Hello All! I've been keeping abreast of information on the forum, although I haven't posted in a while (not felt that I've had much to offer in the way of answers ). However, I was hoping I might get some more guidance from the wise folks on here.
I've updated my bio. with the latest chapters related to my thyroid and I've been doing dose tweaking along with regular testing of thyroid hormones - following correct protocol (for all bar one GP test) - I'll post a screenshot of my full result chart in a reply to this post.
In my latest Medichecks comprehensive test, the ferritin and iron results were very odd. I've often seen comments that say "It's possible to have low ferritin and high iron" - but I've not been able to find any information about what to *DO* about this.
RESULTS:
Ferritin: 59.4 mcg/L (30 - 264) 12.56%
Haemoglobin: 137 g/L (115 - 165) 44.0%
Iron: 29.2 micromol./L (10 - 30) 96.0%
TIBC: 57.4 micromol,/L (45.0 - 81.0) 34.4%
UIBC: 28.2 micromol./L (13.0 - 56.0) 65.6%
Transferrin saturation: 50.9% sat. (range: 25.0% - 45.0%) = 113.1% = percentage through range, i.e. over upper value of reference range percentage
I've watched some vids explaining what this shows and how it can arise, I've also tried to read various "iron-related" posts on the forum... but it's unclear to me what to actually do in this situation. I've been supplementing iron based on very low in range values, AND low iron, in previous tests (see table posted in reply to this thread for historical values) - but stopped when I saw these latest results. Then had a massive increase in hair loss and fatigue, so decided to compromise and am currently taking iron on alternate days... alternating with a zinc/copper tablet.
I can't tell if this is the right thing to do - how is one supposed to address LOW ferritin but HIGH iron (and HIGH transferrin saturation)? The Medichecks doctor's comments even said something along the lines of "... you have low ferritin so you could consider taking iron supplements..." while making no mention of the iron level (yes - I know the Medichecks comments are, typically, a load of baloney, but I keep forgetting to select not to get them!).
Does anyone have any advice about the correct thing to do in this scenario, please? Any advice would be very much appreciated! 🙏😊
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ERIC107
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Sorry the table values are so hard to see - I hope it's possible to zoom into the table to see the numbers! The ranges for all the values are colour-coded in the column headings... hopefully they all make sense.
Hi humanbean - all the results for all folate and B12 tests are in the table, but I realise the values are quite small without zooming in. The most recent values are enlarged in the attached image. The ranges are in the column headings with the appropriate matching text colour coded - so grey folate value and grey text range in column heading, for example.
I take Igennus Super B-complex soluble tablets (containing methyl cobalamin, methyltetrahydrofolate) one per day, but stopped eight days before the blood test - for biotin reasons.
all the results for all folate and B12 tests are in the table
Sorry, I was tired, and wasn't taking things in.
I take Igennus Super B-complex soluble tablets (containing methyl cobalamin, methyltetrahydrofolate) one per day,
Igennus Super B is a good supplement, but I'm jealous that just one per day has got your folate and B12 up to such a good level.
If anyone ever tells you that high B12 is dangerous and you must stop supplementing, or something similar, then you might find this link helpful to fight back. The worst thing you can say about high B12 is that you might be wasting money by supplementing to such high levels.
Folic acid should be avoided in supplements because not everyone can convert it into proper folate and it just hangs around in the body and bloodstream. You might not be aware of this, but folic acid was first developed in 1943. The human body simply isn't that great at converting it into "proper" methylfolate. The people who are worst at the conversion have a gene that is less than ideal that affects this conversion (the problematic gene is called MTHFR and problems with it affect about 50% of the global population ) that reduces and slows down the conversion of folic acid to methylfolate.
The reason for mentioning the stuff about folate and B12, and supplemental methylfolate and methylcobalamin is that, as you can see from the names, both supplements contain "methyl donors" within them. If you have too few of these methyl donors then the ratio of ferritin to serum iron can get distorted.
You've mentioned in your opening post that your ferritin is 12.56% through the range and your serum iron is 96% through the range.
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.
So, if normal ferritin for women is 20 - 200 ng/mL and optimal is 90 - 110 ng/ml then ferritin should be roughly 40% - 50% through the range. Your ferritin is much too low - but I'm sure you knew that already.
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This link gives some info on reasons for high iron :
Some people have found that high iron has dropped and low ferritin has risen as a result of optimising Bi12 and folate with the methylated supplements.
