Serum iron: 10 (14-30)Transferrin : 2.49 (2-3.6)
Transferrin saturation 16% (15-50%)
Iron binding: 62 (50-85)
Ferritin: 50 (13-150)
Would be grateful of some input. I know my Ferritin is low, ferrous fumerate works too slow, have been supplementing for nearly 2 years, although not always consistent. So I want to order three arrows.
Many thanks!
Will tag FallingInReverse and humanbean to comment
Iron is below range and ferritin low
So yes can supplement
retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
Medichecks iron panel test
Hi JUUJOO
One thing to know is that at a biological/cellular level, T3 needs iron to get around and do its job in your body.
Transferrin saturation needs to be a minimum of 30% for that, and optimally 35-45%. So take heart, improving your iron should offer some relief!
No one iron number tells the whole story. But your iron profile is oh so low!!! Long story short, it’s really just down to deciding how much Three Arrows to start with.
Can you provide the info on previous supplementing? What was iron panel before, what did you supplement and for how long, then what was the result? Also, when is the next time you’ll be able to get a full iron panel after you start supplementing?
Hi FallingInReverse I've been taking 1 x 210mg ferrous fumerate every other day for around 2 years now, although not always every other day as its often the one I forget. A sympathetic menopause nurse prescribed it originally as at the time my hair was falling out and she wanted to get my ferritin to atleast 90. My gp/endo has never been interested in my iron levels. I can't find any older iron panel results. It appears they only tested ferritin before prescribing the iron in 2022. But I do have older ferritin results.
Ferritin:
06/21: 70 (13-150)( when thyroid problems started, Graves dx)
04/22: 27 (13-150) ( 5 months after Rai, Agranylucytosis )
10/22: 31 (13-150)
12/22: 43 (13-150)
03/23: 32 (13-150)
08/23: 50 (13-150)
11/23: 54 (13-150)
06/24: 64 (30-207)
I will be having a full thyroid medichecks test towards the end of Jan so will get the ferritin then aswell and I will either pester my gp for another iron panel or book a medichecks iron pancel if they wont agree..timings dependant on what you suggest?
The whole trick for managing iron is understanding how your own body absorbs it and slowly calibrating your supplementation plan to maintain iron (55-70%) and transferrin saturation percent (~35%~ and not going past 45% under any circumstances) over time. If you do that, your ferritin will slowly rise.
You’ve learned a lot with 2 years of your ferrous fumerate.
Synthetic iron:
Keep in mind - your ferrous fumarate is a synthetic iron. 210 mgs only has about 70 mgs of elemental iron. The rest is binders/fillers/coatings, etc to help it stay stable and to aid in absorption etc.
The absorption rate is about 2-20%, and so you will only have about 1.5-10 mgs iron max absorbing in that pill (which is also highly influenced by the food you eat it with so closer to the lower end.)
Heme iron:
By comparison - one Three Arrows is 100% dehydrated animal organs and has 20 mgs heme iron which is all elemental iron. Absorption rate is about 3x non-heme iron - about 15-35% - which gives you a more predictable 3-7 mgs absorbing in each pill.
Liver:
To give real world context for that say that one serving of chicken liver (~100 grams) has about 6-10 mgs of elemental heme iron. At 15-35%~ this is only about 1.5-3 mgs absorbed.
The iron in other foods are all pretty much less than that. It doesn’t get much better than liver.
I think it really puts it into context as to what our bodies are up against trying to get enough iron, esp for us hypo/hyper people when our gut is all messed up.
Complex food matrix:
Equally if not most important is to understand that when we eat iron in real food, the complex food matrix it comes with (fiber, fats, proteins, vitamins, etc), hours of digestion, AND the fact that even the most iron rich foods only deliver a few mgs of iron at once - it’s not possible to eat yourself into iron toxicity. (Unless you have something like hemachrosis or other genetic iron issues.)
Our bodies have an incredibly effective set of defenses to protect ourselves against iron toxicity….
BUT iron supplements overwhelm those defenses.
Iron is toxic in excess, our bodies can’t excrete it, and over time it settles in our organs and soft tissues.
(PS. Because it sometimes comes up, if you do eat lovers/pates, realize that it has an incredibly high level of vitamin A, which has its own risks of toxicity . So only eat liver/pate once or twice a week max.)
Avoid iron toxicity:
So when you supplement - you must be sensible, low and slow. And commit to regular full iron panels. Not just ferritin.
Your ferritin is low, but not as low as many peoples (I spent the last year in the single digits and am now up in the 30’s).
Confirming the results above are fresh and it was with one 210 fumarate every other day.
And assuming you can get a full iron (not just ferritin) no later than 8 weeks.
I think you could take one three arrows every day until end January when you test next.
You will need to leave 5-7 days without iron supplements before the iron panel.
Whatever you do, please tag me when you decide, and I’m happy to weigh in if you want to tag me when you get your next iron panel.
pennyannie humanbean am I missing anything regards to iron management and graves?
Disclaimer: I am not a doctor. I am just a fellow sufferer who has managed my and my daughters low iron anemia issues. I have Hashis. My daughter is 18, not diagnosed but has ambiguously low free Ts. That’s my only experience and so take it all as my experience and do your due diligence to see how it may apply to yours. I am also way more conservative than most, and for me personally at this point am not willing to have excess iron at all. Low and slow. You will read others who do higher dosing. I am not one of those people.
I'm not sure what I can add -
RAI is known to trash vitamins and minerals -
Everywhere I researched regarding thyroid hormone replacement suggested ferritin needed to be at least over 70 for any thyroid hormone replacement to work well -
Please read my bio for more information - as I am not prepared to think and re-write about how ill I was back then :
Basically by 2015/16 my ferritin reading was 22 and I think because of my age - 66 - I first needed the ' all clear ' of an endoscopy and colonoscopy before being prescribed any iron supplements -
My RAI was back in 2005 -and I believe my adverse reactions to RAI started in around 2012 with my eyes and nose becoming very dry, which progressed through to my mouth and mucous membrane tract - I had no saliva for some 18 months and the endoscopy was aborted and in such pain during the colonoscopy that I fainted and woke up attached to several machines - I had both these proceedures years earlier prior to RAI or even a diagnosis of anything and without any issues.
P.S. Just read your bio - and see I touched base with you on your very first post/question on this forum some years ago :
so you know of Elaine Moore already - and my understanding of Graves / RAI / and treatment options - post invasive, definitive treatment :
Most recent research :
pubmed.ncbi.nlm.nih.gov/338...
ncbi.nlm.nih.gov/pubmed/306...
and RAI is still the first line - and sometimes only treatment - offered in what we understand to be a health care setting.
Thanks Penny as always. Also, I’ve read about the 70 ferritin threshold too, but I think it’s more of a proxy—an assumption that when ferritin is at that level, markers of available iron, like serum iron or transferrin saturation percent, are also sufficient.
Ferritin as an indirect measure, but serum iron and transferrin saturation are direct measures which if sufficient, thyroid hormones can still work effectively even if ferritin is below 70.
Yes thankyou, you've been very helpful previously and were the first to point out how low my iron was originally when I left hospital. I appreciate you sharing your knowledge.
You've a much better memory than me !!
FallingInReverse Thankyou so much for the explanation. I feel more confident going forward now. I will tag you when I get my iron panel results.
Iron levels -test results
Thoughts on my Iron results
Advice on Medichecks and GP iron results please
Iron Panel Results
Confusing Iron Results
