I finally got the funds to do an iron panel as suggested by the very helpful SlowDragon and would love some thoughts on my results please.
Are they rubbish? To be honest I'm actually wondering if my poor iron issues are the cause of my subclinical hypothyroidism? Is that a possibility? I have always struggled with low iron for as long as I can remember but NHS GP has never cared or ever done a full iron panel.
My ferritin was previously scrapping along the bottom of the range but was at least in range so I'm worried that this is now dropping lower.
I've already been supplementing with iron for around 8 weeks so thought things would be on the up. The Medichecks GP comments suggested I should see my GP and focus on adding more iron sources into my diet. However I already eat red meat twice a week at minimum plus chicken. I eat pumpkin seeds every day and regularly eat iron rich veggies so I don't understand where I'm going wrong. I 100% have symptoms of low iron all the time...
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.
thanks for coming back to me so quickly. You’re always a fountain of wisdom and thanks for tagging some others that may have some thoughts too! Lots to read through!
I have actually just ordered Three Arrows so will get cracking on those ASAP!
I really struggle with liver it stinks so bad and I find it repeats on me for hours after 🤢 but I will up my red meat consumption now I have these results!
I don’t appear to have hashis and was just diagnosed subclinical but with symptoms last year. I feel like all my bloods just make things more confusing. My iron appeared to be improving end of last year. I have continued to supplement and now they’ve tanked which seems bizarre.
I love steak especially but it’s crazy expensive!! I’ve ordered some Three Arrows already so will get started on it asap when it arrives! I guess I’m just concerned cos my ferritin appears to have been dropping the past 6 months or so despite me supplementing with iron bisglycinate.
Think I’ll book in with my GP anyway to make aware of my results and how much I’m struggling health wise.
Absolutely, they really ought to be doing some checks to see what is going on, but Three Arrows is a good shout as the stuff they give you is slow acting and hard on the stomach... who knows they might actually offer you an iron infusion to get things moving 🙃
Yes I am a bit worried as things seem to be going in the wrong direction despite me making great efforts to increase iron foods and supps. I’ve def noticed I’ve been feeling pretty awful the last couple months and I wonder if this is why.
Tbh I would LOVE an infusion, fingers crossed for a sympathetic GP!
That’s what really confuses me as before starting levo last year my ferritin was around 40 (not great I know but not under range) but since I’ve been on levo this has steadily dropped further and further. I definitely felt over medicated on 75mcg levo (my t4 was right on top range) so wonder if this has had a detrimental effect on iron? It’s all so complex and confusing and no nhs gp seems to give hoot about how I’m feeling.
Ferritin isn't the most stable of things to test as it can increase due to inflammation or infection but it is a vital part of the chemistry that gets levo into the system and converted to fT3
Yes your iron panel results are rubbish, which should give you hope as there is no doubt those levels are causing their own symptoms independent of thyroid or whatever else you have going on
"I have always struggled with low iron for as long as I can remember but NHS GP has never cared or ever done a full iron panel."
Curious how you know this if you never had an iron panel?
"My ferritin was previou.sly scrapping along the bottom of the range but was at least in range so I'm worried that this is now dropping lower. I've already been supplementing with iron for around 8 weeks so thought things would be on the up."
What were your results prior to starting the 8 weeks supplementing?
It is incredibly difficult to eat enough iron in general, and probably impossible to ingest enough to correct a deficiency. So don't beat yourself up about it - you are not "going wrong".
Iron rich foods range from 1.5-2 mgs a serving (about 30 grams) (like the delicious macadamia nuts, pumpkin seeds, some beans, black-strap molasses, and let's not forget dark chocolate!) through to chicken liver which has about 6 mgs in 100 grams.
The daily value for iron is 18 mgs. If you lay out enough food with 18 mgs of iron on the counter... you will be shocked at how many calories it is. I tried for a while to reach my 18 mgs a day with food... and it was just too much food.
Further, not all iron is created equal. Heme/animal iron absorbs at a rate of 15-35% (3x better than non-heme sources.) Of the 6 mgs in a serving of chicken liver - you only absorb about 2 mg. If you ate 6 mgs of non-animal, you might absorb less than 1 mg.
And, if you eat any of those iron sources with things that block iron (calcium, coffee, etc) - then even less gets absorbed. So dark chocolate by itself... great! In your coffee... not so great. Spinach... has iron AND calcium. Not great. Iron rich cereal with milk. Nope! And while vitamin C will aid in absorption, I think you are getting the picture. It's really hard.
