I have very low ferritin 22(15-250) but I cannot raise it. I have had a iron panel and my other iron tests were ok. I was previously eating 200g liver a week and got my ferritin up to 43 when I had my iron panel (with a different reference range however of 0-400) but then my periods returned after around 2 years. I am now having regular monthly periods and my ferritin last month was 25 my test last week showed a level of 22. I am under medicated with a t4 of 14.5 (10-20) and t3 of 4.6(3.5-6.5) but really struggle to raise my dose even by minuscule amounts and I’m assuming iron is contributing. I really don’t know how best to raise my ferritin and it looks like its forming a roadblock to me getting better. I also have severe acid reflux as a symptom of hypothyroidism so I can’t eat/drink acidic stuff and normal iron tablets worsen my reflux and constipation. Does anyone have any ideas? Huge thanks!
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I haven’t! Thank you I will look into that! My ferritin was this low last year too but when my ft3 was much higher in February my ferritin was 89 so it seems intrinsically tied to my hypothyroidism.
I haven't read your previous posts, but some of the titles are relevant to your iron problems...
Irregular fast pulse rate, anxiety and dizziness - should I be concerned?
Low iron and ferritin can cause irregular pulse and fast heart rate (aka tachycardia).
Anxiety is also associated with low iron and/or ferritin.
I've never had dizziness myself but it wouldn't surprise me if you were dizzy because your red blood cells will probably not be as good at carrying oxygen around your body as a result of the low iron/ferritin.
Can ferritin hugely impact ability to raise medication ?
Yes, when it is very low.
Sudden jumps in heart rate and wired anxiety - undermedication?
Could be low thyroid hormone levels and/or low iron/ferritin.
Which kinds of iron supplements have you tried? How much iron did they contain? And what dose were you taking? What symptoms do you get when you take iron supplements?
Hi there thank you so much for the detailed reply! That basically describes what happens to me at the moment which is why I think undermedication but also iron is the problem - the dizziness is in the form of I can’t walk around for more than 5 minutes and I can’t climb stairs without feeling lightheaded and needing to sit down. I was on the ferrous fumurate syrup prescribed by my endo with the normal anemia dose which I think is 280mg ferrous fumurate, I tried liver weekly and I then tried 15mg daily of iron in the form of spatone. The liver was making some improvement monthly but since my periods returned it dropped instantly backdown to where it was before I started and now is not budging. When I took them I got worse constipation and that it turned worsened my reflux.
There are quite a lot of iron supplements available and nearly all of them are available without prescription. Depending on the amount of iron in them they might be available without prescription from a Pharmacy with the Pharmacist's permission. Some of the weaker products may be available in supermarkets or online.
you can see dosages of different doses and types of ferrous fumarate supplement and on this page you can see the different ferrous fumarate products that the NHS prescribes (many of which can be bought without prescription)
and you can see a list of the "medicinal forms" of ferrous fumarate there are. If the product has (P) in the unit column it can be bought at a pharmacy in the UK without a prescription with the Pharmacist's permission. If the product has (POM) in the unit column it is a prescription-only product.
I am not sure why some products have a (P) and some don't when they look like they are identical products.
If you want to know more about iron supplementing and what options you have, you might find this post I wrote for another member of use :
You may want to try the haem/heme and ferritin products mentioned in that post if you can find any available for sale in the UK and they aren't too expensive - apparently they don't upset the gut like iron salts do.
I took 420mg ferrous fumarate per day for 5 months (for perspective, the RDA of iron is 14mg per day) and my ferritin went from 31 to 53... it was a very slow process. I then added liothyronine and barely remembered to take my ferrous fumarate and within one month it had gone up to 74 (the highest I've ever seen it) – so basically increased by the same amount it took me 5 months to increase it by, when I was only on levo. I say this to highlight the importance of having optimal thyroid hormones. If you're under-medicated it will be extremely difficult for you to increase your ferritin, so your thyroid hormones need immediate attention.
Thank you I have a similar experience - I am 99% sure my iron problem is ft3 related as back in february I had an ft3 of 5.6 so .9 higher in the range and my iron shot up to 89 for the first time in my life. I am on some liothyronine right now but my ft4 is on the low side to so I want to get that up first as I feel bad with a low ft4 too
I've recently been using the iron spray from Better You - which is supposed to bypass the digestive system. I really struggle with iron tablets too! It does seem to be making a difference. My ferritin levels are slowly but steadily increasing after a couple of months use, (with no tummy troubles).
I third that, it's been slowly but surely working for me with no digestive issues! (although obviously addressing thyroid hormones is the most important thing)
Absolutely - total nightmare - and even if you leave off the issue of competing foods, if you have any kind of low stomach acid or malabsorption problem you will spend a long time getting nowhere!!
