Dear Forum Members,
I am wondering if anyone takes a maintenance dose of iron to keep ferritin optimal?
After reading the recommendation here for the Three Arrows supplement I am about to start taking this but would appreciate any advice you have on raising and maintaining ferritin levels.
Yes I do, I'm just awaiting results to see if 2 a week is enough, I'm post meno and don't eat red meat
I'm sure the reason you are asking is because you know that the risk of iron toxicity is real and causes permanent organ damage.
The important thing to remember is that when you get iron through food, even the highest iron rich food is only 1-6 mgs per serving, it's digested as part of a meal with many other nutrients, slowly, most isn't absorbed and your body has natural defenses (hepcidin) to combat any excess. All these things make it impossible to accidentally overload on iron through diet alone.
But iron supplements overwhelm the body's natural defenses. It's too much all at once.
Iron is optimal at 55% through range. The rule is if you have iron higher in range, and certainly above range, you should stop supplements.
If you supplement iron, you must test regularly to avoid this.
Regards to Three Arrows - myself and many many others on this forum are huge fans. I can't say enough about them. Zero stomach upset, zero rules about taking with food or not. Just pure dehydrated animal organs.
Each capsule has 20 mgs of heme iron. Heme iron absorbs at a rate of about 15-35% (3x better than non-heme sources.) So each capsule on average not taking into account any individual absorption rates, 3-6 mgs.
Our bodies naturally shed 2-4 mgs of iron a day.
So when you first start Three Arrows, I think they recommend 1-2 capsules a day. Clearly you do the math, and if you have high iron and low ferritin, then 1-2 capsules a day would blow you out of the water.
So with that information - if you plan to supplement with iron pills of any kind when you have had any iron test that shows above 55% in range, you are undertaking a hands-on, delicate balancing act with long term consequences if not managed properly.
That being said - your body needs optimal iron to feel comfortable sending any of that to our ferritin storage cabinets - so we all have to figure out a way to dose, monitor and adjust our iron intake.
Edit - My daughter went from below range to above range in her iron blood tests after 5 weeks of Three Arrows. I think we did 1 capsule for a week or 2, then did 2 a day, and she stopped taking them about 5 days before the iron was tested. Three Arrows is concentrated, well absorbed, and works much faster than the other options. The doctor said supplement for 3 months and test again. That would have been too long.
Many thanks for your detailed reply.
Previously eating liver x2 100g per week was enough to keep my ferritin at 98. It’s been at 55-60 for the last six months with no improvement. I’m having horrible headaches and fatigue at the moment.
I’m thinking of trying 1 three arrows supplement either every day or every other day. Which do you think is a better place to start?
I’m a Kindergarten teacher so I have a very busy, physical job and I’m up at 5.30am every day for work.
I’ve just seen your edit! Many thanks for the dosing information and results from your daughter. I think I’ll start on one a day and see how my headaches are in 2-3 weeks. I’ll go to one every other day after this.
1) What is your iron result? There is no way you should pick a dose/frequency without a full and recent iron panel:
- Iron
- Ferritin
- TIBC
- Transferrin saturation
- High sensitivity CRP
2) I've also read that chicken liver 100 gram serving once a week was enough to raise ferritin. As I'm sure you also know, chicken liver has enough vitamin A to be toxic. I think even 2x is a little too close to too much, so not a bad time to switch to Three Arrows.
ALSO - my latest bright idea has been to split the pill over meals and over days. When you look at the numbers, 20 mg of heme is A LOT. Average foods are no more a few mgs. So I pop open the capsule and take half at a time, with food to slow absorption. No one can say to what degree this will work, hence the need to closely and regularly monitor. But for maintenance, it's sure better than blasting your digestive system with 20 mgs heme at a time.
3) My thoughts have been to consider one 20 mg capsule as the equivalent of a massive once a week chicken liver dinner (without the Vit A toxicity : ) ) Err on the side of caution, and dial down versus dialing up when in doubt. Hard to believe one a week would work, but one 10 mg portion of 100 grams of chicken liver works, then I'm going to try to test if that 20 mg Three Arrows is the equivalent.
But do not take Three Arrows or supplement at all if you are not able to get a full iron panel every 4-8 weeks regularly and monitor. Iron is volatile (ferritin is not.) As I noted above in 5 weeks my daughter went from 49 to 210 (below to above range) and I went from about 90% through range to 20% in the bottom of the range in the same time period. Proceed with caution.
Let me know re my reply above.
Please let me know iron test, and if you don’t have, get one before taking three arrows!
My haemoglobin is good so the doctor won’t do an iron panel. He did do my ferritin in October (55) and then again in February (60) Chicken liver x100g twice a week (max dose recommended on the forum) only raised it 5 points in 5 months. That’s why I’m looking at supplements.
Unfortunately where I live it is difficult to get private testing outside insurance so I’m a bit stuck. It’s why I started with the chicken liver too!
Personally I would not supplement iron without an iron number at the very least. I can’t stress enough that iron toxicity causes permanent irreversible damage.
