Could someone advise on my iron blood test please? I've been trying to raise my Ferritin levels since I had a reaction to starting carbimazole and was hospitalised with agranulocytosis 2 years ago. My levels before were 70 and on release from hospital were 19. I've lost tons of hair and lots of symptoms aswell as dealing with hypo symptoms /levothyroxine.
Anyway, 2 years on and I've found a Dr who is sympathetic (endo not bothered by anything other than Tsh) re my iron concerns. I've read lots of info supplied to me on here and my Ferritin is now higher finally after taking supplements and trying to eat iron rich foods for the last year. However serum iron is low. Can someone with iron knowledge advise as I have a 4 week wait for a non urgent appointment. Thanks.
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HiSo still not great then, urgh. No I've not tried Three Arrows but I have googled it previously, that's the one from the US? I might give it a try if others have seen improvement.
No, he didn't offer T3 yet, he's started me on Testosterone gel instead, need to go back again in 3 months.. Testosterone has lifted me somewhat, but not helped with fatigue and general feeling rubbish.
This is a summary of what I have read up and found out about iron supplements over the past few years. I am not in any way medically trained. You are strongly encouraged to check every detail before making any decisions for yourself.
Note that iron and iron-related results can sometimes be contradictory - this is quite common.
Ferritin : Optimal for ferritin is often suggested to be 90 - 110 umol/L and yours is clearly well under this and you will almost certainly need a higher level to feel well.
The lower level of the reference range you've been given is only 13. This is out of date according to the NICE Clinical Knowledge Summary (CKS) on iron deficiency anaemia.
Serum ferritin level is the biochemical test that 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.However:
Ferritin levels are difficult to interpret if infection or inflammation is present, as levels can be high even in the presence of iron deficiency.
Ferritin levels may be less reliable in pregnancy.
Iron : Your level of 10 is well under range. Optimal for iron is, according to the first link I gave
• 55 to 70% of the range
• higher end for men
With the range you've been given 55% to 70% equates to a level of 22.8 - 25.2 umol/L so you definitely need more iron according to this because yours is miles away from this.
I'm sure there must be many possible reasons why your iron is low. Some I can think of - and this list is definitely not complete :
a) Is there any chance you are losing blood from your stomach, intestines or colon? If you haven't had your poo tested for blood (it can be invisible to the naked eye so don't assume if you can't see any that it definitely isn't there) ask your doctor to arrange such a test.
If you do have such a test done, please read this thread before providing your sample :
Note that the thread is old and testing could have improved since it was written, but the suggestions on how to get the most reliable result won't do any harm even if testing has improved.
b) Is anaemia or low iron common in your extended family? You could have genetic issues causing poor absorption of iron.
c) You could have low stomach acid - very common in thyroid disease and it gets mentioned on this forum often.
d) You could have SIBO (Small Intestinal Bacterial Overgrowth). This can be tested for but I don't think it is easy to get the tests done.
e) You could have Anaemia of Chronic Disease (or Chronic Inflammation).
f) Note that people can have iron deficiency with or without anaemia. Anaemia is usually diagnosed when haemoglobin goes under range or under 120 g/L. Iron deficiency should be treated with or without anaemia.
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 is 31% through the range and your TIBC is 34% of the way through the range, suggesting that you have a lack of capacity for additional iron. This happens quite often in people who have very low iron and seems contradictory, and is often connected with Anaemia of Chronic Disease.
Transferrin saturation.
From the first link I gave :
Saturation
• optimal is 35 to 45%
• higher end for men
Since your saturation is only 16% your level is miles away from optimal suggesting that you need more iron.
...
What treatments have you tried to improve your iron levels?
If you have supplemented with iron tablets what were they, how did you react to them, and how long did you take them for?
Have you ever tried having an iron transfusion?
Any treatments you have tried... How long was it before your levels nose-dived again?
Thanks for the explanation. I still have periods, am perimenpausal but do have heavy periods, with regular mid cycle bleeding. Just had scans to check womb lining etc, all OK so waiting another appt as may need to stop /change hrt.
Not sure on familial link with iron issues, but my daughter had thyroid testing recently and her Ferritin was very low end of range.. So suspect may be a hereditary link.
Not had a stool test, will bring that up in my appt.
Ive been taking ferrous fumerate 210mcg once a day for atleast 6 months, my Gp recently increased to 2 times a day. I don't have any symptoms from taking them, other thank black stools.
Not sure on familial link with iron issues, but my daughter had thyroid testing recently and her Ferritin was very low end of range.. So suspect may be a hereditary link.
If there is a hereditary link it could be an iron absorption issue or a thyroid problem or both. Having low iron stores is extremely common amongst patients with thyroid disease.
Ive been taking ferrous fumerate 210mcg once a day for atleast 6 months, my Gp recently increased to 2 times a day. I don't have any symptoms from taking them, other thank black stools.
One thing to be aware of is that iron absorption is almost never quick with iron tablets. It could take a couple of years or more to repair extremely low levels.
If your levels of ferritin and/or serum iron drop like a stone whenever you stop taking supplements you could ask your doctor to be referred to haematology for an iron transfusion. They can also be done privately for a fee.
There are other types of iron supplement than the iron salts you are taking, and you might want to consider trying them. A couple of products are discussed in these threads :
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