Help with iron results please

Hello

As always, a huge thank you for all of your help to date!

I’ve recently had an iron panel and could really do with some help understanding the iron results.

I really don’t know what these mean and I’m confused by the over/ low and what this all suggests?? I don’t supplement at the moment as wanted to see where things were before adding anything in.

I’m due to get NHS thyroid blood results this week as I’ve been increasing my Levo slightly, alongside introducing T3 under a private consultant. Early days so will see what those bloods bring later in the week.

I’d really appreciate any thoughts or advice on the iron if someone is able to shed any light. I’ve never had over range results before and can see that my Ferritin seems low. So, would I supplement or not? And if so, what type would I need to get, do you think?

Thanks in advance

🦋

[SeasideSusie Remembering]

Buterfly1942

Optimal iron panel levels according to rt3-adrenals.org/Iron_test_... are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 85.37% so it's high in range, doesn't suggest iron deficiency or the need to supplement with iron

Saturation: optimal is 35 to 45%, higher end for men - yours is 61.9% so it's high, doesn't suggest iron deficiency or the need to supplement with iron

Total Iron Binding Capacity (TIBC): Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is very low in range so does't suggest the need to supplement with iron

Ferritin: Low level virtually always indicates need for iron supplementation; High level with low serum iron/low saturation indicates inflammation or infection; High level with high serum iron and low TIBC indicates excess iron; Over range with saturation above 45% suggests hemochromatosis - yours is 36.64% through range

You obviously don't have iron deficiency, you shouldn't supplement with iron. If you do you will take your serum iron and transferrin saturation percentage way too high and too much iron is toxic.

Ferritin is generally suggested to be half way through range, as you can see yours is less than that. You can try to help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

[Hidden in reply to SeasideSusie]

Thank you so much SeasideSusie! Strangely, I’ve been craving liver pate these last few weeks so I was wondering if I’d over done it. I’ll leave out any supplementing and see what my next bloods show.

I really appreciate your detailed response😊 x

[radd]

Butterfly1942,

Your iron results are a little unusual. Your serum iron is great at 85.37% through range but you have hardly any transferrin either bound or unbound. Transferrins are the proteins which bind & mediate iron transport around the body.

This is why your transferrin saturation % is so elevated, because the small amount of transferrin you have is heavily saturated with your good levels of iron. In healthy iron metabolism serum iron would correlate with transferrin to keep iron bound, with a spare supply of unbound transferrin to ‘capture’ further ingested iron.

Low transferrin levels are usually due to anemia of chronic disease, kidney issues where there is high urinary loss of transferrin, liver issues where transferrin is produced or insufficient calories and/or protein to manufacture it. Do you eat well?

Ask your GP about anemia of chronic disease which is when usually more than one condition stops healthy iron and RBC metabolism. Are you diagnosed with any anemias? Have you had a full blood count? Apart from ferritin (which is low at 37% through range), have you had any other inflammation markers tested?

[Hidden in reply to radd]

Hello radd Thank you so much for the detail and explaining these results. I did have slightly raised inflammation (likely due to Hashi flare some weeks ago). I don’t have anemia, haven’t been diagnosed with this.

I have had these results as well. Again, I’m not sure what these indicate. I’ve been unwell for some time, assuming it’s thyroid related. I eat a very good diet.

🦋

.

[radd in reply to Hidden]

Butterfly1942,

It’s is very useful that you have these results that show physical characteristics of your RBC's such as size, shape, and content. They need to be read in combination with your iron results as RBC’s & haemoglobin are iron dependant.

Red blood cells usually decrease with age but yours are bottom of range, and we need adequate RBC’s to carry haemoglobin. Haematocrit is low in range as a result of too few RBCs.

Haemoglobin is made from iron (via bone marrow) and carries oxygen around the body, and myoglobin to muscles. Your haemoglobin is low in range because your transferrin is low so iron can not be transported and utilised in a normal fashion to make haemoglobin.

MCV describes RBC size and yours is quite high indicating large sized cells. RDW stands for red cell distribution width and yours is over-range. Abnormally large blood cells are seen in anaemia and commonly caused by Vit B12 and/or folate deficiencies.

MCH & MCHC refers to the average haemoglobin amount in RBC’s. Yours are over-range because your RBC’s are large and again this is indicative of anaemia.

Anaemia refers to a drop in the number of RBCs and/or the amount of haemoglobin within the RBCs. Both your RBCs and haemoglobin are bottom of range. Typical symptoms for anaemia are shortness of breath, dizziness, chest pain, maybe muscle pain.

Although you have enough iron it is unusable and like low iron may be prohibitory in allowing thyroid meds to work effectively and then symptoms may become muddled. Low iron can also cause a fast or irregular heartbeat.

You need to discuss these results with your GP and tell him you feel unwell. Have you had your NHS bloods taken yet?

[Hidden in reply to radd]

Hi radd

Once again, can’t thank you enough for explaining. I’m so very appreciative of your time and knowledge. I will mention to my doctor at my review next week.

