Question about iron levels? : Hi I am new here... - Thyroid UK

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Question about iron levels?

Willow7733 profile image
20 Replies

Hi I am new here, not new to having Hashimoto’s Thyroiditis (hypothyroidism) for around 15 years. Recently, I was sent to a hematologist because my iron levels were so low. Practically non existent. I was put on iv iron right away. The specialist and I were trying to figure out why I was so anemic....my diet is pretty good. I eat healthy enough, and get enough iron from my food. Nothing we went through was applicable to me. My question is: could anemia be caused by hypothyroidism??? I am asking because, though the iron infusion worked, I am feeling like it is happening again. (Craving ice all the time, so tired).

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Willow7733
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SlowDragon profile image
SlowDragonAdministrator

Welcome to the forum

How much levothyroxine are you currently taking and when were levels last tested?

Absolutely essential to test Ft4 and Ft3, not just TSH

What about vitamin D, folate and B12 levels too

With Hashimoto’s, when under medicated low stomach acid is almost inevitable. This leads to low nutrient levels

What’s your diet like

Are you vegetarian or vegan?

Have you had coeliac blood test done?

Are you on strictly gluten free diet or lactose free diet

See other posts mention asthma.

Do any of your asthma medications contain steroids....these can lower TSH

Willow7733 profile image
Willow7733 in reply to SlowDragon

Thank you! I am glad I found this forum! I take 125 mcg of Levothyroxine in the morning. I go for my 6 month blood tests to check if the levels are ok in three weeks. I don’t remember what my FT4 and T3 were, but when I was diagnosed, my doctor told me they were low. My vitamins are ok. B12 is fine (don’t know the numbers). I am not a vegetarian...I love meat! lol I eat skinless chicken or lean hamburger at least two meals a day. No celiac disease, I was tested. I had a problem with GERD when I was younger, but I am on medication for that, and haven’t had problems since. Not on a gluten free or lactose free diet. For my asthma, I have been on Prednisone a few times this year. My ferritin levels were very low last time I had my CBC done...the hematologist actually brought the lab report up on his computer, showed me the value, and printed it off for me! (Never had a doctor do that for me before!) normal values were 10-150, and mine was at 4. So right away he said that no pills, he will get me to get iv iron once every week for six weeks. My other hematocrit and hemoglobin results were out of whack too. Something g he did find which was odd...I had a high ANA count. He told me I should mention this to my GP because he suspected arthritis. My GP is actually testing me this week for Lupus. (Some of my kidney function came back decreased and with my lung problems all of a sudden, he thinks something bigger is happening.) I just never thought of telling him I am feeling the same as when I had a low iron. At work (I work in a hospital) they laugh at me because I am always eating cups of crushed ice. I laugh it off....but honestly I actually crave it! I find this whole Covid/doctors calling and talking on the phone difficult. When I do, I don’t bring up anything new because I just want it to be done and over with.

SlowDragon profile image
SlowDragonAdministrator in reply to Willow7733

When you say you are taking something for GERD .....what exactly are you taking? It a PPI ..eg omeprazole

Strongly recommend you get hold of actual Ft4 and Ft3 results

And definitely get FULL thyroid and vitamin testing

Reduced kidney function fairly common hypothyroid symptom

ncbi.nlm.nih.gov/pmc/articl...

Breathlessness often low iron

Willow7733 profile image
Willow7733 in reply to SlowDragon

I will look into that next week. Good to go in with all this info!

SlowDragon profile image
SlowDragonAdministrator in reply to Willow7733

PPI like lansoprazole lower stomach acid further And lower vitamins

SlowDragon profile image
SlowDragonAdministrator in reply to Willow7733

Poor conversion of Ft4 to Ft3 is common with low vitamin levels and low vitamin levels common with low Ft3....it’s chicken and egg

Many Hashimoto’s patients need to supplement continuously to maintain optimal vitamin levels

Strictly gluten free diet is frequently helpful and often essential

Willow7733 profile image
Willow7733 in reply to SlowDragon

Is there anything g out there, in books, that I can learn more about this? I would like to know more about this kind of info! I had no idea how little I know!