Other alternatives for supplementing methyl donors if B12 and folate are already optimal are :
Thank you humanbean - I really appreciate all the detail in your reply!
What you say about the link between ferritin/iron and methylation is really interesting. Lots to think about and read about there.
Unfortunately, I'm heterozygous for three out of five MTHF gene variants (two out of three MTHFR genes) - so not the worst, but not the best either - and homozygous for one of the five MTHF variants, so I think there's a high possibility for problems with this pathway (although not a certainty, of course - it's all percentages).
Unfortunately, I'm heterozygous for three out of five MTHF gene variants (two out of three MTHFR genes) - so not the worst, but not the best either - and homozygous for one of the five MTHF variants, so I think there's a high possibility for problems with this pathway (although not a certainty, of course - it's all percentages).
The suggestions I've made about methylcobalamin and methylfolate and the other methyl donors are good for everybody whether they have problem MTHFR genes or not.
But they are particularly good for people with MTHFR gene problems because they help to do the conversions that require the methyl donors that the people with the gene problems don't have.
The only safe option with iron and saturation % that high is to correct via diet. Eat as much iron rich foods as possible.
When you do that, it’s helpful to count iron intake (ie, # mgs with a note on whether it’s from animal-based sources or non-animal-based sources.) Our bodies absorb animal-sources iron at 3x rate otherwise. For example organ meats can be as high as 25-30% whereas iron in vegetables can be around 10% or less. Also, eating vitamin C with non-animal sources boosts absorption. And things like fiber, coffee, tea and other things can significantly block all iron. So avoid those when ingesting iron.
Armed with knowledge of your iron intake from food, then regularly test a full iron panel and start to find your own balance… once those measures return to target, you can start a very low and slow supplement program again .
You want to find out for yourself how much iron do you need to ingest to maintain 55-70% through range iron. And to stay at 35-40-45% saturation %. Without going over on either.
Our body has no way to excrete excess iron - which you have by those measures. This leads to the iron settling and accumulating in your organs, which can lead to permanent, irreversible organ and tissue damage.
Iron toxicity is real and should not be messed with, but is only a risk with supplements. It can’t happen in any practical circumstance when eating iron through food.
Thank you, FallingInReverse - I was hoping you would reply as you've given very helpful iron-related responses in the past!
I'm vegetarian - so all dietary iron is plant-based. I am also post-menopause, so I have no iron loss through periods. I am, however, a runner - so there is likely some iron destruction through impact haemolysis. I'll stop the alternate day iron supplementation and see how the levels look in my next thyroid blood test.
Do you have any insight as to why my ferritin is result is low, whereas the other values are high? The low ferritin triggered a "... take an iron supplement comment..." from the Medichecks GP - which is obviously dangerous in this case. How will not supplementing at all effect my ferritin level, possibly (I realise you can't actually say for certain, but do you have any further insights at all, please?). I'm quite concerned at the level of hair loss I have at the moment. It was quite bad with typical iron panel results (low ferritin and LOW iron/transferrin saturation) from my previous tests - but it's really accelerated now... falling out like it's going out of fashion!
Up until this last test, even daily supplementation was not really shifting either ferritin or iron values - not sure why it has changed so much this time... 🤷♀️
1) Your ft3 is dismal ! In my personal experience- optimizing ft3 is what fixed my hair loss, even when my own ferritin was still in the teens. I will also acknowledge of course that low ferritin causes the same (and many more issues). My daughter’s hair loss reversed with iron supplements. But ft3 without a doubt is an issue for you.
Also, 60 ferritin is not really horrible ! I know we aim for 100… but many people here are def jealous of that 60!
2) the trick is this …. Find the right amount of iron intake that will keep your iron 55-70% through range…. When this happens over time, your body will have enough for its daily needs and cellular processes, and will feel comfortable sending some to storage.
Edit: storage = ferritin. That’s why it’s so slow. We need actual iron in the blood to be just right for an extended time where it will send some to that ferritin storage.
Iron - though- is fast moving up and down. An iron rich meal the night before a blood test can impact it, a month of supplementing for me popped my iron from below range to above range.
So No single measure on an Iron panel tells the whole story. So the other one I like to watch is Transferrin sat aiming for 35-40%-ish.
Tsat% is a derivative of other aspects of your iron profile and also more slow moving.
