My ferritin has dropped from 82ug/L (30-150) 4 months ago to 64ug/L (30-264) this week (both Medichecks- Inuvi lab). I’ve been scratching my head to find out why this could be, as my diet hasn’t changed.
The only change I’ve made is to increase my usual turmeric dose (which I think helps reduce pain/inflammation associated with palindromic rheumatism/early signs of osteoarthritis). About 6 months ago I increased from 600mg turmeric to 1200mg per day (with ginger and black pepper to aid absorption)
I’m wondering if the extra turmeric has affected my ferritin:
It binds to ferric iron in the gut and causes iron deficiency in mice. We report here a possible case of iron deficiency anemia in a human taking turmeric
Interesting.
I swear you just can't win sometimes.
I wonder if taking it well away from food would off-set such an effect.
It certainly takes a lot of brain cells to absorb iron information 😵💫
Cellular Level
The absorption of most dietary iron occurs in the duodenum and proximal jejunum and depends heavily on the physical state of the iron atom. At physiological pH, iron exists in the oxidized, ferric (Fe3+) state. To be absorbed, iron must be in the ferrous (Fe2+) state or bound by a protein such as heme. The low pH of gastric acid in the proximal duodenum allows a ferric reductase enzyme, duodenal cytochrome B (Dcytb), on the brush border of the enterocytes to convert the insoluble ferric (Fe3+) to absorbable ferrous (Fe2+) ions. Gastric acid production plays a key role in plasma iron homeostasis. When proton-pump inhibiting drugs such as omeprazole are used, iron absorption is greatly reduced. Once ferric iron is reduced to ferrous iron in the intestinal lumen, a protein on the apical membrane of enterocytes called divalent metal cation transporter 1 (DMT1) transports iron across the apical membrane and into the cell. Levels of DMT1 and Dcytb are upregulated in the hypoxic environment of the intestinal mucosa by hypoxia-inducible factor-2 (HIF-2α).
Agree with TiggerMe… most logically, Tumeric reduced inflammation and in turn that reduced ferritin.
Although seems extreme - but in the past did you see any of your ferritin levels correlated to high inflammation?
Do you have a CRP result, or any other things tested 4 months ago and now to see what else changed?
Another silly question… although unlikely, no chance of internal bleeding…? Heavy periods? Other blood loss in the last 4 months? Tumeric is a blood thinner…
edit: your thyroid numbers are stable over the the same period?
I haven’t had a full iron panel for a couple of years(last was when my ferritin was at its lowest, 40ug/L and I supplemented for a couple of months after this).
I’m working on advice from dailyiron.net to eat or drink something with vit C alongside iron rich food and will retest key vitamins in a couple of months. I need to anyway as my folate result was corrupted. I think I will also trial reducing turmeric to one capsule a day…
I'm fairly sure that the vitamin C idea is good - but is not relevant to iron in the form of haem (or ferritin). Therefore, it depends which sort of iron rich food!
My ferritin seems to have dropped further. Other results do not suggest to me that I should supplement (although I’ve already placed my 3 Arrows order!what do you think FallingInReverse ?
radd and humanbean could you also please advise, as I know very little about iron panels. Many thanks!
Quick first reply, but I’ll come back and look again as well.
Iron is 79% through range - we aim for 55-70 so this one indicator says your slightly over. The caveat for this one is iron can change daily based on our diet for example and so I use this as a moment in time marker, in context.
Next one I look at is Transferrin Saturation. Ranges for this ARE helpful in this case. Across different tests 25-45 is pretty standard, and we aim for MID-RANGE. So you are a-ok on this but do not want to supplement and risk pushing this higher.
So these two for starters say - good but no supplementing.
But - lmk this, as I might modify my “what would I do if I were you” opinion:
My question:
What has your iron intake been to get these results? When was the last iron panel done and results, what has your iron intake been/what changes and for how long on each stable “dose”/regimen… if you’re even supplementing at all.
Thanks for your response. I will definitely hold fire with any thought I had of supplementing iron.
Interesting that my CRP has moved from 0.7 to 1.3 in a week…. I wonder if that’s because I have halved my turmeric dose? Or maybe just a little more achey this week! (I don’t currently have a cold)
I haven’t had an Iron panel for a couple of years, as my ferritin has been at a good on my twice yearly key vitamin checks. I did supplement iron for a short while a couple of years back when transferrin saturation was low.
The two other points I was going to make were about:
1) “maintenance “ levels of iron intake. Because ferritin is our storage cabinet for iron, we have to have enough in our blood and cells where it’s needed for essential functions (like carrying oxygen around), then once it’s comfortable those things are covered, it will send some to storage.
Iron in the blood 55-70% and Transferrin Saturation at 25-45% is the trick.
So finding the right amount of iron a day that will keep that up for me is the prize.
I would be interested to know how much iron you eat a day. Our bodies cannot make iron… we need to ingest it. With ferritin dropping, clearly you have an imbalance in the in vs the out.
2) Also, you can’t EAT yourself into iron toxicity. I mean - you COULD conceivably but you’d have to eat A LOT of food each day. Prohibitive amounts. Plus the “food matrix” that iron is part of in a normal meal are all part of the ways our body is protected from excess iron.
