Low ferritin caused me shortness of breath and thyriod results after increasing my dose

[Meriam881]

Hi all, I am 38 years old and I am struggling with hashimoto disease and to get my thyriod levels optimal. I was taking 75 of Euthyrox every morning.Since my diagnosis three years ago, I struggled with my doc to raise my T4 and to prescribe T3 and he is reluctant to do so. My problem was the non conversion of T4 into T3 as my T3 was always normal but always in the lower range. I also suffered from bloating, abdominal pain, and gases all the time. So, at the beginning of this year I raised my dose of Euthyrox to 87.5 and I become gluten, dairy, soy and grains free. I also do intermittent fasting for 16 hours daily to improve my body functions. Because of the pandemic situation I could not do any tests for approximately awhole year but I felt a lot better. Unfortunately, this feeling did not last. Since more than a month, I suffer from shortness of breath, and severe anxiety. My anxiety is through the roof right now and I can barely work. I went to my doc and he just asked for thyriod panel and ferritin test. He refused to do any extra tests. There are the results of the thyriod panel:

Free T3 3.07 pg/ml ref range: (1.7 - 4.2

)

Free T4 1.15 ng/dL ref range: (0.89 - 1.76)

TSH 0.371 uIU/ml ref range: (0.55 - 4.78)

My ferritin is 6 which is too low. I had two problems. My doc wants to decrease my T4 because TSH is low? What do you think ?? I do not want to decrease my dose. My heart palpitations stopped after using this dose so I think we should not judge by TSH only. Do you think I should continue taking this dose?

He also wants to describe iron tablets to increase my ferritin. These iron tablets have gluten. All iron tablets in my country have some kind of gluten so I refused to take it. I found gluten free multivitamin which has iron but the iron in this multivitamin is 17 mg only. Is this dose sufficient to increase my ferritin. I eat red meat and liver but probably I had malabsorption problem. Do you think my low ferritin is the cause of my shortness of breath?

Thanks for support.

[Meriam881]

I forget to say that my thyroid blood tests are done in early morning while fasting and no thyriod medication 24 hours prior to the test.

[jrbarnes]

First of all your FT4 levels are extremely low. My FT4 levels are at 1.6 (.82-1.77 ng/dl.) You need to find a new doctor if this one can't see how low your FT4 levels are. I had to do the same thing because my doctor wanted to keep decreasing my medication despite having very poor FT3 levels. He wasted three years of my life keeping me very unwell and I'm currently on a medical leave because of it. You feel short of breath and have anxiety due to being on a too low of a dose. I weigh 100lbs and take 88mcg and when the doctor reduced to 75mcg I couldn't get out of bed. I had to look my doctor in the face and tell him that he was disabling me by dosing me according to the TSH. You already know you feel better at 87.5mcg and that's all the proof you need. All your low nutrient levels are a result of being on a low dose.

[Meriam881 in reply to jrbarnes]

Thanks a lot for reply. I feel sorry for you. I hope your new doc is a good one who judges by symptoms not labs. Do you think I need T3 medication or FT3 may increase if I increase T4?

[jrbarnes in reply to Meriam881]

At this time I don't think you need T3 because your T4 is low and T3 is a little over 50% of the range so I think that if you increase your Levothyroxine that it will bring your T3 up to the 70% in the reference range. You appear to have a good conversion rate. I'm envious! Your T4 is currently about 30% in range. You may feel much better if you bring it up to 1.4 to 1.7 and T3 levels closer to 3.8 to 4.2. Find yourself a better doctor because this one is taking you two steps backwards.

[Meriam881 in reply to jrbarnes]

Thanks. But I think free T4 is 65 % in range. The ref range is 0.89 - 1.76 and it is 1.15. I am often do not convert well at all. But I think quitting gluten made the difference. I am gluten intolerant besides I had many food sensitivity issues.

[humanbean]

Which country are you from?

[Meriam881 in reply to humanbean]

I am from Egypt.

