Ferritin level going down - is this why I feel rubbish?

[Londonist]

I've just had another Medichecks test done as I still feel really tired and sluggish. I'm on 125mcg levothyroxine and followed the instructions on here about testing early AM on an empty stomach before taking medication etc.

Folate, Active B12 and Vitamin D have improved but Ferritin has gone down. What can I do about this? Also, if my FT4 is still right at the top of the range why is my FT3 fairly low?

Thanks in advance for any tips

[SlowDragon Administrator]

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

Have you been increasing iron rich foods in diet

What vitamin supplements are you currently taking

Vitamin D, B12 and folate all improved nicely

Are you also now on absolutely strictly gluten free diet

If not, that’s next step to trial before considering adding T3

Hashimoto’s patients frequently have poor conversion of Ft4 to Ft3

Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3 if necessary ...NHS and Private

[e-mail]

[Londonist in reply to SlowDragon]

Thanks v much for replying. I’ve been eating more red meat and leafy green veg, but there’s probably more I could do on that front. Will try gluten-free after Christmas I think… how long would I need to give it a fair chance? (You can tell I’m loath to give up bread!)

I’m taking Igennus Super B complex, purolabs D3 + K2, magnesium spray when I remember it and Ferroglobin capsules. I’ve had the same brands of levothyroxine for a few months at least - Mercury 100mcg and Teva 25mcg. Tests done as per instructions on here.

[SlowDragon Administrator in reply to Londonist]

Get Mercury Pharma 25mcg tablets instead of Teva

Teva brand upsets many, many people

Remember to stop taking any vitamin B complex a week before all blood tests as contains biotin

GF

There’s plenty of good GF bread…especially if toasted (in a separate dedicated GF toaster)

Waitrose brown seeded

Warburtons sourdough

M&S

Read all labels…cut out absolutely all rye, barley and wheat

[Imaaan in reply to Londonist]

Everyone is different but I started seeing improvements around 3 months of being gluten free.

[Imaaan]

I start feeling horrible whenever my ferratin drops below 70 at a range of 12-125. It defn effects my TSH and conversion process as well. Eating red meat every day and adding liver here and there helps keep my levels up. Also if its possible ask your doctor for prescription vit d3. You'll start feeling better as your levels improve hopefully

[pennyannie]

Hello Londonist :

The accepted conversion ratio when on T4 Levothyroxine only is said to be 1 - 3.50 - 4.50 T3/T4 with most people preferring to come in at around 4 or under.

So to find how well you are converting T4 into T3 you simply divide your T3 into your T4 and I'm getting yours coming in at around 5 showing you going out from centre and having poor conversion of the T4 into T3.

This is why your T4 is high in the range and your T3 low in the range, and as your ferritin builds, your conversion should improve, and you'll see that staying on this same dose of T4, your T4 will go lower as your T3 rises.

Apart from the ferritin, your vitamins and minerals are building up nicely, and remember my ferritin taking forever to tip over 45 and I know now I feel at my best at around 100.

Can you increase your iron supplements ?

I was prescribed 3 x 322 mg tablets daily, but found these upset my stomach so I purchased Gentle Iron, but any form of Iron Bisglycinate will work, I also ate liver twice a week, and I also took Spatone liquid iron sachets.

I think iron needs to be taken 4 hours away from anything else and it's recommended you take vitamn C to bowel tolerance if that becomes, or is, an issue.

I see you have Hashimoto's and so it's recommended to rule out for Cealiac Disease, and then look at food intolerances such as gluten, dairy, wheat and believe Dr Izabella Wentz is a recommended read on " first healing the gut " to repair the stomach wall for optimal absorption of thyroid hormone replacement and the necessary vitamins and minerals.

P.S. Just read you are already taking a gentle form of iron - considering your iron has gone down a little, maybe you need to reassess your dose ?