So what to do:
Warning about iron toxicity
The most important thing I will say here is this though - remember that excess iron is toxic and causes permanent and irreversible organ damage. The body has no way to get rid of the excess, and it settles in your organs.
Target/optimal for iron levels is 55% (you are 8% right now) and iron is volatile
Iron levels when supplementing are volatile.
In 5 weeks of supplementing my daughter Increased from 49 to 210. And I DEcreased from 80% in range to about 15% in range. So put toxicity and volatility together - and if you supplement YOU MUST CHECK A FULL IRON PANEL REGULARLY. Some people say 3 months, I target more like 2-ish months. Don't mess around with iron toxicity.
Ferritin - on the other hand - is slow as molasses! For example, even with the wacky results for me and my daughter's iron, both of our ferritin levels are stuck under 10. Many of us spend months and years improving our ferritin. In order to raise your ferritin, your body has to have a consistent and sufficient iron level to feel comfortable sending iron to storage (ie, Ferritin). All without going iron toxic.
Why eating iron and supplementing iron are completely different
You can't eat yourself into iron toxicity, because food that has so little iron to begin with, is buffered by robust nutrients in the food, it is eaten slowly and digested slowly, and all the while your body's natural defenses block excess before it gets absorbed. But supplements overwhelm your body's defenses. An iron pill delivers a tremendous amount of iron to your system all at once.
Three Arrows
You are “lucky” in a way because your iron is low. That means you can easily and safely supplement. (While not waiting more than 2-3 months to test again).
Keep in mind each Three Arrows capsule has 20 mgs of heme iron. Studies give guidance that 40-45 mgs a day is recommended for short term anemia correction. In my daughter’s case, she was told to take 60 mgs/daily of the other supplements - Ferrous sulfate or ferrous gluconate or something – for three months. I don’t know anything about those ferrous versions because they aren’t absorbed as well and cause stomach upset. Three Arrows all the way!
My daughter took 1 Three Arrows capsule a day, then increased to 2 a day, and in 5 weeks it increased her iron … but a little too much.
So – I bet your doctor will say exactly this – supplement at 45-60 mgs of iron a day for 3 months. Sh/e will assume you are taking one of those ferrous versions.
Actually - did you tell us what dose you've been supplementing for the past 8 weeks?
But since you are taking Three Arrows, I would recommend 2 a day for 6 weeks, then test again. I can only share my experience, and I am just very cautious to stay well clear of excess iron.
I will be interested to see how you iron and ferritin react. Let us know whatever you choose to do, then come back in a couple months with new iron results. No one knows how you will response… slow, fast, who knows.
Thank you so much for such a thorough and detailed response, this is all such useful info to have! So to answer your questions:
Never had an iron panel on NHS but have had iron/ferritin tested many times and these are often low or just in range by one point.
The 8 weeks before I was taking Optifer heme iron 11mg from Amazon but tbh I’m wondering if they literally had nothing in them 😂 before this I also tried iron patches but I don’t think they did anything for me.
I only had ferritin tested previously over last year. It was 40 before (30-150) when I first started levo and has fallen steadily throughout the year.
I think I will follow your plan of taking 2x three arrows and then test at 6 weeks. I have more funds now so will put some aside to order this test then and will definitely post back again here.
Your iron and ferritin are so low that I’m not surprised the 11 mg dose didn’t make a dent.
And like I said - at those levels you have a lot of room to improve so at this point you have less risk of going over, than I do, for example.
I am one person (with data points for me & my daughter), everyone is different and there are so many variables that will affect absorption. 11 didn’t help you, but it might have for someone else.
The next 6 weeks will give you more info on how you absorb, so you can make a data-led, informed decision for the next dose change.
So back beginning of last year when my ferritin was 40 my dr recommended Spatone as a gentle way to get it above 50 but then as it dropped no one else has advised or said anything.
This is so useful thank you so much! I will look at the dosage guidance and take it from there.l, repeating test in 6 weeks. I intend to speak to my nhs gp about all this next week cos I just feel like it’s all getting so complicated and out of hand now. Me and my partner want to have a child sometime soon and I just feel all hope is lost at them because. I have absolutely no idea what’s going on with my health.
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