But you CAN easily supplement your way to toxicity. Imagine the most iron rich foods only provide 10-12 mgs of iron per serving max… iron tablets provide 20-60-or more mgs all at once. It overwhelms our bodies natural defenses. We only shed about 2-4 mgs a day.
Also - I read something this week that has stuck with me. We all know that our bodies can’t excrete excess iron. And then it settles in our organs and causes irreversible damage. But it didn’t occur to me that that means the excess iron ACCUMULATES over time up and up. So by the time someone is older all the excess iron that’s accumulated is still all there. That’s why I am so conservative and track my iron as I raise my own ferritin from a low of 5 last year.
Since you’re keeping your iron and saturation up with diet, yet your stores are depleting, it’s worth understanding why you might be eating less lately and be aware of how much more you need to eat to correct it.
Because if your ferritin is dropping (ignoring inflammation for the moment) then the only way to fix it is to maintain your iron intake.
I’m certainly going to keep a close eye on the amount of iron rich foods & try and log this until I test my ferritin again.
However, I honestly don’t think my diet has changed in any way….with exception to the increased turmeric to help with ‘early signs’ of osteoarthritis. I also take glucosamine and chondroitin for this condition, so will be investigating whether this too can raise iron levels….
Clearly I’m mistaken thinking my increased CRP in a week is due to reducing the turmeric….I really shouldn’t have done a vigorous exercise class (30min high intensity spin) prior to my finger prick blood draw! 🤣
Serum iron fluctuates daily depending on what you have eaten. These results show good iron levels, and the transferrin in proportion indicates the serum iron levels has been maintained for a while (they influence each other).
However, without an iron storage reservoir, if intake was reduced serum iron level could drop very quickly. And you don’t want huge fluctuations because that risks changing the other iron measurables and how well iron is working.
Equally supplementing iron won’t necessarily raise ferritin if those mechanisms aren’t ready to be raised yet. If this was me I would continue as you are without supplementing to keep day to day levels adequate in the hope that ferritin will start being made to bind any excess and so create stores.
And be mindful of adequate gastric acid: betaine + pepsin or ACV, bitters, etc. Also taking Vit C with iron rich meals and a little bit of alcohol if you like it 😁. And avoiding eating food with iron binders such as milk or tannins in a cup of tea. Other binders are calcium, oxalates, polyphenols and phytates.
A sample size of 1 tells us very little other than it might be something for bigger studies to investigate… Given it’s a case study article, I guess that’s why they published it. I get frustrated by the research that isn’t done - I think we all do!
Although I can’t comment on your case, this has made interesting reading. I did turmeric a good while ago and off the top of my head don’t remember why. It might have been muscles as I am always looking for that kind of help. Made no difference BUT further research said it simply was not strong enough concoction. I did buy something stronger but never got around to using it. The reduction of high ferritin is interesting to me re: high ferritin = high inflammation - assuming it’s not haemachromatosis. I am going to check it out again. Thanks for raising it.
I asked a practitioner about this some years ago as suffer iron overload but was told the amount required would be so huge and likely induce other side effects. I’ll try and find her emailed answer later,
I really appreciate that radd. It seeems to me that you can benefit from supplements in so many ways, but there can be an adverse consequence from having an excess. I honestly think turmeric has helped reduce inflammation and pain linked to the start of hereditary osteoarthritis (in so much that I don’t need ibuprofen or other pain relief at regular intervals), but wasn’t aware of any adverse reactions.
With regard to tumeric reducing iron absorption, the advice was the action within this pathway is on an acute phase protein called hepcidin. This is released naturally by the liver in the presence of iron excess and when there are inflammatory cytokines present (such as Tnf and Il 6 - both common in Hashimotos).
It blocks ferroportin which is a transporter that takes heme from intestinal cells and transports to transferrin for delivery to bone marrow. Thus there are many complex factors to consider and taking large amounts of turmeric will affect individuals differently and not always positively.
I also previously contacted the Heamochromotosis Society regarding turmeric and they advised not to take for the reason of reducing iron (although it does have plentiful other benefits).
I also investigated rosemary that has many benefits and can reduce non-heme iron absorption as the affects renin-angiotensin system. "rosemary may reduce non-heme iron absorption as a phenolic-rich antioxidant in foods and so the utilization of dietary iron.' Paper here .... content.iospress.com/downlo...
I think these papers depend upon certain genetics and health, etc, and often refer to amounts unattainable for daily use. I even found a paper once that stated PPI’s reduce iron levels 🤣
Last folate test with Medichecks 6 months ago was 33.9 (halfway through range).
Just a thought…..as I keep having trouble with the finger prick tests, I actually went on my spin bike for 30 min prior to the iron panel test this week to ‘get my blood flowing’…. Can vigorous exercise affect ferritin/ CRP? If so, I won’t do this again (even though the blood draw was easier!)
Thanks for your input humanbean 👍
Update: I feel rather silly as I’ve just Googled….Can strenuous exercise raise CRP levels?
‘There is a short-term, transient increase in serum CRP after strenuous exercise, produced by an exercise-induced APR, mediated by the cytokine system and mainly IL-6’
…..I obviously won’t recommend a 30 min spin session to any members immediately before a blood draw!!
This was my test last week but unfortunately the folate isn’t shown.
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