I have looked at the Better You spray and have similar problems re getting iron levels up - diet alone isn't doing it for me - there are 2 iron sprays - would be interested to know which one you are using.
It could be low stomach acid that impedes breakdown and absorption of iron in the intestine during the digestive process. I think low stomach acid is a result of hypothyroidism (but could be mistaken) that would also cause the reflux
I am sure its low stomach acid as it gets worse the worse my hypothyrodism is. Back in february I had a higher ft3 aand my acid reflux all but disapeared along with a ferritin of 89 - highest in my life.
Are you gluten free? I wonder whether your gut is the source of your issues Mostew suggests getting heliobacter tested. That made a massive difference to my indigestion when I got it sorted. Plus going gluten free. To sort out your constipation, significantly increase the amount of water you drink is the first step. Have a bottle of water on the go with you all the time and aim for 3 litres of water in addition to tea or coffee. You can also add magnesium. Calm magnesium powder draws in water to the bowel and it’s also very good for calming nerves so good to take at night.
If your bowels are working well then you will have more chance of absorbing vitamins and iron from your food. Having said all that I still struggle to increase my iron but I feel much better in myself since having done all the above.
When you find a source you can take, it's best to take it before going to bed. I took iron tablets daily for several months and on my last private test, it had gone over 200 (dr. commented on it). I cut back to 2-3 tablets a week. Haven't had a test since, so need to check that out but feel much better than I did some time ago. All the best.
Hi owl87 . I don't have any answers, I'm afraid, but will be watching this post, since I'm in the same boat with the low ferritin and acid reflux. (Do you happen to have any tingling in hands, eye twitching or pain in joints, by the way?)
Me too, I copied the following info to get them to monitor my chronic low ferritin without anaemia, so I could raise it safely. I've got a load of other issues too, but starting to sort this at last is helping a lot. I'm also at last on b12 injections and folate for my deficiencies. See my other comment somewhere on this thread about hypochloridria and how it can cause acid reflux.
I tried compensating for possible hypochloridia but had to give up after developing some kind of intestinal issue (possibly diverticulosis; they've done scans and blood tests but aren't seeing anything).
Hi! Unfortunately they seem very connected - in february I had perfect ft3 levels and my acid reflux disapeared and ferritin shot up to 89 for the first time in my life. I don't get those I am afraid I do get a feeling like my entire body is thrumming and buzzing though!
Very interesting, owl87 . I definitely need to get by t3 level measured; I've been relying on NHS tests for the past year+, and they only do TSH. My ferritin test a few months ago was 18, and then it improved to 29 after several months of eating liver. I did go off the meat and live recently after getting the intestinal issue, since I thought they might be the cause, and the tingling hands and eye-twitching I'd had before came back. So maybe it's because my ferritin's dropped again ...? This whole auto-immune thing is such a crazy puzzle!
Hello, you need to take iron supplements, you can't do it with food, and liver will massively spike your copper and mess up your zinc which you need for thyroid conversion. I use bluebonnet chelated iron 27mg, I take 7 a day when I'm like you, with orange juice, last thing at night, well away from meds. You do that for about 2 months then test. Also if periods are heavy ask your doctor for tranexamic acid, you take it day one to three of your period, alongside ibuprofen, max dose on the packet, that will cut your bleed by 50%.
Girlscout2 , several folks on this forum have advised against taking iron supplements when blood results are all good except for ferritin. But you seem to be advising otherwise. Where can I find out more about this to get some clarity?
For years, I had a ferritin of 2-3, which did not rise even with supplements and injections. This also didn’t make sense since I was not vegetarian. My ferritin finally jumped to 92 and my B12 was above normal, and my endocrinologist just about fell off her chair. She asked what I had changed and I told her I went 100% gluten free in the past year and by the way, I don’t have celiac disease. Gluten is an anti-nutrient and affects the absorption of your nutrients from your other foods.
The light headedness could also mean low aldosterone. If raising your iron doesn’t help address this, you could try making Himalayan or Celtic sea salt capsules and taking 1-2 with each meal. If this doesn’t work, ask your doctor about Florinef. If you have low sodium (even if normal on blood work), you will have a fast pulse and light headedness too. By the way, my sodium on blood work has never changed even with taking 6 capsules of the good salt per day.
One other possibility is low thyroid issues which can cause heavy periods or more frequent periods. It would be good to look into this making sure to check not just TSH but also free T4, free T3, reverse T3 and thyroid antibodies. It may be worth checking for Celiac disease, hormone panels too. Keep in mind, you may not feel better raising T3 without getting your ferritin scores up.