Iron and ferritin are not correlated by default. You can not intuit iron from ferritin.
I like to say “there are no ferritin supplements.” When iron is high and ferritin is low - a situation many of us are in - supplementing is not recommended. And as I said above, if you do, you must test your actual iron levels regularly.
We all wish it could be easier and faster but it’s not.
Many thanks for your good advice. I’ll look into getting an iron panel somewhere/how otherwise i’ll have to wait until I’m in the UK during the summer and do medichecks/blue horizon.
I really appreciate the time you’ve taken to share your experience. Many kind regards Lyn
Unfortunately where I live it is difficult to get private testing outside insurance so I’m a bit stuck.
Please country you are based in
as this is U.K. based forum we tend to assume you are also U.K. based
I’m in the UAE. I’m British and lived for many years in the UK.
Hi where did you get 55% through the range? Thanks
Hi. Sorry I wasn’t very clear in that post. It was 55 in the range 13-150ng/ml
hi can I ask how do you work out your % through range of iron? Many thanks
There are range calculators people share, you may keyword search this forum as I don’t have those links handy.
But to do it manually you take the two numbers in the range - the high and the low, and subtract them. So for iron it might be a range of 50 - 170. The difference between those is 120.
Then you take YOUR RESULT and subtract the lower range number from it. So say your result was 110. You do 110 minus 50 = 60
Then you take that number - 60 - and divide it by the 120. That would be 50% through range.
Like I said - there are calculator links other people have that will make it more plug and play, but the above will get you there in the meantime.
Thank you
I googled how to do it and now I can’t find the website! I’m sorry.
I had very low iron and very low ferritin when I first started supplementing iron back in 2013.
I started supplementing one of the iron salts - ferrous fumarate 210mg, one tablet, three times a day. The NHS has reduced the dosages for all the iron salts NHS doctors usually prescribe since I started taking that dose :
bnf.nice.org.uk/drugs/ferro...
bnf.nice.org.uk/drugs/ferro...
bnf.nice.org.uk/drugs/ferro...
Doses have been reduced because of this :
healthunlocked.com/thyroidu...
I absorb iron poorly so it took me nearly two years to raise my ferritin to mid-range.
Once I got to that point my serum iron was still low, but experimentation showed that when I kept on supplementing it was my ferritin that kept rising (slowly) and my serum iron hardly budged at all. So from that point on I continued to dose with ferrous fumarate 210mg, but I took one a day instead of three, and I only took that one a day for between 2 and 5 days a week, and I raised and lowered my dose to maintain my ferritin at mid-range.
I kept taking a maintenance dose for five years. Then for the first time ever my serum iron started to rise. When I felt both my ferritin and my serum iron were at a safe level I stopped supplementing iron altogether.
I still do a full iron panel (the Medichecks iron deficiency test) twice a year to keep tabs on my levels, and I would go back to taking iron at a maintenance dose if my ferritin started to drop dramatically.
I think the reason for my iron problems were related to this medical condition :
irondisorders.org/anemia-of...
For future reference you might find this link useful :
irondisorders.org/wp-conten...
.
If I had my time over again I would raise my iron and ferritin differently.
I would investigate whether or not I would benefit from an iron infusion, and would pay for one if I could afford it.
If I wasn't a suitable candidate for an iron infusion I would raise my levels with heme iron supplements :
healthunlocked.com/thyroidu...
Good luck.
Dear human bean,
Many thanks for taking the time to reply with such detail. Your message is extremely helpful and also encouraging to know that it is possible to improve and in the long term.
I have suffered with anaemia all of my adult life if I don’t supplement or eat liver. I’ve never found out why despite undergoing many tests and a colonoscopy.
Thank you once again for your excellent advice. It is very much appreciated.
LynLyn ,
Our thyroid issues make it hard for us to absorb iron. I haven’t clicked through to your other posts but I assume you are hypo as well.
There is a pathological co-dependence between thyroid hormones and iron. Sufficient iron is needed for optimal thyroid function, and sufficient thyroid hormones are needed for iron transport as well.
That also why the full iron panel is helpful - for example one measure (transferrin % saturation) needs to be a minimum of 30% and optimally between 35-45% for T3 to do its job. No one measure alone tells you the whole story, but together with FT3 and others can give you some of the what & whys.
I will also pass along a resource that’s been recommended to me called The Iron Protocol (there is a Facebook group for it.) I don’t have Facebook right now, but the people that have dug in with it swear by it! I will try it also if my Three Arrows dosing strategy doesn’t work.
Dear FallingInReverse
Yes, I’ve been hypothyroid for +25 years. I’ve had iron deficiency or iron deficiency anaemia for most of that time too.
Many thanks for the information in your last message. I will join the Facebook group to learn more.
I need to read up some more on iron and I will try another doctor to see if I can get some support with raising my ferritin level.
Many thanks for the time you’ve taken to help with this. I very appreciate it!
What is optimal Ferritin level?
Optimal ferritin levels? 
Low Ferritin and raised Iron 
Iron vs. Ferritin - do we need both optimal to feel best?
