My thyroid is well replaced, but I have been feeling so tired and achy, so I asked my GP to test vitamins. She said all is well. I'm gutted because I feel TERRIBLE. What do you think to these results?
Serum Ferritin: 29 (r 20-204)
Serum Iron Level: 11.7 (r4.4-27.9)
Serum Transferrin: 2.63 (r 2- 3.2)
Transferrin Saturation Index: 17% (r 0-55)
B12: 728 (r 187-883)
Vit D: 67 (r 50-150)
I take a low dose Iron tablet (just RDA), vit d spray and b vit supplements. Stopped all supplements for 2 weeks before test.
Thanks!
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Suzanneharb
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Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. 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.
Thyroid disease is as much about optimising vitamins as thyroid hormones
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
I don't think my GP will. I'll try though. And I haven't got the money for more medichecks. Anything else I can do? What are your instincts with these test results?
Me again. I can’t make myself call the dr. I tried email but they said to call. I have a slight panic attack at the thought of calling. Years of being mistreated and gaslighted by Drs has left me traumatised. I just can’t bear to call or be controlled and mistreated again.
My results do seem to show low iron, so perhaps I could take 200 a day (the usual prescription dose) and save up for a private test in 3 months time?
Tested for hemochromatosis - negative. But I have one gene linked to it.
I recently donated pint blood to lower ferritin under 300
My ferritin levels are probably high due to mix of having Hashimoto’s, post menopause and I eat high protein and absolutely strictly gluten free and dairy free diet.
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
Please be aware that contradictory results are common.
...
Serum iron
• 55 to 70% of the range
• higher end for men / lower end for women
Your Iron (31.1% through range) is much too low, suggesting that you need more iron.
...
TIBC (total iron binding capacity) or Transferrin
• Low in range indicates lack of capacity for additional iron
• High in range indicates body's need for supplemental iron
Your Transferrin (52.5% through range) is very close to mid-range suggesting that your iron levels are neither low nor high.
...
Saturation
• optimal is 35 to 45%
• higher end for men / lower end for women
Your Saturation (17%) is much too low suggesting that you need more iron.
...
Ferritin
• Low level virtually always indicates need for iron supplementation
• High level with low serum iron/low saturation indicates inflammation
or infection
Your Ferritin (4.9% through range) is much too low suggesting that you need more iron.
...
It is quite clear that you need more iron. You said that you already take a tablet of iron which is just the RDA, and, from memory, I think the RDA is roughly 15mg of iron per day.
If you want to know more about the iron supplements and doses available to you in the UK then please read this reply I wrote for another member :
If I could go back in time and start treating my low iron again I would probably start with ferrous gluconate 300mg. The maximum dose is 6 tablets a day, but I would start with a much lower level than that - say 1 or 2 per day, taken separately. Then raise dose depending on my tolerance. Always make sure that iron is taken at least four hours away from thyroid hormones because iron can block absorption of the thyroid hormones.
...
Optimal for ferritin varies according to source and can also vary by reference range. As a result a good way of being consistent is to go by percentage through the range. It has been suggested that a good level to aim for for ferritin is 50% - 70% through the range.
...
When I was treating my own low iron I took ferrous fumarate 210mg, 1 tablet, 3 times a day, making a total for the day of 207mg of pure iron per day. I took that dose for nearly 2 years then dropped dose to 2, 3, or 4 of the same tablets a week as a maintenance dose. When I needed to adjust my maintenance dose, I would just raise it or lower it by 1 tablet a week.
I notice SlowDragon has already mentioned the fact that the reference range for your ferritin breaks the most recent NICE guidelines on iron deficiency anaemia, and allows for a ferritin less than 30. I think people should ignore the lower level of the range if it is less than 30, and just substitute the level of 30 into the range for their test.
Thank you so much for this! You also highlight an interesting point, and which means I'll have to go to a Dr. In July, Medichecks test showed:
Serum Ferritin: 60 (R 13-150)
Iron: 36.1 (r 5.8 – 34.5)
So why has my ferritin plummeted when supplements have been the same (and diet etc ). But also, my iron was over range! So if I start high dose iron, will that result shoot up again, with ferritin staying low?
You said that you were on an iron tablet that contained the RDA of iron per tablet, which I guessed contained 15mg of iron.
This is obviously insufficient to maintain your level of ferritin and/or serum iron. It is not likely to raise your iron/ferritin.
At one point I was trying to maintain my level of ferritin rather than raise it, but I also wanted to raise my serum iron, which was way below optimal. I decided, just as an experiment, that I would take more iron for long enough to raise my serum iron to closer to optimal, but in doing so it raised my ferritin above range, which I had expected, but wanted to know how far above range it would go. Once I'd decided to give up my experiment I stopped taking iron for four months. My ferritin dropped by 90 points in that four months. So, people can lose iron very quickly in some circumstances. I don't have periods any more, but for women having periods their blood loss might be high enough to make them have low iron and/or ferritin very quickly , if they were short of it for a long time.
Also, another non-scientific theory of mine... (I'm not a biochemist or doctor.) People need iron for lots of processes within the body. Suppose your body has been short of iron for twenty years. You give yourself a little more iron and it gets used up within hours. You do this again and again. But it would take a long time to replace the low iron that you should have absorbed over twenty years. And obviously some of the iron supplement you took wouldn't be absorbed and might be excreted.
If you want to raise your iron and/or ferritin you would need to raise the dose of supplement you take, and start testing more frequently.
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The serum iron result you just quoted was slightly over the range. High iron can happen for several reasons. See this link :
The most common cause is having less than ideal MTHFR genes. About 50% of the world's population has MTHFR genes which aren't the best. This may cause people to have too low a level of "methyl groups", which are used in lots and lots of processes within the body. It often leads to low levels of folate, and has a knock-on effect on reducing absorption of other nutrients including iron.
Since getting the over-range iron result have you taken supplements to improve your folate levels? And if yes, what did you take?
Thank you. The MH test is too pricey for now. Guessing GPs don't bother with it? I don't know what my folate level is (just B12 was tested and that was in the top range). I've been taking this for the past two years: amazon.co.uk/dp/B01787EPEE?...
Most people don't need to bother testing for MTHFR. I've certainly never done it. They can just supplement as if they have the problem, whether they have it or not, because the required supplements are not harmful.
In many cases all you need to do is optimise your vitamin B12 and your folate.
If B12 is low (and I know you said yours was quite high - which is not a problem since B12 is not toxic) they should supplement with methylcobalamin.
If folate is low they should supplement with methylfolate.
The MTHFR gene problem leaves the body with too few "methyl groups" or "methyl donors" which are needed for loads of biochemical processes in the body. Methylfolate in particular helps to provide those methyl groups.
If folate and B12 are already optimal but the patient still wants to get more methyl groups from somewhere they can supplement with
Please note that betaine and betaine hydrochloride are NOT the same thing, although both have their uses. Betaine hydrochloride is used as an artificial substitute for stomach acid in people who have low levels but this is not relevant to this conversation. Stick with the name TMG or Trimethylglycine rather than betaine so there is no confusion.
TMG is sold by Amazon, Ebay and other supplement websites.
Another possibility is MSM (Methylsulfonylmethane)
I also have Gilbert's Syndrome, if that's relevant? I've been on GF diet for 12 years (highly likely I am coeliac, but I didn't go for testing) and I have IBS, so have to be careful with my diet, Normal periods, normal weight (my weight has never been affected by hypothyroidism).
I’ve decided to start iron now because the next available gp appointment is 20th April. I can’t go another 8 weeks feeling this ill. Is it safe to wait that long for a blood test?
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