Help with latest blood results, dropping ferritin / B12 and whether to increase T3

[Slowrunner1208]

Hello, I need some help with my latest bloods, whether to increase my T3 and how to address a drop in ferritin and active B12

Meds; 100mcg levothyroxine and 10mcg of liothyrinine. B complex, folate, zinc, omega 3, magnesium, vitamin D & K2

I’m gluten free

Latest bloods done following all advice here and results are:

TSH 0.08 (0.27-4.2) -4.83% thru range

T4 17.1 (12-22) - 51% thru range

T3 4.7 (3.1-6.8) - 32.43% thru range

Ferritin 25 - Very disappointed that this has dropped back again as I’d raised it to 75

B12 100 - This has also dropped from 150

Vit D 84 - This has increased slightly after advice here to take a loading dose.

No folate result as the sample not good enough, I will be redoing it.

I feel ok, better than in the early days but not as good as I’d hoped on combination meds. I get very tired still particularly in the afternoons, though splitting my current T3 into two doses has helped.

Questions:

What do my levels suggest?

Should I be increasing my T3, perhaps adding in another 2.5mcg?

Any ideas for increasing ferritin, I’ve worked so hard on my diet for this so am gutted and don’t understand how it’s dropped so low?

Should I be taking an additional B12 supplement?

Any other comments or advice?

Thanks so much for reading and any responses!

[FallingInReverse]

Ferritin 25 - Very disappointed that this has dropped back again as I’d raised it to 75

Do you have results from a full iron panel including CRP (ie, inflammation)?

Without having CRP tested with a full iron panel (not just ferritin), there is no way to conclusively evaluate why your ferritin was high and/or dropped low.

What was the time between ferritin tests, and assuming you are not supplementing?

[Slowrunner1208 in reply to FallingInReverse]

Thanks FallingInReverse I had the Monitor My Health ‘Full Health Screen’ this doesn’t cover CRP and I can’t afford another test straight away.

The drop in ferritin is since January. I don’t take any iron supplements but upped my iron rich food consumption from October when I’d previously tested and got advice here to change diet.

Does this help cast any light or is CRP critical?

😊

[FallingInReverse in reply to Slowrunner1208]

It’s hard to tell. Active iron management for us individually is a long game.

Generally (and I’ll say “generally” since we are all so different in how we absorb iron) generally ferritin is indeed slow moving. For those with absorption issues (like myself) we spend 6-9-12+ months or more increasing it. For example, it’s taken me six months or so to increase from about 5 to mid 20s.

I am not personally experienced with drops in ferritin, but clinically it can mean a few things that get back to the balance between iron intake, iron utilization and hence when your body can send iron to storage or when your body needs to draw on that storage you have.

1) possible it was high due to inflammation in the first place. So it’s not that it necessarily dropped, but was increased in the first instance due to inflammation that since decreased. You should include CRP-hs in any iron panel you do, along with iron, transferrin saturation percent… and you’ll prob also get transferrin, TIBC and maybe UIBC along with it. CRP/inflammation will shed light on one of the easiest reasons to explain a ferritin jump or drop.

2) could be increased iron utilization… which then triggers release of ferritin stores, hence the drop.

3) Might also be a drop in iron absorption. Which then means you’re using the same anmount of iron but need to dip into your ferritin stores to get it.

can you share here for easy reference your past history of full iron panel results with dates?

Ps

Is that B12 active B12? Can you edit your post with the range?

Also, my thyroid hormones are similar to yours 75-100 Levo and 10 t3. I am currently slowly titrating my Levo up with a goal of upper quadrant first … like - trying for 75% through range. After that I’m goin lg to reevaluate my T3.

In my experience- I see your T4/T3 as both needing a low and slow boost. I chose Levo first since that will also impact my t3. So that’s what I did.

[Slowrunner1208 in reply to FallingInReverse]

Hi FallingInReverse I’ve had a replacement test through from Monitor My Health. They want to retest the anemia part of the screening. I’ll repost results when I get them back.

The B12 is active but there isn’t a range on the results.

Have a good weekend and thanks for the advice / info 😊