Do I need a dose increase?

[liaratsoni]

Hi,

I had a blood test done on Friday as I have not been feeling too good: I’ve been gaining a bit of weight, have poor digestion/constipation and reflux and I’ve been having uncomfortable thrumming and heart thumping with elevated heart rate at the same times every day often after eating. I wake up with a racing heart and have sort of leg jolts. I take iron tablets and 87.5mcg t4 and 6.5mcg t3. My results came back:

Ft3: 5.4 (3.5-6.5)

Ft4: 17 (10-20)

Ferritin: 15 (15-250)

The results have confused me a bit as my ferritin has moved up 1 point despite being on the iron tablets for 2 months but my ft3 had much improved. I had in general been feeling better before the awful thumping fast chest discomfort started but wasn’t expecting a ft3 of 5.4 eith my symptoms especially feeling so horrid with the incredibly uncomfortable thumping/thrum chest discomfort. Do you think this could be undermedication and I need some more thyroid hormone? Thanks!

[RoboTh]

Leg jolts sounds like restless legs probably caused by low ferritin. Mine have kicked off now my ferritin had dropped to 15. I have worsening symptoms when it gets to 10 , tongue sore and swollen, low mood, peeling nails etc

[liaratsoni in reply to RoboTh]

Ah I’d never thought of that that’s a good point! I do have restless legs though mine often manifests as just an ache that I keep stretching to try to relieve but it does nothing. The leg jolts do also seem tied to adrenaline as they often come with the thumping heart.

[SeasideSusie Remembering]

liaratsoni

Obviously a ferritin level of 15 confirms iron deficiency. Has your GP also tested for anaemia?

How much iron are you taking?

What is your GP saying about your level and it's lack of improvement?

[liaratsoni in reply to SeasideSusie]

Hi susie, I have been tested for anemia - my ferritin has been under 15 for ages and at one point got down to 9 when I had a full blood count done and I didn’t have anemia though strangely my white cell count and platelets changed. I take 1 90mg tablet with 500mg vit c a day as my digestive issues prevent me from taking anymore. My gps are useless - my ferritin was 12 about six months ago and my doctor says they’d have to check it didn’t decrease again but when it did to 9 they did nothing. I only found out because I checked my own patient access online and I’m having to monitor myself because they aren’t! The only time it was normal was feb 2020 when I also had an ft4 of 17.5 and an ft3 of 5.6.

[SeasideSusie Remembering in reply to liaratsoni]

Has your GP considered an iron infusion or investigating further why your results are so bad? Maybe a referral?

[liaratsoni in reply to SeasideSusie]

I had thought of that but they haven’t said anything and since my ferritin has been 13 my doctor always writes normal no action against my results. One other doctor said they could give me the pill to stop my periods but I have only had them back for half a year after amenorrea for years, I have had issues with sex hormone changes before and I’ve only just stabilised them so I really don’t want to do that - plus I don’t think it will solve anything!

[SeasideSusie Remembering in reply to liaratsoni]

Maybe suggest a referral yourself, mentioning how long this has been going on and the very low levels.

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Symptoms of iron deficiency include:

◾Persistent fatigue

◾Pale skin

◾Shortness of breath

◾Headaches

◾Dizziness

◾Heart palpitations

◾Dry skin

◾Brittle hair and hair loss

◾Swelling or soreness of the tongue or mouth

◾Restless legs

◾Brittle or ridged nails

[liaratsoni in reply to SeasideSusie]

Thank you I might have to. Who would it be a referral to? My endocrinologist did mention iron infusion before so I will email him too.

[RoboTh in reply to liaratsoni]

You would be referred to gastroenterology I think....incase it's an absorption issue. Only speaking from experience. I don't have anaemia but chronic iron deficiency once mine goes below 10 I get re referred to gastro and have iron infusions due to intolerance to oral iron but usually your Hb has to be below 10 I think to qualify. I was lucky and got an brilliant consultant who agreed to mine but having further ones is proving difficult

[liaratsoni in reply to RoboTh]

Thank you that’s helpful to know! I def think it’s an absorption issue as I have big digestive problems with my hypothyroidism unfortunately