Hello, I had new blood tests done and the results are:
T4 17.9 (12-22)
TSH 0.77 (0.27-4.2)
T3 4.5 (3.1-6.8)
Been taking 75mcgs of Levothyroxine for last 5 weeks - endo says these results are good and to stay on this dose. I have been feeling so unwell for the last week - same bouts of symptoms I get from time to time which I associated with hypo - fatigue, shortness of breath, weakness, heart palpitations: only way I can manage is to lie very still in bed.
But these results are good so now wondering if my symptoms are more related to low ferritin and iron ( last months results)
Iron 10.9 umol/L (Range: 10 - 30)
TIBC 56.5 umol/L (Range: 45 - 81)
UIBC 45.6 umol/L (Range: 13 - 56)
Transferrin Saturation X 19.3 % (Range: 25 - 45)
Ferritin X 14.90 ug/L (Range: 30 - 207)
Would be grateful for any thoughts
Written by
jenny876
To view profiles and participate in discussions please or .
5 weeks is a little early to have a blood test following a dose change. Usually 6-8 weeks is recommended and in fact even after 10-12 weeks things can change a little.
Free T4 (fT4) 17.9 pmol/L (12 - 22) 59.0%
Free T3 (fT3) 4.5 pmol/L (3.1 - 6.8) 37.8%
Your Endo is likely just looking at your TSH but even then you have room for an increase.
FT4 not even 60%, it should be up in the 80's or 90% range. FT3 needs to be around 70% and its trailing down at under 40%.
If you can get your Levo dose raised enough you might raise your FT3 a little more.
Vitamins are key to conversion.
Your ferritin is deficient and GP should be prescribing you iron. Take it 4 hours away from Levo with orange juice to help it absorb better.
Thanks for your reply. I missed my last endo appointment due to illness and got another appointment for Tuesday there so had to get bloods done. I started Three Arrows Heme iron last Thursday but have bad gastritis now and wondering if its those because cant link it to anything else.
I would like to increase my levo but not sure how to do - also I take Vencamil which only come in 100mcgs tablets and even using a pill cutter it is impossible to get even amounts of tablets so it means Im never really taking the correct dose.
Maybe I could start by increasing to 100mcgs twice a week and work my way up from there - for my weight my dose should be 100mcgs X 5 days and 75mcgs the other two.
Vitamin D 43.1nmol/L (50-250) in February and have tried to persevere with Better You Spray but I get bad bone pain and already suffer with chronic pain and fibromyalgia so really struggling to increase that.
Folate - Serum 11.8 nmol/L (Range: > 7)
8 months ago it was Folate - Serum 15.1 nmol/L (Range: 8.83 - 60.8)
Tried to take B complex but it gives me severe head pain so got a separate folate recently and have taken a few so far.
Vitamin B12 - Active 68.9 pmol/L (Range: 37.5 - 188)
8 months ago B12 was Vitamin B12 - Active 52.2 pmol/L (Range: 37.5 - 188) and have been using spray since then so some improvement.
Even if you cant get precisely accurate quarters of Vencamil its a storage hormone so not so critical to get exactly the right amount. It will even out over the week if you cut it.
Some people do struggle with vit D. Have you tried a different formulation with maybe less additives? It would be worth at least testing out different products.
Working on your vitamin levels is critically important as we need optimal levels of all key vitamins for our thyroid hormone to work well. Keep chipping away at it.
There are a few brands that have less additives that you might find better tolerated such as metabolics and Biocare.
The betteryou spray has no additives that I know of and the capsule I sometimes take is Bio-Vitamin D3 3200. It contains olive oil and capsule shell is bovine gelatine.
I think from reading on this site that bone pain is to be expected if you have been deficient for a long time - will persevere as would really like to get levels up. Thank you for your help
Are you still taking the Heme iron tablets? i started last Thursday taking 2 a day and last couple of days I have had severe gastritis, belching and vomiting burny bile.
The heme iron tablets are the only thing I can attribute it too - are you aware of anything like this connected to the heme iron tablets? They say that they have no side effects and are gentle on the stomach.
I was spacing out the two heme iron capsules - one morning and one evening but not taking them with food. The last 2 days I have reduced to one and have taken it with main meal - my stomach is a bit better so maybe that was the cause of my gastritis.
