Hi! I'm brand new here. I have learned so much reading over some other posts on this message board, thanks already! I've finally gotten on what I believe to be the right dosage of NDT for my Hashimoto's after 6 years of ups and downs. I'm currently on 160mg of Armour Thyroid and have a Free T3 at 3.8 pg/mL (2.3-4.2) and Free T4 at 1.1 ng/dL (0.8-1.8.) However, I am now experiencing extreme fatigue, which is a new symptom for me. It has been suggested that I am pooling so I tried to dive in a bit more.
I'm pretty sure I am in an anemic state due to my serum iron being through the roof while ferritin is far too low. Here are my iron labs, they were from 4 months ago just before I increased Armour from 120 to 160.
Total Iron: 208 (40-190 range)
Iron Binding Capacity: 347 mcg/dL (250-450 range *I've grown to understand this should never be above 330, under 300 is best*)
% Saturation: 60% (range 16-45)
Ferritin: 22 ng/mL (range 16-232) I've had this one tested six times over the past 3 years, and have had a max reading of 24 and minimum of 13.
I believe I have the MTHFR gene mutation and plan to get tested for the specific mutations.
What else should I have tested? I haven't any recent results but my B12 is usually rock bottom, except for the 6 months after I got a B12 injection. My D3 is always low. I have never yet been tested for Folate but will request it. Over the past 2 years, I got lazy about my supplements but now I've just restarted these:
Vit D3 10,000 IU, Methylated B-complex, milk thistle 175X3 mg, 750 mg Vit C. I am also drinking no alcohol, I wasn't a heavy drinker but was in the past. *I didn't take methylated B-vitamins prior to now but took a powerful b-12 plus complex.
Do these supplements sound good? Is there something else I can do? To me from my research it seems the #1 recommendation for methylation issues regards remove folic acid and replacing with methylated folate or folate from the diet. I will try, I am admittedly a huge wheat lover, despite that I went gluten free for a year and I did not notice any changes in my health other than always begin hungry. (Do they add folic acid to wheat everywhere? Hard to avoid..)
Thank you for your advice!
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Xheila
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Iron Binding Capacity: 347 mcg/dL (250-450 range *I've grown to understand this should never be above 330, under 300 is best*) - 48.5% of the way through the range
% Saturation: 60% (range 16-45) - Over the range
Ferritin: 22 ng/mL (range 16-232) I've had this one tested six times over the past 3 years, and have had a max reading of 24 and minimum of 13. - 3% of the way through the range
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Total iron - Yours being over the range suggests you have plenty of iron.
Iron binding capacity - Yours being mid-range suggests your iron is fine. If iron binding capacity was high it would suggest that you were low in iron and needed more.
% Saturation - Yours being over the range suggests you have plenty of iron.
Ferritin - Yours is way below optimal, suggesting you need more iron.
Optimal levels of iron are described on this link :
Having inconsistent iron panel results is quite common i.e. some of your results suggest you have plenty of iron, some suggest that you need more. I think you might be right about having an MTHFR problem.
To reduce the effects of an MTHFR problem you need to supply yourself with more methyl groups. The easiest way to do this is to do the following :
my B12 is usually rock bottom - Supplement with methylcobalamin 1000mcg per day on top of the methylated B Complex. Test after the first bottle is finished. Optimal for serum B12 is about 1000 ng/L, for active B12 it is over 100 pmol/L. Once optimal is reached take 1000mcg fewer days of the week - perhaps only once or twice a week, but you would need to test to know, and just take enough to maintain your level.
Folate - Optimal for folate is top half of the reference range, but don't allow it to go over the range. The best supplement is methylfolate which you may need to take on top of the methylated B Complex. Take 1000 mcg per day. Test after the first bottle is finished. Once optimal is reached continue taking 1000mcg methylfolate per day, but take it fewer days per week. You might only need to take it once or twice a week, but testing is necessary to find out your maintenance dose.
I don't think you can avoid folic acid, but I would just suggest either ignoring the problem, or if you are determined to avoid it, try avoiding the foods which have been fortified.
Regarding methylation, this link should be of interest :
If you are happy with your B12 and folate levels and want to reduce your intake there is another supplement that is sometimes used to increase the intake of methyl groups and that is something called MSM which stands for methlysulfonylmethane. It often comes in a powder. I know almost nothing about MSM but you might want to research it.
The above calculator from grassrootshealth can be used to calculate the dose required to raise vitamin D to optimal.
Vitamin D supplements taken should always contain vitamin D3 not vitamin D2.
The best vitamin D supplements are capsules containing only oil and vitamin D3. An alternative is mouth sprays.
Vitamin D raises the amount of calcium absorbed from the diet. In order for that calcium to end up in bones and teeth, rather than lining the arteries, there are two other supplements recommended. They are magnesium and vitamin K2. If you search the forum for references to vitamin K2 and magnesium you'll find they have been referenced hundreds of times.
Thank you immensely for your detailed reply. I added all the supplements you recommended to my regimen and three weeks in, I cannot believe how much my life has changed for the better. I have energy every day, this has not happened during the past seven years when I first became ill. I am starting to add things back to my life that had been long swept aside due to my lack of energy.
I realized I forgot to thank you and want to get my head out of the sand and send you warm wishes. I am so grateful for your help.
I am stunned by how helpful people are on this site. I will create a new post when I get my new blood tests in a few weeks to hopefully help others too. x
If your B12 was low, before supplementing you should have had a test to exclude Pernicious Anaemia. P.A. is a serious condition if undiagnosed/untreated.
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Update - Thyroid Test Results Requesting Dosage Increase
vitamin supplements really working but need further advice please 
Test results from lab:
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Comments on my TSH, Free T4 and Free T3 please
