Bloods taken last week in the morning before Levo or any other medication at 8.50 in the morning.
I’m currently taking 200mcg and 212.5mcg alternative days. As Aristo brand. Still getting a few palps and still very tired. Would I benefit from t3 if so why as need support as endo not wanting me to take it.
I really need help with my iron results now and before. I’ve not stopped supplements yet it’s dropped again.
TSH 0.23 (0.38-5.50)
T4 16.7 (10.0- 18.7) pmol/l
T3 5.2 (3.5-6.5)
Iron profile
Iron 12 (9-30)
Transferrin 2.20 (2.5-3.3.8)
Tibc 55 (45-81)
Transferrin sat 22% (15-50)
Ferritin 106 (10-291)
I was just taking 200mcg everyday about 6 months ago but felt more tired and my TSH was about 1.39? Though I can’t remember without looking back on here. I was advised to increase dose.
I literally can’t get out of bed and my body never feels energised.
Taken about 2 months ago on Aristo Levo dosage was 200mcg and 225mcg alternative days. I had bad heart palps and felt anxious.
Tsh 0.29 (0.38-5.50 mlU/L
T3 5.5 ( 3.50-6.50pmol/L
T4 18.7 (10.00-18.70
Vit D 94.4 is this now adequate should I still take vit d?
Serum iron 15 (9.00-30.00umol/L
Serum transferrin 2.2 (2.50-3.80g/L
Saturation iron binding cap 55 (45.00-81.00
Transferrin saturation index 27% 15.00-50.00%
Serum ferritin 114 (10.00-291.00ug/L
Thank you for all your help.
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Cheekycharlie1981
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On the face of it, your thyroid numbers are not bad. FT4 is 69% through range and FT3 57%. So you don’t seem to have a conversion problem. T3 doesn’t seem to be indicated here.
Your Vit D3 is not bad either. But I wouldn’t stop taking it. I prefer mine to sit over 100.
I’m not particularly up on ferritin and hope someone else comes along who is. Are you trying to get some through your diet as well as supplements? For example through liver, dark chocolate, dark leafy greens? I wonder if you should keep your thyroid meds as they are for now and put real focus on this for the next couple of months and review?
Another possible point of exploration is cortisol. Have you done a saliva test at all? That could be useful at least to rule it out.
I’ve had a cortisol test done and repeated as first time it was low but then suddenly I’m normal. I’ve try try suit my histamine intolerance diet too which contradicts the thyroid healthy diet so it’s difficult.
I can’t eat liver for this reason, red meats my stomach does struggle as I get terrible indigestion.
I watch what I eat and know lots about my condition and how to support it but I’m still struggling. My iron makes no sense to me and my gp always says normal due to my stores.
I did ask humanbean last time if they are now able to comment on my last few threads on my iron. It turns out I don’t have inflammatory bowl disease as my last bloods showed no markers. I’d really appreciate the help as I feel utterly shattered all the time.
I take barefoot nutrition supplement which had vit d and k in as well as zinc and magnesium.
I also take selenium, q10, evening primrose, vit c, iron and a b complex.
It’s really hard when you feel like you’re doing everything right and still not getting there.
I know you don’t have IBD. Have you done any work on your gut/microbiome? In a not too dissimilar position to yourself, I did some work via Healthpath last year. I like them because you can do tests, they give you feedback and then you get on with it yourself. Like DIY functional medicine. Anyway, I discovered a few things from that that helped me understand some of my absorption issues. I think it has really helped.
How much did that cost as I simply I’m on a low income and the supplements cost a fortune already. I take lactobacillus rhamnosus daily which is good for histamine intolerance and then I take flaxseed oil tablets, mixed ground flaxseed as well as bacillus coagulans.
I don’t drink caffeine in any form and drink lots of gut friendly teas.
I simply don’t seem to be winning, and things are harder after having my daughter and I’m older.
I’ve even tried tinctures and getting help from a herbalist.
I did two tests, one of their gut function and their SIBO test. I think it was around £500, but they have a thing you can pay it over several months. They did suggest some supplements which I also bought. I decided to swap out others in order to afford these. They do a free 15 call if you’re interested. Sorry, I sound like I’m selling for them. I’m not. I just thought it really helped.
I’m totally dairy free and gluten free diet, I take a my vits at the correct times from advise on here previous times.
I’m not celiac.
Should I reduce my Levo? My TSH seems to have jumped a lot from taking 200mcg over 4 months ago then increasing to 225mcg and then reducing again to 212.5mcg but my TSH is more suppressed.
I’ve had lots of bloods done and various test and nothing comes up, my gut is obviously poor at absorbing iron as it’s very erratic. I’m constantly supplementing yet my ranges drop.
Optimal is 55% - 70% of the way through the range, and yours is substantially lower than this suggesting you need more iron.
.
Transferrin and TIBC
Low or low in range indicates lack of capacity for additional iron suggesting you already have enough.
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Transferrin Saturation
Optimal is 35% - 45% and yours is substantially lower than this suggesting you need more iron.