To help with heavy periods, you could see a naturopath and try supplements like DIM, Vitex, calcium d-glucarate, NAC and milk thistle to help balance estrogen/progesterone and result in less heavy periods and increased ferritin. Having more progesterone can also help with light headedness as progesterone can be converted to cortisol and aldosterone when needed if your adrenal glands are struggling.
Please remember this is not medical advice. Just some things I have done myself to finally get my ferritin in the nineties and some avenues for you to explore with a licensed medical professional.
Were you able to normalise heavy periods with any of the nutrients/supplements you’ve described? Or was it something else? I’ve been gluten free for several years now.
Yes, I was able to normalize my periods and that of both my daughters who also both have PCOS. A lot of us who have struggling adrenals have this issue due to low T3 as well as your body will use progesterone as a back up system to produce the cortisol and aldosterone your adrenals are struggling to make. This means you will see low progesterone on blood work or saliva testing. Relatively speaking, this means you have excess estrogen which will cause a whole slew of terrible symptoms including heavy periods
DIM is an excellent way to excrete excess estrogen, and Vitex to increase progesterone. Liver supplements (milk thistle , NAC (1800mg per day also helps blood sugars as well as Metformin in one study) are absolutely necessary as many of us who are dealing with any sort of chronic illness are poor detoxifiers.
As an iron supplement, I have used slow release Hema Plex with good results. It has a lot of other blood making cofactors that work with the iron. I believe the American IHerb.com delivers to the UK as it does to Canada - just in case you don’t find it locally there.
By the way, I have diabetes, hypothyroidism and adrenal insufficiency, so its been a battle to navigate my own health and I became super motivated when I started seeing the same health issues in my kids. But don’t give up, the research is there and unfortunately, you have to be your best advocate when speaking to your healthcare provider. The very best chance you have to get the right support and treatment is to back up what you’re saying with research - I have even printed out the research so my doctor would be on board. This was key for my recovery and my kids. Hang in there and don’t give up! 😊
I just looked up the Hema Plex product - wow - I'm very interested - but hope you won't mind answering a question about it. I would be planning to take it at night - close to bedtime, so as to avoid reactions with foods etc at other times of the day. Would that stop me sleeping [due to the b vits etc in it which would otherwise be "alerting"]. What time of day did you take it?
I take my iron with dinner so it is 4 hours away from my Cytomel (T3) bedtime dose. I have not found that the B vitamins make me alert. Perhaps you could take it in the mornings if that has been your past experience with the B vitamins. I also take my vitamin D3 with K2 and magnesium all together for better absorption in the evenings. Maybe the "relaxing" magnesium offsets the "alerting" B vitamins?
The nutrients [right amounts/right type/ timings and not messing them up with eating the wrong food alongside them or taking them too close to thyroid meds!!] are SO tricky. You could indeed be right that the "relaxing " magnesium at the same time offsets the "alerting" B vits - I like the fact that this iron comes in with the B vits at the same time which you need for its proper absorption, and if I did a mag footbath at the same time as taking them late on in evening [with slice of toast perhaps - would that suffice re the "with food" element do you think?] then that might be a way for me to address the iron. I'd be going for a later on in the evening dose as opposed to with dinner (or with any other day time meal) to make sure that there were no other foodstuffs interfering with absorption.
Thank you so much for all this information! I will look into all the things you mention! I definitley think whats going on is either or both ferritin/cortisol problems arising from undermedication. I have been gluten free for years and fortunately I always get FT3 and FT4 tested as I have secondary hypo so TSH is never tested for me
Taking iron every second day is at last raising my chronic low ferritin, and is kinder on the digestion...
Theres a lot of research that shows the body can block absorption if iron is taken every day, or something like that. Google 'taking iron every second day' for more info. Best of luck!
I take 210mg ferrous fumerate a day, very cheap from pharmacy, and it's going up nicely at last. With vit c (I use l-ascorbic acid powder in a vegan capsule as no additives) away from food/tea/coffee.
I'm not anaemic, my b12 deficiency will have previously enlarged my blood cells however... I'm at last on b12 injections and folate, but MCV has increased to 104, mine is often high with macrocytosis which made me suspect a Thyroid issue. So I requested testing and here i am!
Also low white and red blood cell count. All a bit complicated....
Initial Thyroid tests indicate rare central hypothyroidism, which my brother has. More testing soon.
Thanks. From what I've heard on this forum, though, it can be dangerous to supplement iron if not anemic, so that leaves me stuck wondering what to do.
Excellent reply from CdnMom, there OP. I second low aldosterone as a possible explanation for the dizziness. I have been struggling with dizziness for several weeks which and finally figured it must be cortisol related. Been adding lots of sea salt to my food and find I have no dizziness for several hours to a day after a salty meal.
I also read a bit of salt in orange juice at night helps with sleep for similar reasons. Going to try the milk thistle.
