I'm low on ferritin 43 (10-322) and folate 7.9 (5.4-24).Would these cause light headedness and short of breath feelings? Had anyone supplemented and felt better?
I have had these over the years but they've significantly worsened after a COVID infection. iron used to be 60 and I only had milder sob and light headed Ness. Only just got folate results recently.
Not sure how much to supplement by and what optimal levels are. Any advice appreciated.
Hardly ever got sob on level 60 ferritin. Currently long COVID with dysautonomia so that complicates things...as do histamine issues. Seems all LC symptoms are magnified hypothyroidism issues. All hypo numbers in range... TSH 0.52.
previous post here shows low Ft3
Low Ft3 leads to low vitamin levels
Low vitamin levels leads to low Ft3
Vicious circle downwards
healthunlocked.com/thyroidu...
have you got new TSH, Ft4 and Ft3 results
How much levothyroxine are you taking
Exactly what vitamin supplements are you taking
Vitamin D and B12 results?
Ft 3 :4 1. TSH 0.52. Ft4 20. Vit d : 68(50-100). B12: 599(211-911). 50mcg levothyroxine. Currently supplements vit D3. Iron tabs , fish oils, B12, . Long COVID lowered ferritin from 60 to 43. Folate 7.9(5.4-24). Ft 4 near top of range @20.1. Probably been iron deficiency for years but no chronic symptoms.
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
cks.nice.org.uk/topics/anae...
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Never supplement iron without doing full iron panel test for anaemia first and 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
medichecks.com/products/iro...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
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Posts discussing why important to do full iron panel test
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Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
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Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Thank you.
Ft 3 :4 1.
TSH 0.52.
Ft4 20.
please add ranges
Was test done early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
50mcg levothyroxine
this is only standard STARTER dose levothyroxine
Levo doesn’t “top up” failing thyroid, it replaces it
Absolutely ESSENTIAL to be on high enough dose
How long have you been left on just 50mcg
Low vitamin levels tend to lower TSH because we need GOOD vitamin levels for good conversion of Ft4 to Ft3
Low vitamin levels results in higher Ft4 and lower TSH
ESSENTIAL to maintain GOOD vitamin levels
Vitamin D at least over 80nmol and between 100-125nmol may be better
Folate at top of range
Serum B12 over 500
Active B12 over 70
Ferritin at least over 70
so work on improving low vitamin levels as first step
Currently supplements vit D3. Iron tabs , fish oils, B12
Exactly how much vitamin D are you taking
Clearly not high enough dose How long
iron and ferritin
Never supplement iron without doing full iron panel test for anaemia first and 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 3-5 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
Ranges TSH 0.27-4.2. Ft4. 12-22. Ft3 3.1-6.8. test early morning no food 24 HR always. Vit d 5000iu. Been 10 years 50mcg...... tried me on 75 had bad palpitations sob dizzy. Convert to t3 could be issue. My TSH looks closer to hyper! Won't be increasing levo.
Only just started iron tabs but without full panel might just need chicken liver pate etc.
Been 10 years 50mcg...... tried me on 75 had bad palpitations sob dizzy
Many patients
A) need to increase much slower than 25mcg steps
B) often different brand can badly upset, especially Teva. Teva used to be the only brand that made 75mcg
C) low vitamin levels make it much harder to increase dose Levo and frequently need to be maintained by daily supplements
d) autoimmune thyroid - always worth trying strictly gluten free diet and few months later dairy free
If dairy free is beneficial, swop Levo to lactose free brand
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help maintain B12 levels
You can experiment with reducing and possibly stopping separate B12 in few weeks
Difference between folate and folic acid
healthline.com/nutrition/fo...
B vitamins best taken after breakfast
Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week
Post discussing different B complex
healthunlocked.com/thyroidu...
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
Is your hypothyroidism autoimmune?
Ever had BOTH thyroid antibodies tested for Hashimoto’s
Testing TPO and TG antibodies
If not suggest you get FULL thyroid and vitamin levels retested 6-8 weeks after working on improving low vitamin levels
Post all about what time of day to test
healthunlocked.com/thyroidu...
Testing options and includes money off codes for private testing
Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
Only do private testing early Monday or Tuesday morning.
Tips on how to do DIY finger prick test
support.medichecks.com/hc/e...
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
looking at your previous posts can see you have been left on extremely low dose levothyroxine years
If/when you increase dose this will need doing extremely SLOWLY
Eg
50mcg 5 days a week and 62.5mcg 2 days
Wait 8 weeks and retest
Increase again to
50mcg 3 days a week and 62.5mcg 4 days
Wait 8 weeks and retest
Etc etc
Haven't had antibodies test, not sure difference between hashi and autoimmune. Endo a few years ago said to my GP freet4 was too high at 20 most are 14....I would think higher thyroxine=higher T4. GP suggested going lower. I haven't seen many with my numbers on 50mcg. Had many problems initially with palpitations on levo. Settled on ,50. TSH 0.52 ?!? Needs be lower,?!
test early morning no food 24 HR always
you only need to not eat between waking and testing (no need to fast for 24 hours)
And you definitely last dose levothyroxine 24 hours before test?
Most important result is Ft3 and GOOD vitamin levels
Hashimoto’s is autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
NHS only tests TG antibodies if TPO are high
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)
Were you originally diagnosed as autoimmune thyroid disease
High iron / low ferritin, advice on B12 and folate levels - results in pics
Low Levels of Iron Can...
continuing low folate levels
Can Hashimoto's cause iron deficiency?
Can low SHBG levels cause hair loss