SlowDragon profile image
SlowDragonAdministrator in reply to Willow7733

Plenty of websites...most are USA based

Links about leaky gut and gluten intolerance

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first

healthcheckshop.co.uk/store...?

Assuming test is negative you can immediately go on strictly gluten free diet

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Why gluten intolerance can upset cortisol levels

kalishinstitute.com/blog/gl...

SlowDragon profile image
SlowDragonAdministrator in reply to Willow7733

Izabella Wentz has several books

Susan Blum - the Autoimmune reset Book

Tired thyroid Barbara loughheed

Infection connection to Hashimoto’s

hypothyroidmom.com/hashimot...

SlowDragon profile image
SlowDragonAdministrator

Persistent coughing can be GERD or acid reflux, very common low stomach acid symptoms

healthline.com/health/gerd/...

Willow7733 profile image
Willow7733 in reply to SlowDragon

I cough during the day too. It isn’t GERD as my medication I take for it is working so well. I have never felt so good in that area.

SlowDragon profile image
SlowDragonAdministrator

Low stomach acid can be a common hypothyroid issue

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Links about low stomach acid

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

humanbean profile image
humanbean

I eat healthy enough, and get enough iron from my food.

I wonder how this can possibly be tested. Your diet may contain enough iron but if you can't break down your food enough to extract nutrients from your food then you could still end up getting far too little iron because you will be excreting it. I have heard of one or two people getting their stomach acid levels tested during an endoscopy but it is really rare, at least in the UK as far as I know.

How is your gut health? Do you get indigestion? Do you burp a lot? Are you on PPIs such as omeprazole or lansoprazole? Do you take lots of antacids?

Doctors assume that all indigestion is caused by excess stomach acid, and in some rare cases it is. But the vast majority of people who get indigestion have too little stomach acid. So, shutting down stomach acid production with PPIs or neutralising stomach acid with antacids is the exact opposite of what people should be doing. Those people with too little acid should be adding acid instead.

There are some people who simply don't absorb iron well at all and there may be genetic reasons for this. It doesn't help that doctors think they can "cure" low levels of iron by giving someone a prescription for a month's worth of iron pills and then refusing to prescribe more.

The maternal side of my extended family has huge problems with repeated iron deficiency and anaemia, and at least two people in the family have been hospitalised with life-threatening anaemia. Even some of my male cousins become anaemic.

I've learned how to deal with my own iron deficiency by testing privately, learning how to interpret my own iron testing results, buying my own iron supplements. I can absorb iron, but I just do it very, very, very slowly and I also lose it at amazing speed if I don't supplement. I had below range serum iron and very low in range ferritin (iron stores) several years ago. It took me 21 months to get my ferritin up to optimal, and even then my serum iron was low in range.

I maintain my own iron levels now, by taking a prescription-strength iron tablet 4 or 5 days a week. But I do monitor regularly, to be sure I'm getting my supplementation right.

If you get a full iron panel done you should post the results and reference ranges in a new post and ask for feedback.

To do an iron panel with a finger-prick test :

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

Permanent 10% off discount code : healthunlocked.com/thyroidu...

Medichecks is currently having a 20% off sale. Discounts can't be added together.

From an email I received from Medichecks :

"Save 20% off all tests*

With the holidays over, the children back to school and a change in season from summer to autumn, now is the perfect opportunity to put yourself first and give yourself a health MOT.

Take advantage of 20% off all tests and understand your health status as we approach the winter months.

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Willow7733 profile image
Willow7733 in reply to humanbean

Well I have been tests for vitamin deficiencies and all appears to be ok. I eat a balanced diet, follow the recommended amounts. I do have indigestion and no belching. No antacids. I used to take proton pump inhibitors but I am off them now.

humanbean profile image
humanbean in reply to Willow7733

My vitamins are ok.

