Next steps after Thyroid Panel + Iron results - Thyroid UK

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Next steps after Thyroid Panel + Iron results

c_alex profile image
5 Replies

Hi all, I have done some tests with Medichecks after GP said no to more tests. They have come back with thyroid antibodies raised, and low ferritin, as I was expecting. The advice from the Medichecks doctors was that everything else seems 'normal', but wanted to check in here, and especially around starting to supplement iron as I read somewhere here there can be risks with this?

My symptoms are hair breakage, memory fog/loss, and I also have PMDD. I'm currently on 25mg levothyroxine after taking it for 4 weeks, and am told to review and test again with GP in 8 weeks time.

Thanks in advance xx

Thyroid Function Panel -

CRP HS 0.60 mg/L (Range: < 5)

Ferritin 23.40 ug/L (Range: 13 - 150)

Folate - Serum 10.96 ug/L (Range: > 3.89)

Vitamin B12 - Active 71.600 pmol/L (Range: > 37.5)

Vitamin D 82.10 nmol/L (Range: 50 - 175)

Thyroid Hormones

TSH 2.35 mIU/L (Range: 0.27 - 4.2)

Free T3 3.78 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 12.600 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 55.500 kIU/L (Range: < 115)

Thyroid Peroxidase Antibodies X 115.00 kIU/L (Range: < 34)

Iron Panel -

Iron 30.11 umol/L (Range: 5.8 - 34.5)

TIBC 62.11 umol/L (Range: 45 - 72)

UIBC 32.00 umol/L (Range: 24.2 - 70.1)

Transferrin Saturation 48.48 % (Range: 20 - 50)

Ferritin 23.40 ug/L (Range: 13 - 150)

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c_alex
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5 Replies
Localhero profile image
Localhero

Hi there

I’m no expert on ferritin (or anything TBH! Just another person getting to grips with a thyroid issue). However I’m aghast that the Medichecks doctor says this is all normal. You clearly have thyroid antibodies, indicating Hashimoto’s. Also your TSH is a little high, and your T3 and T4 are just scraping into their ranges. You must feel pretty awful?

In my personal opinion, you are on too low a dose of Levo and should have an immediate increase, rather than waiting 8 weeks. 25mcg is the starter dose normally given to older people or folks with heart issues. Normal starter doses are 50mcg, which are increased by 25mcg increments. It's not unusual for folks to end up on 100mcg or more as their stable dose.

c_alex profile image
c_alex in reply to Localhero

Hello and thank you for your reply! The medichecks dr acknowledged my antibodies were raised and that ferritin was low, however didn’t mention TSH, T3 or T4. I asked to have my dosage raised or for a review to happen sooner and it was denied by GP, so I’m not sure how to get anywhere with that.. Yes I do feel quite low however as it’s come at a similar time to being diagnosed with PMDD it’s been really hard to differentiate between the two! Do you have any tips on getting results from reluctant GPs? It’s so hard to make any progress it seems.

Thanks 😊

c_alex profile image
c_alex

humanbean and SlowDragon I wondered if either of you had any tips on iron supplementing with these results? And any advice on getting a higher Levo dosage from GP? X

SlowDragon profile image
SlowDragonAdministrator in reply to c_alex

Clearly you need dose increased to 50mcg

Bloods should be retested 6-8 weeks after each dose increase or brand change in levothyroxine

Always get tested as early as possible in morning before eating or drinking anything apart from water

Last dose levo 24 hours before test

FT4 is currently right at bottom of range

When adequately treated FT4 should be in top 1/4 range - typically at least 18-20

On levothyroxine TSH should ALWAYS be under 2

Most people when adequately treated will have TSH under 1

SlowDragon profile image
SlowDragonAdministrator

Ferritin is far too low

Are you vegetarian or vegan?

Look at increasing iron rich foods in diet

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/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

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.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

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

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first

Post discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Why low ferritin needs improving

healthunlocked.com/thyroidu...

Iron/ferritin and restless legs

healthunlocked.com/thyroidu...

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