Hi everyone, I am having some confusing blood results compared to symptoms that I would like some help with. I have been feeling so much better for the last 6 months after getting my vits and mins mostly optimal and starting an iron supplement. Almost all my symptoms are gone but I am still having digestive issues (though nowhere near as bad) and what seem to be lingering pms problems. I had thought maybe I just needed a small dose increase to resolve last issues but my bloods have just come back as following (bloods are always done same time of day 8 hours post half my dose of t3 and full dose of t4):
Free T4: 20.2 range 10-20
Free T3 5.7 range 3.5-6.5
Ferritin: 18 range 30-250
This is on a dose of 87.5mcg t4 and 7.5mcg t3. The t4 is concering me a little as I like it a bit lower and it seems to be going up. My last blood test two months ago on the same amount of t4 and 7mcg t3, all the same supplements except iron was this:
Free T4: 18.2 range 10-20
Free T3 5 range 3.5-6.5
Ferritin: 14 range 30-250
Vit d 112 range 76-250
b12 563 range 200-1000
Before that my blood test done in september 2021 when i was taking all the supplemements including iron and was on the same dose of t4 but my dose of t3 was 6.3mcg as was this:
Free T4: 17 range 10-20
Free T3 5.4 range 3.5-6.5
Ferritin: 17 range 30-250
The only thing that has changed between my blood tests now and those before is that I started taking a probiotic 2.5 weeks ago that seems to have helped my bloating. One thing I have noted is my ferritin never budges but if I stop taking iron my t3 levels reduce significantly. I am very confused about why my t4 is increasing though when neither my lifestlye nor my dose has not changed but my ft3 has gone up. I am also confused about my continuing symptoms when my levels are so good.
My remaining issue is digestive which I assume is the reason for my low ferritin level and pms type symptoms. The symptoms I have is burping, some bloating and bad acid reflux which is worse when I try to eat meat or slightly bigger meals (I eat small meals) and I often get tiredness and internal thrumming after eating paticularly after breakfast and sometimes dinner which are the meals I eat 2 hours post thyroid medication dose. Strangely my constipation is almsot gone some of the time but comes back with pms. From ovulation to period I have some constipation, acne, feeling warm, trouble sleeping etc and the last two cyles have been a bit weird in length - 29 then 25 days. .
I take 45mg liquid iron with vit c daily, a b12 supplement twice weekly, probiotic daily, vit d +k2 daily.
Could the rise in t4 between by first two blood tests be linked to me stopping taking my iron as my t3 went down? I am also wondering if the recent big rise is due to the probiotic improving my gut flora and therefore my abosrption of t4? Still very confused about why my stomach issues though massively improved are still present? Any insight would be hugely appreciated!
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owl87
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(bloods are always done same time of day 8 hours post half my dose of t3 and full dose of t4)
Am I reading that right? You only left 8 hours between your last dose of levo and the blood draw? If so, you have a false high FT4. It should be 24 hours.
Free T3 5 range 3.5-6.5
That is only 50% through the range. A lot of hypos need it higher than that. And, you're only taking a small dose of T3, so there's plenty of room to increase and see if it helps with those reluctant symptoms.
What really worries me in your results is your ferritin. What does your GP say about that? He should be doing a full iron panel and taking steps to find out why it's so low.
Your gastric symptoms sound as if you have low stomach acid. Which would account for the low ferritin, to some extent. How are your other nutrients: vit D, vit B12 and folate?
I did leave 8 hours with the t4 aswell - I was told the t4 stays the same but I will be making sure I do 24 next timeMy ft3 currently is 5.7 so 73% through range. It was 5 back in january when I wasn't taking my iron supplements.
My gps have been very unhelpful with my ferritin. Its been this low and lower for years and only increased briefly into the 80s when I was first put on t3 and to 30 when I ate liver before my periods returned - since theyve come back liver no longer works. At one point it was 12 and she said they couldn't let it fall below that but when it did they didn't do anything! Yes I was thinking it sounded like low acid too paticularly as more watered down meals give me more symptoms. my other nurtirents are good - Vit d is112 range 76-250, b12 563 range 200-1000 and folate hasn't been tested for a while but last time was 22 range 2-17. They are all supplemented.
OK, but it could still be that you need your T3 higher than that. Some people just do. Some people need it slightly over-range. It doesn't hurt to try, because ranges are only a rough guide to what your levels should be. And, if you find it's too much, you can always lower it again.
But, I think you're going to have to be more pushy about that ferritin, because it just isn't right that it's that low. Politely, but firmly, insist on a full iron panel.
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
I had a FBC done and that was all normal - no low haemoglobin or anything. I am currently taking 45mg liquid ferrous fumurate with a vit c tablet. When I take this daily consistently my ft3 increases and if I stop it goes back down. I eat iron rich foods and tried eating liver 3x a week which worked for a few months when I had ammenorhea and was raising ferritin quickly but when my periods returned it dropped right back down to where it was at the start and stopped working and now it doesn't have any impact. My periods aren't paticularly heavy.
The hashimotos diagnosis is interesting - I have no antibodies and had normal tsh on diagnosis but theres a strong family history - every woman on my dads side has hypothyroidsm and my aunt had an 'oddly shaped thyroid' on ultrasound. I am on a strict gluten free diet and had a previous coeliac test done which came back negative.
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