I am hypothyroid, about 5 years & take just under 100mg levothyroxine daily. I have a high T4 & low T3 and see a private endo who has offered to prescribe T3. I'm generally feeling ok but do struggle with puffy & very sore eyes, dry skin & high cholesterol. I am thinking of trialling the T3.
I posted my latest blood results recently & it was suggested by a forum member that prior to trying T3 I obtain a full iron panel. Results are posted here. Ferritin seems fine but iron & transferrin saturation are low. I'm not sure if this is a concern or just an indication that my body 'sees' inflammation somewhere.
The iron situation seems complex, I don't want to supplement unless I have to (haemorrhoid problem!). Please could anyone with better knowledge of the iron panel tests comment on these results? It would be very much appreciated.
I took the sample at 7pm evening, I do eat red meat & a pretty healthy diet - plenty of fruit, veg etc.
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Will_blue
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Suggest you significantly increase iron rich foods in your diet
Retest again in another 3-4 months
Ferritin can be false high due to inflammation
This is classic case where ferritin looks fine …..but iron is very poor
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
Note that iron results can be contradictory - this is quite common.
CRP HS is a measure of the level of inflammation in the body. It isn't specific though, and any inflammation could be anywhere in the body - joints, muscles, lungs, gut etc. Optimal for CRP is less than 1 so yours is slightly higher than optimal, but not high enough to be worrying.
Iron is a measure of the free iron flowing through your bloodstream. Note the link above from rt3-adrenals suggests an optimal level of 55% - 70% through the range. Yours is miles under that, suggesting that you need more iron. In the event of someone having inflammation or infection, iron levels will be deliberately kept at a minimum by the body to prevent iron being available to any pathogens, since pathogens need iron to reproduce just like humans do. With low iron, and ferritin which is above optimal, it is likely that you have Anaemia of Chronic Disease (or Chronic Inflammation). It would be interesting to know if your haemoglobin is low. This is usually tested in a Full Blood Count :
Your TIBC is in the lower half of the range and UIBC is in the upper half of the range. Taken together with your other results it backs up the idea that you have Anaemia of Chronic Disease.
Saturation : Your level of 17% is well under range. According to the rt3-adrenals link the optimal level for Transferrin Saturation is 35% - 45% through the range. Yours is very low suggesting that you need more iron.
Ferritin - The rt3-adrenals link is too vague on optimal levels for ferritin, so a better suggestion comes from this link :
Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.
Your ferritin is higher than the suggested optimal level which is what you would expect in Anaemia of Chronic Disease. This suggests that you have plenty of iron stores and don't need a higher level.
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Your results as a whole seem to be typical of Anaemia of Chronic Disease (ACD). But the thing which sticks out to me is that your CRP, which would usually be high in ACD, is in range. It is possible that you could have both a degree of iron deficiency, and ACD. Just to give you some context on CRP, I once saw a program on TV in which a (real, not an actor) woman had a chest infection and her CRP was 50, so your level of 2 is not a worry.
If you do have a result for your haemoglobin it might be useful.
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You have a few choices...
You could treat yourself as if you have iron deficiency by taking iron supplements. The outcome of this could be that your iron and saturation improve and your ferritin doesn't change much. Your haemoglobin might improve too. Another, more dangerous, possibility is that taking iron supplements might feed some unsuspected pathogen or cancer allowing it to reproduce more and make you sicker.
You could treat yourself as if you have ACD and do nothing to your iron levels while trying to improve and optimise other nutrients, thyroid hormones, cortisol, gut health etc to see if that helps.
You could ask your doctor if you could get an iron infusion done on the NHS. With your level of ferritin I think this would be denied. You could get in touch with a private iron clinic and ask if they would recommend an iron infusion with your results.
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If you choose to take iron supplements I would suggest trying heme iron supplements along with vitamin C which helps iron to be absorbed :
If you choose to have an iron infusion your ferritin, saturation, and serum iron will be extremely high for a few weeks. I don't know how fast they would decrease.
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In your shoes I would try the heme iron supplements for eight weeks. I would get an iron panel done after the first four weeks, then again after the second four weeks. Along with the results you've quoted in this thread, it would give you an idea of whether your various levels are increasing or decreasing. It might make it clearer if you have ACD or iron deficiency.
In some cases, if Vitamin B12 and/or folate are below optimal and are improved with methylcobalamin (an active form of Vitamin B12) and methylfolate (an active form of folate) this can improve the ratio of serum iron to ferritin - but there are no guarantees. Both the suggested supplements mentioned can be bought without prescription on the internet.
Many thanks for your very informative response. I'll read through all the references carefully & try & decide what to do next. Thank you very much for this insight.
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