[SlowDragon Administrator in reply to Meriam881]

You need further testing Extremely low ferritin, so you need Full iron panel test for anaemia

Vitamin D

Folate

B12

Are you vegetarian or vegan?

[Meriam881 in reply to SlowDragon]

My doc refused iron panel. He just told me I have iron deficiency. No, I am not vegan. I eat meat. But my period is heavy. I think it is a factor in iron deficiency.

[SlowDragon Administrator in reply to Meriam881]

It’s a vicious circle

Heavy periods are often hypothyroid symptom

Leading to low iron

Low iron/ferritin can cause heavy periods

Can you get an iron panel test privately

[Meriam881 in reply to SlowDragon]

I will try to do it privately. Currently I will take B12 and multivitamin contains iron. Do you think it is sufficient? My friend suggested iron infusion but I am afraid of this procedure. I usually react badly to infusion thereby.

[humanbean in reply to Meriam881]

My ferritin is 6 which is too low.

Do you have the reference range for that result? I agree it is desperately bad by the standards of every reference range I've seen for ferritin, but it would be nice to know what the range was anyway.

The optimal level for ferritin is mid-range or a little bit higher. For example, if the range was 13 - 150 (a common range in the UK), then a result of 82 - 120 or 82 - 130 would be optimal.

He also wants to describe iron tablets to increase my ferritin. These iron tablets have gluten. All iron tablets in my country have some kind of gluten so I refused to take it.

Do you have access to an Amazon website which will post supplements to you? Or an Ebay? If you can buy from them you should be able to buy some gluten-free supplements.

This is a website I've dealt with several times and they claim they deliver worldwide, but that customers should check that they deliver to where the customer lives :

healthmonthly.co.uk/deliver...

Supplements sold in the UK or by companies with a business relationship to the UK generally tend to be gluten-free.

One thing to be aware of is that you always need to know, for any iron supplements, what the level of "elemental iron" is i.e. how much pure iron there is in each tablet.

As an example, ferrous fumarate 210mg has 69mg of pure or elemental iron per pill. It is the 69mg you need to know.

Roughly speaking, anyone taking ferrous fumarate 210mg can take a maximum of 1 tablet, up to 3 times daily, if they can tolerate it. But trying 1 or 2 per day would be worth doing to see if it would raise your ferritin.

The products you need to look for are :

ferrous fumarate,

ferrous sulfate (a lot of people don't tolerate this well),

ferrous gluconate.

Lower dose products which might be more easily sourced are :

ferrous (or iron) bisglycinate

Gentle Iron (another name for iron bisglycinate)

Floradix

If you eat meat, liver is full of iron.

You might find this website of use :

dailyiron.net/

and this link :

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

You should find this article by Helvella of interest - it gives alternatives to the iron salts I've mentioned :

dropbox.com/s/4d885frbic4z8...

Good luck.

[Meriam881 in reply to humanbean]

Thanks a lot for your great information. The ref range is 10- 120. Currently there are some problems dealing with Amazon ( delay in customs, unable to deliver products, etc.). I will check the other website and try to find secure sources. I will see the other websites you referenced to know more.

[deetree50]

Hi don't be afraid of iron infusions .I had 2 last year and felt much better after them.

[Meriam881 in reply to deetree50]

Thanks. It will be my last resort after medication.

[Emmanuelle33]

I use BIOCYTE Fer (iron). It's a liposomal form of iron and it is much better absorbed than other form of iron. You can find it on amazon.fr: amazon.fr/s?k=Biocyte+Fer&_...

It doesn't contain gluten

[thyr01d in reply to Emmanuelle33]

Thanks Emmanuelle for posting this - amusingly when I clicked on your link Amazon showed me a number of clothes irons!

[Newmummy82]

Just to add to the great advice already given, I had symptoms of breathlessness, palpitations and anxiety when my ferretin was low so these symptoms could resolve by addressing your low iron levels. Mine did.

[Meriam881 in reply to Newmummy82]

Thanks a lot