I did take synthethic iron about 8 years ago for anaemia but cant remember the dose - struggled with it but did take it all and anaemia got better.
I hope you start to see some improvements with your iron and ferritin levels
For me it was helpful to realize that one Three Arrows Heme capsule has 20 mgs of iron, and for comparison, chicken liver - one of the top iron rich foods around - has only 10 mgs in a 100 gram serving. That's a lot of chicken liver, by the way : )
In my layman's perspective, that helps me understand what happens when I take iron supplements and blast my system with a level of iron it would never get in any eaten meal. On top of that, 10 mgs of iron in chicken liver is buffered by a matrix of food nutrients, fiber, etc. that the supplements don't have.
Although I haven't heard many/any people complain of stomach upset, it really is a lot of iron at once and all alone. Which is needed to break through the anemia so you are on the right track.
Obviously if taking it with a meal is helping, definitely continue to do that.
That's great that you take Levo only once and so early, leaving tons of room for iron. The reason I ask is that the other thing I will do for myself - as long as it's 4 hours away from my Levo, is break open the capsule and sprinkle part of it on food, to mimic the buffering effects of the food matrix. 1/2 the capsule is identical to one serving of chicken liver, and since Three Arrows is 100% dehydrated beef spleen, I do think it's the secret weapon for those of us who hate organ meat, with low ferritin but middling iron!
Reminder that consistency is key - whatever you do, try to be consistent so you know how to calibrate when you get your next blood test in 4-6 weeks.
Thank you for this - my gastritis has got much worse and I have terrible stomach pain. I was googling it and came across this article about "iron pill gastritis" - its rare but could be what I have - ncbi.nlm.nih.gov/pmc/articl...
Apparently liquid iron is better if susceptible to gastritis - do you know anything about it?
I dont want to stop taking iron altogether - maybe it would be worth trying the liquid iron?
If I were you I would absolutely stop entirely for 3-5 days, see if the symptoms lift. And check back in and tag me in a week if you decide to do this.
We should see if this is indeed the iron causing this. The heme iron itself really shouldn’t (unless someone comes along to tell us something we don’t know : ) ), and so my first thought is that it was too much at once and also possibly a coincidence of something else happening at the same time.
But surely a 3-5 days or weeklong break will tell . I’m guessing that you have never experienced this GI upset and that it was totally new when you started the iron pills? Gastritis is a really common gut problem… us hypo people are prone to gut problems… so I’m also on the lookout for other root cause issues that the iron maybe triggered, but where the iron is not the root of the problem.
I am not a doctor nor expert, but in my opinion:
* The study you shared is about ferrous sulfate. Also, they don’t say how much and for how long. But those iron pills are well known to create GI upset.
* The study is also interesting as gastritis is obviously very very common. The study and its footnotes are more talking about iron deposits in the esophagus and stomach walls that create the problem. For you to take 40 mgs elemental heme iron daily over one week just doesn’t make sense that there would be anything like that happening.
Also, regards to the paper, In the Discussion section:
One serious potential complication of iron supplementation is iron pill-induced gastritis. The proposed mechanism for how oral ferrous sulfate produces this gastritis involves iron oxidation and subsequent damage to the esophagus and stomach. More specifically, when iron is oxidized from the ferrous to ferric form, an epithelial injury occurs [2].
This points to the fact that nonheme synthetic iron is more prone to oxidizing, which is the mechanism that triggers GI upset. Vs heme iron which is absorbed as a whole molecule and therefore with fewer of the chemical reactions that happen when we absorb synthetic iron.
So it’s not quite likely that this paper explains anything for you.
Here’s another explanation of the same thing:
It is believed that the only regulated step of the iron metabolism cycle occurs during absorption in the duodenum and jejunum.2,3 If the system becomes overwhelmed due to high iron levels (local or systemic), then iron can be absorbed very quickly in a passive concentration-dependent mechanism.4 Once there is an excess of iron in the body, it is initially stored as hemosiderin in the liver, and then later in the pancreas, heart and joints (Figure 1).2,5 Since ferrous and ferric ions are catalysts for the formation of reactive oxygen metabolites and highly reactive radicals, damage will occur to the various organs and joints where iron accumulates.2,4,6,7 When iron accumulates in the gastric mucosa, it is known as gastric siderosis (GS).
