Hi I’ve posted before but I don’t understand if I have a thyroid problem or not or if my iron deficiency is my cause.
I’ve attached a picture of recent labs. Can someone assist with input please. I’m feel awful and wait every day to feel better and function. I was convinced it’s my low iron/ferritin but don’t want to disregard my thyroid if getting on meds would help me.
A normal healthy person would have a TSH of no more than 2, often around 1, with FT4 around mid-range-ish.
Your TSH is about right but your FT4 is very low in range. However, because none of us are tested for our levels in health, none of us know what is normal for us so your low FT4 may be normal for you or it may be a problem.
Looking at your iron panel results on your previous post:
Serum iron: 11 (11-34)
Transferrin: 2.84 (2.0-4.0)
TIBC: 71 (50-100)
Transferrin saturation: 0.15 (0.13-0.5)
Your serum iron is at the very bottom of the range, your saturation is very low in range. These two alone suggest iron deficiency and I hope you are being treated appropriately for this.
Thank you so much for reviewing. I have severe brain fog and very tired all of the time. I don’t want to put off thyroid meds while I work on my iron if my thyroid could be the problem and the cause of my brain fog.
I’m on 300 mg elemental iron a day with vit C and my ferritin is currently 29, up from 11 a year ago.
A year ago my iron panel was:
Serum iron : 7
Saturation % : 10%
So it’s come up but hardly at all.
The best thing you can do is keep your eye on your FT4 level. If your TSH stays within range and your FT4 goes to the very bottom or below range then you could be looking at Central Hypothyroidism which is where the problem lies with the pituitary or the hypothalamus rather than the thyroid and the signal for the thyroid to make thyroid hormone doesn't get sent.
Central Hypothyroidism isn't as common as primary hypothyroidism so many doctors haven't heard of it. You may need to do some research and present it to your doctor if you think you may have CH.
Ok I will keep an eye on it and get it tested periodically. I do see an endo already because I’m diabetic so he’ll run it as well.I did recently have an mri which was normal and I’m wondering if that would have shown a pituitary or hypothalamus issue?
Could I have central hypothyroidism if my FT3 is 4.6 (2.6-5.8), wouldn’t it be lower?
Because T3 is the active hormone that every cell in our body needs, even when FT4 goes low our bodies, in order for us to survive, will continue to make as much T3 as possible for as long as possible.
Wow that makes sense! I have so many symptoms I can’t tell if my issue is originally thyroid or iron.
I can’t seem to increase my iron saturation or serum iron. Even after a year on iron it’s still very low. Ruled out GI bleed as well. 😕
Would an MRI show a pituitary or hypothalamus issue? I had one last yr.
An MRI can show some pituitary issues. However, if an issue is visible on an MRI, it doesn't mean it is actually causing an issue. Oddities visible on MRI seem more common than issues which are relevant and have effects.
The standard approach if a pituitary issue is being considered is to put in a set of tests for other pituitary hormones and see if they are unusual. Luteinising hormone, follicle stimulating hormone, etc.
Oh wow I didn’t know that! I actually just got some hormones tested by my gynaecologist including those. I’ll post them here.If you have input that would be wonderful.
I don't think they look especially high but I am most definitely not familiar with interpretation and where you might expect your results to lie.
A full list of anterior pituitary hormones can be found here: