 2 days in even cause this? I struggle because I had this when I tried upping t3 and it went coming down but I also had periods of higher heart rate a few times recently and over the last month or two despite being on the same dose stably. I thought it was only T3 medication that could have a negative affect on the adrenals but it seems whatever I take 2 days in i start feeling bad?

Regarding my iron panel - I have been eating liver weekly and my last blood test 1 month ago was 33 (15-250) and 23 (15-250) 2 months ago so it’s going up quite slowly. Could this be the reason I’m having trouble tolerating even a small increase? Should I be taking iron supplements too? I as a said feel a bit rough yesterday and today and have been having my first period in around 2 years so I’m concerned I might lose some of the iron it’s taking so long to build up. Thanks!

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14 Replies
SeasideSusie profile image
SeasideSusieRemembering

owl87

TIBC: 55 (range 0-100) (normal 41-77)

UIBC: 35.4 (range 0-125) (normal 24.2-70.1)

Ferritin: 43 (range 0-400) (optimal 44-150)

Iron: 19.2 (range 0-60) (normal 5.8-34.5)

Who did this test?

Was it Thriva?

Can you upload a picture because those ranges are nonsense.

owl87 profile image
owl87 in reply toSeasideSusie

It was thriva - have I picked a bad one? Do I just attach the photo to the post?

SeasideSusie profile image
SeasideSusieRemembering in reply toowl87

Owl87

No, Thriva isn't a bad one, they just make their reference ranges so confusing.

You can add a picture to your opening post in this thread. Go back to your opening post and click on MORE, then EDIT, then UPLOAD A PICTURE, then SUBMIT (or POST, can't remember which it is :) )

owl87 profile image
owl87 in reply toSeasideSusie

Thanks I just uploaded it :)

SeasideSusie profile image
SeasideSusieRemembering in reply toowl87

owl87

Thanks :)

OK, you can see from the bar graph there is an orange area and a green area. It's the green area (both light and dark green) that is the reference range. You take the low limit from the left end of the green bar and the upper limit from the right end of the green bar. The orange area would just show you how far out of the normal range that you are. Some tests also have a red area beyond the orange area, as seen in the Ferritin test result.

The green areas are classed as "normal", purely because if your result lies within that green reference range you are classed as normal. Forget their "optimal" because they make a complete nonsense of that as well, particularly for the thyroid tests!

Optimal levels for an iron panel, according to rt3-adrenals.org/Iron_test_... are:

Serum iron: 55 to 70% of the range, higher end for men - your result of 19.2 (5.8-34.5) = 46.69%

Saturation: optimal is 35 to 45%, higher end for men - yours is 35%

TIBC (total iron binding capacity) or Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 55 (41-77) = 38.89%

UIBC: Low in range indicates that you may have too much iron in your blood which may be due to iron overload syndrome (hereditary haemochromatosis). High in range signifies iron deficiency. Yours is 35.4 (24.2-70.1) = 24.4%

Ferritin: Low level virtually always indicates need for iron supplementation; High level with low serum iron/low saturation indicates inflammation or infection; High level with high serum iron and low TIBC indicates excess iron; Over range with saturation above 45% suggests hemochromatosis. Yours is 43 (13-150) = 21.9% through range

Regarding my iron panel - I have been eating liver weekly and my last blood test 1 month ago was 33 (15-250) and 23 (15-250) 2 months ago so it’s going up quite slowly.

Presumably previous tests were done by GP? The range is different and those results showed

23 (15-250) = 3.4% through range

33 (15-250) = 7.66% through range

So because it's a different range, even though the unit of measurement is probably the same, it's difficult to compare the private test results against your previous ones. I have this with mine, my surgery's ferritin range is 15-300 and the private one is 13-150 so I don't try and compare them, I just do an occasional test with the private lab and use that result.

Ferritin is said to be best at half way through range. Your private results don't show the need for iron tablets, you'd need to iron deficient or have anaemia for that. However, your previous test results are so low that they suggest your GP should have investigated further, but they usually wont if the result is in range, even when it's as low as yours were but it's something you might want to bring up with your GP.

You should be able to raise your ferritin level by eating liver, it takes a few months but you should get there. Mine was 57 in January and results received today show it to be 76. I have been eating about 140g of liver every 7-10 days. I still need to get it higher.

owl87 profile image
owl87 in reply toSeasideSusie

Thank you so much this is very helpful!I thought it might be the case that I need to just trug on with the liver! I have been eating it for a couple of months and it is going up so I will keep on!

Yes my doctors are terrible I was put on iron tablets years ago after being told I was 'a bit deficient' and now I have access to my records I saw that my ferritin was 3 and my b12 was also under range! They stuck me on tablets for 3 months it went up to 26 and that was good enough apparently

😂

Do you know if low ferritin can cause issues with raising even T4? I read it can cause issues with thyroid mediation being utilised properly and my FT3 has moved higher on the same dose recently maybe thanks to all my supplementing but I don't feel better and I need to raise my T4 but my body seems to be saying no!

SeasideSusie profile image
SeasideSusieRemembering in reply toowl87

owl87

Do you know if low ferritin can cause issues with raising even T4?

Not sure on that, possibly because we need a good level of nutrients for thyroid hormone to work properly, but I don't have any notes to answer your specific question. SlowDragon I think might be able to comment on that (and I'll make notes for future use :) )

owl87 profile image
owl87 in reply toSeasideSusie

Thank you! :)

SlowDragon profile image
SlowDragonAdministrator

Do you have autoimmune thyroid disease (Hashimoto’s) diagnosed by high thyroid antibodies/ultrasound scan of thyroid

Are you on strictly gluten free diet?

owl87 profile image
owl87 in reply toSlowDragon

I was diagnosed with a normal TSH but low FT4 and under range FT3. I have a family history of thyroid problems including a great aunt with overactive but no antibodies neither TPO or Thyroglobin so I and my endo are a little confused! I have been strictly gluten free for a few years now!

SlowDragon profile image
SlowDragonAdministrator in reply toowl87

So highly likely it’s Hashimoto’s....gluten free diet often lowers TPO antibodies ...especially if family link

Ever had ultrasound scan of thyroid (costs about £150...if GP or endocrinologist won’t do it)

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Getting all four vitamins optimal often makes it much easier to tolerate dose increase in levothyroxine

owl87 profile image
owl87 in reply toSlowDragon

Thank you! I was wondering about getting an ultrasound! At £150 I am much more tempted now! Interestingly my mother also has the same presentation as me and isn't gluten free and has no antibodies either.

I have been working hard on the others and Vit D, Folate and B12 are very good and I assume thats why my FT3 has gone up and FT4 down recently. Ferritin seems to be the last hurdle and I wonder if its behind my issues raising. Its frustrating as I am so close to getting levels back where they need to be but looks like I just have to hold on a while longer while I work on the ferritin! :)

SlowDragon profile image
SlowDragonAdministrator in reply toowl87

Eating iron rich foods like liver or 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

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post about iron supplements

healthunlocked.com/thyroidu...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

I have details of London ultrasound scan options....if any use ....PM me if want details

owl87 profile image
owl87 in reply toSlowDragon

Thank you very much! I would definitely be interested in the london clinic so will send you a PM! :)

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