This is the one that tells you how much iron is jumping onto the body’s Ubers for iron (ie, transferrin) that transfers the iron to your cells and all over your body where it’s needed.
So when it’s low… you’ve got empty Ubers and a body that isn’t getting iron moved around where it’s needed. When it’s too high - this is actually too much iron saturating the transferrin.
For me, 45-50% sat% is a real red flag and you are wise to stop supplementing. Reset for a month . Then in a month or so once you test again, you can supplement lower iron dosages, and tolerate perhaps lower numbers, maybe a return of symptoms, but avoid toxicity.
Then - you can start again. Very much like t4 or t3 - low and slow… and lifting up to optimal without risking overshooting (where you are now.)
The whole point is to find exactly how much iron you need to ingest to maintain … not pop up and not fall down with iron and tsat%.
So consider the next few 6-12 week periods as learning weeks … track a steady is take of iron and see what happens. Then take it from there.
Ps
We all shed about 1-2 mgs of iron a day. And yes, if you get your period this adds another 1-2 mgs a day.
Knowing that, and knowing the 15-30%~ absorption rate of iron we eat, it makes sense why the daily recommended iron amount is 18 mgs a day.
Because if you eat 18 mgs of plant baed iron and on average you will replace about 2.5 a day. Hence replacing what we shed.
Also an interesting point - out bodies do not make iron. We have to eat it.
Those are averages. Each iron food absorbs differently. But it’s helpful to think about The relationship of the # mgs of iron you eat, the percent of those that absorb, and how that compares to the 2-4 per day you shed.
Again - the whole point is to find your own homeostasis by getting very intimate with how much you need to ingest to maintain a healthy non toxic iron level.
Thank you - this is all very helpful. I'm a detailed logger of all my intakes, so adding Fe to the overall information won't be too much of a problem.
Yes, you're right T3 is my next big mountain to climb. I have 50% of the genetics that predisposes me to be a poor converter of T4 to T3 - but the poor converter gene does seem to be exerting its power!
And you're also right - I've had some improvement in ferritin (12 at diagnosis to 59 now) it just doesn't feel like much... but looking back it's actually reasonable now.
HB will also explore the relationship to your Bs… I don’t have that issue and so not well versed on that very important consideration when it comes to iron.
Also
You need to add a CRP-hs to all future tests that include iron.
When we have inflammation - ferritin jumps temporarily.
Also - you do indeed need full iron panels to interpret all of this (and the related things HB will call out on B).
Your ferritin increased but we do but have the data to say why.
I kinda figured that would be the case, as I do think your increase in ferritin is because your iron and sat% have probably been high too. But then there were all those other gaps in the iron panel so wasn’t sure.
Ps, admirable chart : ) add your CRP is there, any time one looks at ferritin you really need to eyeball that too.
HAHAHA - thanks, there were so may hidden columns to get it remotely "screengrabable" (I'm sure that's a word 😉)... it's in the full version somewhere just not in the image I created...
And - annoyingly, I can only afford the Medichecks test with all the 'bells and whistles' twice a year - once in summer and once in winter - that's why it's a bit patchy with regard to the FULL ferritin/Fe picture.
I have no expertise to offer but to me, I wonder if your folate might be at about double the level of what is optimal?? Googling iron and folate, and their relationship, it states that if you are folate deficient ,you will also be iron deficient. I think your iron is sky high because your folate is too?????
Can you see a hematologist? High iron and TSAT with low/normal ferritin and low/normal TIBC can fit descriptions for Sideroblastic anemia: – where you have excess iron but the body can't use it. Interesting write ups my.clevelandclinic.org/heal... and en.wikipedia.org/wiki/Sider....
It can be hereditary or acquired, including something as basic as zinc/copper imbalance.
"Causes include excessive alcohol use (the most common cause of sideroblastic anemia), pyridoxine deficiency (vitamin B6 is the cofactor in the first step of heme synthesis[8]), lead poisoning[9] and copper deficiency.[10] Excess zinc[11] can indirectly cause sideroblastic anemia by decreasing absorption and increasing excretion of copper."
Thank you Patti/Poniesrfun - this is also very interesting. I have been taking iron every other day, alternating with a zinc/copper tablet, until recently when I stopped both. The zinc/copper link is interesting.
(I don't drink alcohol - so it's definitely not that 😁)
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). However, I was hoping I might get some more guidance from the wise folks on here.
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