Reason I pasted that part is because it notes the gastritis process amps up with the oxidation of nonheme iron, and also when iron overloads our natural defenses in the small intestines and settles elsewhere.
Inconclusive at to whether your supplementing was enough to trigger that… so let’s stop them for a week and see what happens!
Thank you so much for that in depth response - I will stop and see if my stomach gets better - I have suffered with gastritis on and off for many years and also took aspirin for many years until a week ago so maybe because of this my stomach has reacted bad from the iron.
I wasn't expecting to get bad gastritis after stopping aspirin! I will let you know if ceasing the heme iron tablets makes any difference - I really hope it isnt them as Id like to keep taking them! Thanks again
Your response tells me that the gastritis/stomach upset isn’t new and that the iron is aggravating whatever existing issue you had.
An opinion/a guess…. I’m not a doctor : )
My layman’s observations:
- aspirin is likely a non-issue, but this is why we only change one thing at a time : ) because it’s not immediately evident what’s causing your new gastritis flare up
- what treatment have you had for your periodical/recurring gastritis?
- Have you ever been tested for H. pylori bacteria? I don’t know much about it, but it’s mentioned here every once in a while, and I saw it while reading up in your questions today. Iron can actually “feed” it, so if your gastritis is related to this bacteria then that would explain everything.
- liquid iron is better for those with gastritis because it is in a form that absorbs faster and therefore cuts down the time in the stomach where it can cause irritation.
If I were you I’d start to think about your history with gastritis and see if there’s anything to learn.
As for iron - if I were you I would also give it one more try , three arrows, sprinkling half a capsule into my meals. With a big glass of liquid/water to dilute it in your stomach, Starting once a day. Then twice a day. See how it goes.
The reason I say this is that if you can tolerate those doses, those dehydrated beef spleens are indeed excellent sources of iron. Heme absorbs 3X more than nonheme. So you’d have to take 3x the amount in a liquid or other synthetic to equal the three arrows.
Looking ahead, you may also explore an iron infusion which bypasses your sensitive tummy all together!
I had gastritis originally due to alcohol addiction and then I had h pylori in 2009 and was given omeprazole and antibiotics and it cleared up. I stopped alcohol 10 years ago.
Since then Ive had small flare ups which Ive always attributed to the aspirin I took which was Beechams Powders which have lots of nasty additives and isnt enteric coated. I take omeprazole for flare ups but am aware it reduces stomach acid so only take when necessary.
I was wondering if I had h pylori again. Its substantially worse today and was sick bile and white foam and no appetite at all so going to try to get doctors appointment to see whats going on and then will hopefully restart heme iron. Thank you
Fatigue, shortness of breath and heart palpitations can be a sign of anaemia - and it looks like your iron is very low. I would also insist on going back to the GP to prescribe iron. Iron sulphate supplements are sometimes better tolerable, but as others have mentioned you should take them 30min away from a meal, not with tea, coffee or milk, as they can prevent absorption and take them with Vit C, as this will help with the absorption.
Your Vit D is also insufficient, going by your value and the reference range, so the GP should really prescribe that too. How many units are you taking? You may have to increase the dose - or have you tried a higher dose tablet?
Thank you for your reply. My GP insisted my iron is within normal ranges so I had tests done with Medichecks in February which is were I got the results from that show low iron and ferritin - similar results last September too so been a while now Ive had these low levels - so bought Heme iron to treat myself and seemed fine until gastitis started - it may not be connected tho I just dont know.
I have tried taking Vitamin D Better You spray since last September and also a 3200 capsule from time to time but I get such bad bone pain and already suffer with fibromyalgia and chronic pain so struggling to get my d levels up.
Your symptoms can be explained by your abysmal iron and ferritin results.
When my iron and ferritin were at their worst I couldn't even walk upstairs. I had to go up very slowly, on my bum, taking lots of rest before I moved to the next step.
Severely low iron /ferritin can cause palpitations, tachycardia (fast heart rate), and severe chest pain.
Do you know if you've got a rectal bleed? That can trash your iron levels. That's what happened to me - a bleeding polyp in my colon. Your doctor should be able to arrange a test - you have to supply a small poo sample.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Advice on latest results please..
Latest thyroid blood results
Advice please on Thyroid Blood Test Results
Latest Bloods Advice please
Advice needed please for latest blood results