I’m assuming there’s nothing I can do to rectify this? I do feel very fatigued, along with all the symptoms you’ve mentioned.

My NHS bloods are in.

My T4 11.8 (9-22)

TSH is 1.4.

They didn’t do T3 despite being ordered by the GP. I’m on a trial of T3 at 15mcg per day and Levo 3 days at 100mcg and 4 days at 75mcg. Generally, I’m feeling undermedicated so the usual symptoms, along with pressure headaches and nausea.

Thanks so much for helping x

[radd in reply to Hidden]

Butterfly1942,

How are you suppose to know if you medicating the correct amount! (That's a rhetorical question, just thinking aloud). I suppose we have to guess 😬.

Most would need a slightly lower TSH when medicating T3 & presuming that's FT4, it is only 21% through range so very low. Results & symptoms are both pointing towards under medication.

I can read iron bloods well because I have iron overload (heamochromatosis) but am not knowledgable on how to encourage higher transferrin levels. You will need to speak with your GP about this, and ensure he looks at both iron and Red Blood Count results.

[Hidden in reply to radd]

So true radd!

I genuinely don’t know what my optimal will be, but it’s not this! That is my T4 and I know I’m at least functioning when in mid range so this ‘feels’ too low. I’ve never felt great since being diagnosed, but had found a functioning level before becoming unwell in Winter, but at the moment it’s a daily struggle trying to climb back.

I had an improvement in first few weeks of T3 but I do know it was only at 4.2 (3,1-6.8) a couple of weeks ago. I’m feeling I need more of one or the other and wonder if when I reduced T4 from 100 p/d to 75 to introduce the T3, it was an unnecessary decrease and now I’m feeling the impact. I did this under Endo’s instructions at the start of March so I’m thinking possibly

if now my body is responding to that decrease 2 and a half months ago. Maybe in the first few weeks of T3, I was still benefiting from the effects of my usual 100mcg as it was floating around my system?

I did read about the Haemochromotosis- I’m assuming my levels would be too low for this? How do you manage it radd? I have a colleague just diagnosed with this condition. I’ve read your profile and can see what a number of challenges you have had over the years. I know you’ve worked so hard to gain wellness I do hope you’re feeling well?

X

[radd in reply to Hidden]

Butterfly1942,

Iron is immensely interconnected with thyroid hormone, in the making of & utilisation of but too little/too much can also prevent hormones from working effectively by turning T3 to inactive metabolites. Also if we have Hashi’s elevated antibodies (or other body inflammation, ie aches & pains) these can change iron mechanisms by producing substances (cytokines) that influence the development/storage/transport of iron.

Iron mechanisms are also influenced by thyroid hormones and effectively working adequate amounts are required to drive the whole

erythropoiesis production, ie RBC,s haemoglobin, etc. This is why you need to tackle both thyroid and iron issues at the same time.

Your iron levels do not in any way indicate haemochromatotis. My overload is managed by venesection. I am what is known as a slow-accumulator so only require 2-3 venesections a year, sometimes less. I recently started donating blood which was great as allowed more flexibility and the centre was local to my home but I had a TIA last year so blood taken now has to be within a hospital setting. Grrrr ...

I also am recovering from shoulder surgery after a cycling accident 🚴‍♀️ at the moment but actually feeling very well. I think the COVID vacs were a contributory factor to my TIA because although I had suffered some latent BP previously, it went sky high afterwards and was difficult to control. Now it's back to normal 🤷‍♀️. Thank you for asking 😊

[Hidden in reply to radd]

This is really helpful radd thank you 🙏

I’m so glad you are able to control the haemochromtosis and that you’re feeling well. I’m sorry to hear about the TIA. I think the vaccines have a lot to answer for. I wouldn’t have not had them, but I’m sure they have played into things being destabilized, along with a lot of outside stresses. I’ve noted a few members commenting. It’s so difficult with the Hashis to manage additional medications as it’s a fine balancing act. I’m also trying to bring my sex hormones in line after a few years of stability and am sure that this is impacting. I’ve been on HRT for over 8 years & post meno, but since the thyroid has played up (or since the booster)so have my meno symptoms 😡.

It’s great to hear that you have achieved some balance, radd! Long may it continue x

[MirandaIV]

Sorry this isn’t a very helpful comment but I was very interested to read your results as they are the same as mine. I’ve been trying to work this out for ages but have not succeeded so I will be interested to hear what people say. I would add that my endocrinologist said that there nothing to worry about but that I can see a haematologist if I want to 🤷🏼‍♀️ I don’t have any other chronic inflammatory diseases that I know of and my CRP is low.

[Hidden in reply to MirandaIV]

Hi MirandaIV

Thank you for supporting! It’s worrying when bloods are awry, let alone the constant checking on thyroid levels.

I couldn’t understand these readings either, so very glad for the responses. It makes you wonder if just one tweak on levels will have you well so worth investigating!

🦋 X