.
Ferritin
Optimal is usually given as 50% of the way through the range or a little bit higher. Yours is lower than this so you would probably feel better with a higher level, say 150 - 200 with the range you've given.
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Your results are contradictory but this is very common. Iron, ferritin and transferrin saturation suggest you need more iron but your transferrin and TIBC suggest you have plenty of iron. Things are more complicated though. Low (or low in range) TIBC and transferrin can also suggest that you have liver disease or some other chronic disease. Transferrin is made in the liver, and if the liver is not as healthy as it could be transferrin will be low. You may find this link of interest :
Some of the more common possibilities - you have a fatty liver or you are suffering from malnutrition, particularly in protein. Both of these conditions can be improved with a change in diet. Eating more protein and eating fewer carbs and sugar will help. Plus the body needs fat in the diet to be well.
I don't know much about the liver, so you could do some research on it yourself. I managed to improve my own liver health by cutting back on carbs and increasing protein and fat intake.
radd knows a lot about iron. She may have some suggestions for you.
If you choose to supplement iron I wrote about the available types in this reply to another member :
If you choose to supplement iron I wouldn't suggest that you take one of the very high iron supplements like ferrous sulphate or ferrous fumarate. Instead I would suggest something like ferrous gluconate 300mg which contains roughly 35mg iron per tablet. The maximum dose for an adult is 4 - 6 tablets per day which can be spread over the day. And you could start with one tablet and see how you get on, increasing if you want to. Make sure to take iron and thyroid hormones at least four hours apart.
humanbean what brand supplements offer this in this form of iron, my usual only go up to 20mg. Is spartone any good at keeping my iron topped up? I’m now worried about having to much iron free in my body. If I have stopped iron in the past or just taken spartone my daily stores drop out of range.
I’ve written to the gp with your points and radds. Thank you again.
You are on quite a high dose of thyroxine but your labs don't indicate over medication.
Transferrin usually raises in iron deficiency to encourage further iron into circulation. When it remains low it can be indicative of anaemia of chronic disease, with either poor transferrin production because of liver issues or too much pee’d out by the kidneys which would make sense as to why you are medicating higher amounts of thyroid hormone, ie you are also pee’ing out thyroid hormone. I did this when my GFR went really low.
Changes in red blood cells may mean slow production and/or they die too soon so denying that iron amount that is usually recycled. Have you been diagnosed with something like PA or Crohns ? If not have you had FBC?
I've rather lost my confidence with iron recently, mostly because my health is deteriorating generally and my brain fog seems to be permanently bad now, but also because of the following :
For people with Anaemia of Chronic Disease (ACD) I have often seen it said that iron supplements should be avoided. For example...
At the end of the above link is the comment, my emphasis :
"Treatment
There is no treatment for anemia of chronic disease except to address the underlying condition. Iron supplementation is inappropriate in these patients because the added iron can become free to nourish bacteria and cancer cells."
And yet, at odds with that comment is a paper I only came across very recently that was published in 2021 :
Title : Management of Anaemia of Chronic Disease: Beyond Iron-Only Supplementation
The title implies that iron supplementation is a standard treatment for ACD. Since when, I wonder? I haven't read much of this paper, other than to note it discusses iron infusions, which are incredibly hard to get prescribed in the UK, and expensive to source privately.
I totally agree, hence I didn't suggest supplementing iron but enquired re posters gut health.
If I were the O/P I would wish investigations of the low transferrin levels prior to supplementing iron so as not to muddy the waters but also because there's a chance iron levels will independently improve should the reason for low transferrin be resolved.
I’ve had many tests done and I’m sure I was tested for Crohn’s disease many years ago when I had a bowel bleed.
I’ve endured lots of stress and this caused the bleed, I then found out I had anaemia b12 and iron. I’ve managed to control my b12 well through supplements but the iron I yo-yo constantly and I don’t seem to ever win. Gp says my iron is normal but it’s clearly not. Even when I was pregnant I argued for my iron testing as I could barely walk.
The gp thought I had inflammatory bowel disease as a sample came back raised but then tested again and it was within the norm so he then just didn’t do anymore investigations as he’s scratching his head.
All my blood work comes back normal for my kidneys, I’ve had a few tests done as prone to urinary infections.
My gut is unstable I do get a lot of gut pain despite being gluten and dairy free. I suffer from histamine intolerance, but again have symptoms which don’t make sense. I do supplements with gut friendly products and none have really help massively.
I’m constantly tired even sleeping in till 10am and I can feel tired, when I get up earlier than this my guts a mess, eyes sore and I’m so tired.
I do feel a little anxious right now and wonder if I need to lower my Levo back down to 200mcg. But I’m holding out for more bloods in a few weeks.
I don’t know if Levo suits me as I never feel clinically well. I’ve blamed my iron levels for so much but I’m plodding along and feel alone and clueless at what to do.
I’d love some help, something to lift me off the floor.
