Iron levels

[Pearlteapot]

I was reading one of radd 's posts explaining the relationship between iron deficiency and palpitations and decided to look at my recent results. I was diagnosed and started Levo on 19th March.

Between 18 March and 30 June my serum iron has dropped from 25.9 to 11.5.

The Serum TIBC has dropped below range. The Transferrin Saturation index which was over range has also dropped a lot.

I don't understand any of this. Am I now anaemic? Why would it change so dramatically after starting levo?

I don't supplement iron but I do eat chicken livers and spinach regularly. Until recently I haven't needed to supplement iron as my levels were good, I think? Confused.

Can anyone comment please? many thanks.

18 March

Serum Iron 25.9 (11-36)

Serum TIBC 54.6 (53-85)

Serum Ferritin 106 (30-200)

Transferrin Saturation 47.4% (20-40)

30 June

Serum Iron 11.5 (11-36)

Serum TIBC 45.1 (53-85)

Serum Ferritin 123 (30-200)

Transferrin Saturation 25.5% (20-40)

Edited to add:

Haemoglobin is 137 (110-150)

Haematocrit 0.397 (0.34 - 0.5)

Which don't look like anemia? I have dead full feeling in my ears, (not ringing), palps and more hair loss than before. I had thought these were all due to waiting to get thyroid medication optimised but maybe they are iron issues???

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radd

[radd]

Pearlteapot,

Technically yes you have anaemia, because your haematocrit is indicating too few blood cells & you now have serum iron deficiency. TIBC has fallen inline with serum iron, resulting in a better looking T/S%.

Haemoglobin levels haven’t fallen yet and still retain healthy levels, and ferritin still remains looking good. However, if you don’t manage to resume healthy levels of serum iron, eventually ferritin and haemoglobin levels will drop also.

Iron levels often drop due to the increase in metabolic rate after starting Levothyroxine that filters through to erythropoiesis production, ie introducing Levo can increase your demand for iron.

Also do you have Hashi? When we have Hashi we’re prone to unhealthy levels of bodily inflammation from the very nature of having (auto)antibodies. This inflammation can be seen in the form of aches, pains, swelling, possibly indirect weight gain which drives further inflammation. Just as this inflammation can make unwanted changes to our thyroid meds, it can prevent good utilisation of iron.

Iron deficiency (or iron mechanisms that are not working effectively) may be both a cause and an effect of hypothyroidism. Both conditions can also cause palpitations, hair loss and hypo is notorious for ear issues. See my post on ear issues here ..... healthunlocked.com/thyroidu.......

[Pearlteapot in reply to radd]

radd thank you so much for this and the explanation that iron levels may drop due to increase in metabolic rate (I would love it if that is the reason and my metabolic rate has increased!). I do have Hashis and I still have a high TPO Ab count but low CRP.

I have chosen not to supplement iron until now because I didn't seem to need it and because my mother has haemachromotosis. The reason the GP took this recent iron panel was because I asked her to as I was concerned about my over range transferrin saturation rate. I don't know if these new figures rule out haemachromotosis but I will wait to find out before starting any supplementation. I have a GP appointment on Tuesday. I really hope the ear and palps problem can be solved with iron and is not primarily due to my thryoid levels. I had already read your link about ear problems and it was that together with your post about iron and palpitations that set me to review my iron panels.

I saw a private endo last week to review my dose and she insisted my palpitations showed I was over-medicated and that she would not approve an increase. She did not accept that palpitations also come from inadequate T3 and she did not even mention iron. We had a bit of a row and I prevailed. It's so depressing. Were it not for this forum enabling me to self-advocate she would have kept me on a too low dose and the palps and many other damaging side effects would have continued.

Many thanks

[radd in reply to Pearlteapot]

Pearlteapot,

CRP is only one marker for general inflammation. If you have a high TPOAb count then you will most certainly have some form of unwanted inflammation because antibodies are inflammation whether 'auto' or not.

Instigated inflammation to protect from infections/cuts/fever is good but any inflammation generated from an AUTOimmune response is unwanted, as not only is the initial auto-attack damaging but also the resulting antibodies which incite cytokines that damage further healthy cells, tissues, and organs. Hence one autoimmune response often leads to other autoimmune conditions (PA, RA, Crohns, Sjogrens, etc).

I too have haemochromatosis. If your Mum is homozygous & donating then you will also have some risk of haemochromatosis even if only heterozygous so agree you will need your iron levels monitoring, especially T/S% & ferritin. Your risks look small because T/S% is usually difficult to reduce but iron works in mysterious ways and it depends upon the severity of your impairment and what other compensatory factors your body can put in place.

'She did not accept that palpitations also come from inadequate T3 and she did not even mention iron'.

It's depressing isn't it when we know so much more than the so called professionals!' 🤣

[Pearlteapot]

not only is the initial auto-attack damaging but also the resulting antibodies which incite cytokines that damage further healthy cells, tissues, and organs. Hence one autoimmune response often leads to other autoimmune conditions (PA, RA, Crohns, Sjogrens, etc).

I know and very concerned at those risks. My TPO Ab is >600. They don't seem to give levels over 600 so I could have been 1001 and reduced by 400 and wouldn't know. I've been doing all I can to reduce antibodies. Although I read somewhere here that high TPO Ab will not attack other organs as it is a Thyroid antibody. Anyway, antibodies are for another post. This is Iron!

[radd in reply to Pearlteapot]

Pearlteapot,

It is not thyroid antibodies that attack other tissue/organs but the accompanying cytokines, etc induced by the thyroid auto-antibodies.

Thyroid antibodies should reduce is you remove the triggers and make good use of an anti inflammatory diet & maybe supplements such as fish oils, turmeric, etc.

[helvella Administrator Thyroid UK in reply to Pearlteapot]

TPO antibodies should only attach themselves to Thyroid Peroxidase - an enzyme which normally occurs only inside the thyroid.

Antibodies don't attack. They mark their antigen as something that requires the attention of the immune system.

(Nothing is perfect - TPOab could attach to something they cannot distinguish from TPO.)

[Pearlteapot]

I’ve now read further into this and it seems that radd is describing anaemia of chronic disease. Since i last posted I am more breathless, very much more exhausted, more palpitations, more ear filling feeling and more convinced that I have anaemia. I have just today started supplementing Floridix and am seeing an endo that I’ve seen spoken of highly on these pages next Saturday.

My own GP said my iron levels should be retested in 6 weeks, meanwhile no action. Except a cardio work up. The previous endo said my palpitations show I’m overmedicated. No mention of my low iron. Imagine if I had reduced Levo been more hypo and more anaemic.!?! Horror story.