Who told you your vitamins were okay? A doctor? You really need to get copies of all your blood test results (including reference ranges) for the last couple of years from your doctors. Another possibility is that you might be able to arrange to see your results online.

Most doctors only care if nutrient levels are within range. They pay no attention to whether results are optimal. To give an example ...

Suppose three, otherwise healthy, patients A, B and C got their ferritin (iron stores) levels tested. The reference range is 15 - 150 mcg/L.

Results from the testing show :

A : 15

B : 82 (approx mid-range)

C : 150

Most doctors will say that all these results are "normal". But in reality patient B with the mid range result is likely to feel best and patient A with the lowest result will feel the worst.

Willow7733 profile image
Willow7733 in reply to humanbean

Yes my doctor told me they are ok. I go for my 6 month blood work in a week so that will all be tested again. I trust him. I just wondered if hypothyroidism can cause anemia? Has it been known to?

humanbean profile image
humanbean in reply to Willow7733

Yes - people with hypothyroidism end up with low stomach acid which means they don't absorb vitamins and minerals from their food as well as normal people do. And that incudes iron. Low iron may lead to anaemia.

Doctors aren't taught about nutrition, they believe that learning about it is the job of dieticians. Your faith in your doctor on this subject could be misplaced.

Willow7733 profile image
Willow7733 in reply to humanbean

Well, I was diagnosed, and I got the hormone replacement, and I thought problems over. I mean is everything really that complicated?

humanbean profile image
humanbean in reply to Willow7733

When it comes to the thyroid, I would say yes. This forum has 111, 000 members because thyroid treatment is so poor. Lots and lots of people with thyroid problems are left with low levels of nutrients and insufficient levels of thyroid hormones. Cortisol issues are part of the condition as well. Rather than actually treat all of us adequately we are prescribed drugs for anxiety, depression, pain (if we're lucky), insomnia, and still feel like rubbish.

There are some lucky people who do brilliantly well on Levothyroxine and don't have any other issues, but as I said... With 111,000 members there are obviously lots of us who don't get well. Not only that, but in many countries people get treated much earlier than we do in the UK. The UK's own rules mean that people with some thyroid conditions can't even get diagnosed e.g. with central hypothyroidism the pituitary can't produce enough TSH. Since all thyroid treatment is based on TSH anyone with central hypothyroidism has many years of fighting to go through to get treated.

Also, about 90% of people with hypothyroidism in the UK have autoimmune hypothyroidism in which their thyroid output reduces over the years. For those who don't have the autoimmune version of hypothyroidism getting a prescription can take decades. I was first told my thyroid was "borderline underactive" in roughly 1990. I got my first prescription for Levo in 2013. I was still being told I had "subclinical hypothyroidism" that didn't really require any treatment, but begging finally got me the prescription. Unfortunately I was severely ill with other issues at that time, couldn't tolerate Levo and ended up buying my own T3.

SlowDragon profile image
SlowDragonAdministrator in reply to Willow7733

One of the most COMMON problems with hypothyroidism is low iron, low vitamin D, low B12 and low folate

Further to information on vitamin ranges

Vitamin D - GP rarely tests, if tested and result over 50nmol GP will say ok. Actually most people need vitamin D over 75nmol.,Hashimoto’s patients frequently find vitamin D needs to be over 80nmol and over 100nmol may be better

ncbi.nlm.nih.gov/pubmed/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

endocrine-abstracts.org/ea/...

Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.

B12 - range is extremely wide - typically 180-780

Many hypothyroid patients find B12 below 500 is too low. Many people with Pernicious Anaemia struggle to get tested even if B12 is 190

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration.

ncbi.nlm.nih.gov/pubmed/169...

Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.

If you read posts on here daily you will see thousands upon thousands of posts referring to Low vitamin levels as direct result of being hypothyroid

One big problem is the over reliance on TSH instead of symptoms

Low vitamin levels tend to lower TSH

Examples of test results

healthunlocked.com/search/p...

healthunlocked.com/search/p...

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