I thought t3 was my hope but now my ranges indicate to my endo I don’t require any. I did use it a few years ago and my body really reacted over time, even with a pitch but my head felt awake for a short time in the day.
What’s PA and FBC? Sorry I’ve not had time to read the links my 3 year old is time consuming and draining.
Oh, this is terrible and at a time when you should be enjoying your young child.
Research shows decreased T4/T3 levels & peripheral conversion of T4 -T3 with low iron levels but iron deficiency can both be a cause and an effect of hypothyroidism, which usually reverses with thyroxine/T3 meds and iron supplements.
The majority of anaemias are caused by iron deficiency or VitB12/folate deficiency but there are other causes. With an under-range transferrin level I personally don’t think you should be supplementing iron as when your ferritin reaches its limit, any surplus iron will be ‘free’ (which is toxic), ie have no where to go because there is no transferrin for it to bind to.
Most iron is in red blood cells in oxygen-transporting haemoglobin, a little in storage (ferritin ,etc) and all plasma iron is bound to transferrin for transport to bone marrow, spleen, liver, etc and to protect from free iron that creates
free radical oxidative stress. Transferrin is also a part of the innate immune system by delivering white blood cells (macrophages) to all tissues, and impeding bacterial survival by keeping iron bound.
Usually as iron levels reduce, transferrin goes up. GP’s are generally familiar in identifying iron deficiency/anaemia but your readings are unusual which he hasn’t picked up on. Transferrin levels can be used in assessing iron metabolism issues/anaemias by determining the iron-carrying capacity of the blood. An under-range result should not ignored by your doctor as is an essential biochemical marker of body iron status.
Ferritin is generally the first marker to become low when diagnosing iron deficiency and/or anaemia, and if your GP tries to side-line you with your ferritin level of 34% through range, point out your serum iron is deficient, transferrin saturation below normal levels of at least 25% and most importantly your transferrin is under-range.
It sounds as if he has already completed plentiful tests and is unable to offer you treatment to make you well. Explain how ill you are feeling and that is it getting worse. Point out these discrepancies in your iron readings and ask that your GP either seeks advice from a haematologist in how to treat you or offers you a referral. If your GP remains uncooperative write to the practice manager expressing your concerns and asking for a second opinion.
You are welcome to post your full blood count if you wish members to comment but I think you need more specialist help.
Thank you radd for your in depth advice. I’d love to find a reason for my results. My gp just put it down to poor gut absorption and nothing else. I’ve even had an gastroenterologist laugh as me and say my iron levels are fine. Why are these gps so blind? None have ever helped me and I’m so depleted in energy, I’m in pain and my stomach joins in the party. I simply just don’t feel awake and my body does behave like it’s intoxicated as I’ll have violent diarrhoea, sickness and full on body sweats. I take cetirizine hydrochloride daily as I’m currently past off as having histamine intolerance.
I don’t know what to do. I wrote and in depth letter to my gp about what tests I wanted etc and it’s come to a haunt.
I definitely don’t have energy for my daughter and it upsets me.
Can I just ask a question when I don’t supplement I eventually become anaemic and I literally can’t walk. If I stop my iron where do I go? I’ve plenty iron results on here can you look through them to try and understand my readings?
A bowel bleed sounds serious and it sounds as if you have quite extensive GI tract/gut malabsorption issues. What diagnosis did the gastro give? Have you been previously diagnosed with a certain type of anaemia?
My Mother used to have ulcerative colitis & horrendous gut issues but found glutamine really helpful. I also used marshmallow root and slippery elm to heal my own leaky gut after long term inadequate thyroid hormones and unmanaged Hashi. Gut inflammation can alter the way iron is utilised with a compromised supply to erythroid marrow so it may be worth concentrating on healing the gut rather than supplementing iron directly. Are you gluten free?
I have no experience of under-range transferrin myself but read sometimes other drugs are required before or alongside supplementing iron to stimulate the bone marrow or get red blood cell turnover working better just to get your body utilising iron correctly, and then sometimes addressing the underlying cause is enough to recover iron levels without the need for supplementing iron.
The first gastro guy examined me 3 years after my bleeding from my bowels and found no inflammation. He reported my spasmodic bowels are due to stress triggers and how the brain and stomach work together. He said because I was trying to make myself better my body didn’t know how to react. I’ve been examined quite a few times years ago and had my tummy looked at too and I had a few polops.
In 2018 I had my gallbladder out and a few months after fell pregnant with my daughter.
I was fine until I lost my mother and why stability I had as a child. My body coped through stress, I lost some hair, some went white.. I coped for about a year and then had the bleed.
The gastroenterologist said it was probably stress induced over such a long time.
I had bloods done and was anaemic and my thyroid was pretty much not working. I was about 22, I’m now 40.
I’ve been taking iron all these years and on Levo.
I just feel exhausted and don’t know what to do next, I’m almost fed up of fighting my body and gps.
Looks like I need to construct another letter to the doctor, which is hard when time is little and I’m not feeling clear.
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