Thankfully I had the knowledge to refuse the oniprazole! I know its low stomach acid related to hypothyroidsm as back in february I had great ft4 levels and acid reflux disapeared and my ferritin shot up to 89 for the first time in my life
Hypothyroidism affects the hormone gastric which controls gastric secretions. A part of that is stomach acid. Also, good levels of stomach acid are needed not only to break down protein but also to absorb minerals like iron. Plus hypothyroidism also causes heavy periods. I’m in the same boat. My Ferritin hangs around 20. Recently I managed to get it to 30 by regular chicken liver meals each week and iron tablets. Taking iron with Vitamin C helps absorption.
I’ve got terrible hair loss which again needs decent Ferritin for one thing. A Ferritin level of 50 is needed to stop hair loss. A level of 70-90 is needed to grow new hair and according to Dr Izabella Wentz a Ferritin of 90-110 is needed for thyroid function.
Thank you! I have definitely seen the effects of hypo on stomach acid - its been way worse than this before I was medicated and back in february I had great ft3 levels and acid reflux disappeared with a ferritin of 89 - highest ever in my life! Very frustrating how we need good iron levels for good thyroid function but to get good iron levels we need good thryoid function!
mine was low and I ate a lot more liver than that. It has done the job. I am not sure what the argument is for not being good for you to eat a lot of liver. I was vegetarian for many years and low on iron and couldn't get the levels up. loads of chicken liver and my bloods were good this year on most vitamins . My endocrinologist was pleased with me for the first time at my annual heck. Julia.
At first a real lot, maybe one and half pounds a week for two or three months, that is about 600 gms or more I think, then I eased off to one pound a week now I am Ok about half pound, 200 gms like you. and it was as if my body was telling me I needed it. Julia.
I take Desicatted Liver capsules and found that they work very well, it will take longer to raise your level than traditional methods. These have worked very well for me without all the usual issues associated with normal Iron tablets.
Humm, I’m trying to lower my ferritin with regular blood donations. According to Morley Robbins from the Magnesium Advocacy Group on Facebook liver is the way to go. Check out his many articles on Iron. Lots of scientific references. Also check YouTube on Ferritin by many including Dr. Mercola. Just trying to help with more knowledge available to all. Good luck in your quest to feeling better.
I have low ferritin but can’t take iron because my transferrin saturation is top of the range. However at my last blood tests I noticed my ferritin had increased from 31 to 41. At first I was stumped as to how but then wondered if it was due to an increase in eggs. During lockdown I started eating omelettes a couple of times a week something I’d never really thought to eat for lunch previously. I’m veggie so don’t eat liver. It’s the only thing I can think of as I’ve not made any other changes.
Might be worth trying a transdermal route to get some iron absorbed through the skin instead of taking it orally, especially if your gut can be problematic?
I also cannot tolerate oral iron. I have to have iron transfusions every 4 to 5 months as mine continuously drops as well, and we don’t know why. It took a few tries to get the right combo of iron type with Benadryl and steroids to avoid a reaction. I had to see a hematologist to get this done. Good luck.
If ferritin is that low eating liver is not enough to raise it and especially not when you are having periods. I raised my ferritin from 6 to 83 using Ferrett's iron tablets. They were also the only kind that didn't upset my stomach. If you can raise your ferritin it will improve your thyroid hormone conversion. Taking apple cider vinegar tablets or betaine with each meal will make reflux go away.
OK your acid reflux and constipation are linked, and most likely low in stomach acid, odd concept but true, read up on symptoms of low stomach acid, when your low the sphincter that stops the reflux relaxes, use it or lose it is apt here, when you top up your stomach acid the sphincter us used again and no reflux.. (been there) stomach acid is not only used to break foods down it makes nutrients usable, as it add a positive ionised charge to the nutrients so their attracted to an alkaline body, opposites attract. It also populates healthy bacteria too, the only time people should need a probiotic is after a round of antibiotics...
If raising iron is still an issue there's a couple of other things to look at, one is vutamin c deficiency as its needed for iron absorption 1000-2000mg a day or to bowel tolerance if diarrhoea occurs, tge other is also. B2 I believe. Also there's a triangle of nutrients tgat need to be in balance, Iron-Copper-and Zinc if say Copper is high it may be suppressing the iron etc so they may need testing too. If zinc is low then thyroid hormones will be out if balance too if adrenals are involved a wired and tired feeling us common ie high cortisol-wired and low thyroid=FT3-tired adequate zinc balances them out... back to tge triangle of nutrients again... I would also add in a digestive enzymes supplement along with the BetaineHCL with Pepsin to raise stomach acid...
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What helped my ferritin - hopefully helps someone :)
Raising ferritin levels
Raised Ferritin, should I be concerned. 
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Taking iron to raise ferritin
