Hello, I hope it’s ok to post asking for help with my results. I’m 41 with an underactive thyroid and Hashimotos. I’ve a 2 year old and have been experiencing severe hair loss but I thought maybe it was no longer a postpartum issue so asked my endocrinologist to run extra tests. I also have a lot of tiredness and extreme dry skin on my hands.
I am currently on 100/125 levothyroxine alt days and 5mcg liothyronine twice a day.
TSH - 0.61 (0.27-4.2 mIU/L)
Free T4 - 17.1 (12-22 pmoI/L)
Free T3 - 4.5 (3.1-6.8 pmoI/L)
Vitamin B12 - 531 (350-9,999 ng/L)
Folate Serum - 5.5 (3-26.8 ug/L)
Total Vitamin D - 57.6 (50-99,999 nmoI/L)
Iron Profile:
Transferrin - 3.60 (2-3.6 g/L)
Ferritin - 8 (15-150 ug/L)
Iron - 6 (10-30 umoI/L)
Transferrin saturation - 6.7 (16-40%)
As a result of the above he put me on an 8 week course of Iron. Is there anything else I should be doing??
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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 2 per day and/or may need separate methyl folate couple times a week
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-6 days before ALL BLOOD TESTS , as biotin can falsely affect test results
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)
Hello thank you for your comprehensive reply. I am not vegan or vegetarian and would eat meat/nuts/seeds everyday. I’m on Stexerol-D3 1,000unit tablets one a day. The iron tablet is Ferrous Fumarate 305mg. I also have been taking an omega 3, a biotin tablet, Chlorella powder and collagen every day. I was breastfeeding until very recently but have nearly stopped now.
The bloods were taken at my routine Endo appointment so they were not fasting and I had taken my levo at 11pm the night before, bloods were at around 3pm the next day. Would this plus the biotin have affected the bloods dramatically?
Great thanks, so if i get the spray vit D and add 2 1000iu sprays a day to my existing Vit D and take it at dinner that would be sufficient? then add a magnesium supplement at dinner too?
ok if i get retested ill make sure to stop the biotin before. I checked with the chlorella manufacturer and there us no iodine in it. So basically the results would have been worse if id not taken my levo as i should have?
If tested correctly TSH would have been higher and Ft4 lower
You need dose increase to 125mcg everyday
Retest in 6-8 weeks
Then you may need 5mcg increase in T3 after that
Many members on Levo plus small dose T3 find they need BOTH Ft4 and Ft3 approx 60-70% through range
However it’s very important to test CORRECTLY
Recommended that all thyroid blood tests 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)
T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
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
or day before testing split Levo …..taking half dose in morning 24 hours before test and half dose at bedtime as per normal
I can imagine you feel pretty wiped out with iron levels so low I wonder if you couldn't push for an iron infusion?
Free T4 (fT4) 17.1 pmol/L (12 - 22) 51.0%
Free T3 (fT3) 4.5 pmol/L (3.1 - 6.8) 37.8%
Folate - Serum 5.5 ug/L (3 - 26.8) 10.5%
Vitamin B12 531 nmol/L (350 - 999) 27.9%
Vitamin D 57.6 nmol/L (50 - 250) 3.8%
fT4 and fT3 are both on the low side and 10-20% higher might make a big difference, did your T4 dose get lowered when you started on T3?
Also improving your folate, B12 and Vit D will help you to get the most out of your thyroid hormones many of us take a B complex like Thorne Basic B or Igennus Super B and we all need Vit D & K2 aiming for 100-150nmol/L if you put your details into this calculator it will give you dosing guidance
Hello thank you for your comprehensive reply. I’m on Stexerol-D3 1,000unit tablets one a day. The iron tablet is Ferrous Fumarate 305mg. I also have been taking an omega 3, a biotin tablet, Chlorella powder and collagen every day. I was breastfeeding until very recently but have nearly stopped now.
I can’t remember if the t4 was lowered when I started the t3 as it’s so long ago and it was also adjusted when I was pregnant, apologies. I think it may have been but can’t be sure.
I’ve never seen overall iron measures so low. All sorts of things will be suffering in your body, your hair is just one part you can see.
Can you discuss an iron infusion with your doctor?
If you supplement, I would guess in a best case you’re looking at months and months, but not unusual for it to take years (literally 1-2 years), to correct a deficiency that low.
There are risks to everything, so do your research and advocate for yourself as you see fit.
Not sure if any of the below would affect results? I’ll ask my gp re: infusion. What others way would such low iron affect me?
I am not vegan or vegetarian and would eat meat/nuts/seeds everyday. I’m on Stexerol-D3 1,000unit tablets one a day. The iron tablet is Ferrous Fumarate 305mg. I also have been taking an omega 3, a biotin tablet, Chlorella powder and collagen every day. I was breastfeeding until very recently but have nearly stopped now.
The bloods were taken at my routine Endo appointment so they were not fasting and I had taken my levo at 11pm the night before, bloods were at around 3pm the next day. Would this plus the biotin have affected the bloods dramatically?
Biotin may interfere with your thyroid test but no one can say by how much and which way up or down. Could be negligible, but it just casts doubt on the reliability of the numbers.
Re iron - are you telling me those results are WITH supplementing? Ferrous Fumarate 305mg for how long?
Re iron, none of those things interfere with iron tests, although pregnancy can increase iron demand (lowering iron) but depending on how old your baby is the pregnancy/breastfeeding would have also limited blood loss from period (boosting iron.)
In my opinion - it hardly matters with your results.
I know nothing about you but this one post. As they say - no one should take medical advice from the internet : ) and especially with iron, be smart, as iron can be toxic when misused over time. At this point you’re nowhere near that, but as you correct it, it’s a risk.
Low iron/ferritin symptoms can overlap with thyroid symptoms - brain fog, joint pain, skin issues fatigue (oh the fatigue!).
Low iron means you do not have enough oxygen in your blood, and so there are a few other symptoms that are more uniquely iron - heavy legs (feel like lead when walking or taking stairs), and feeling of breathlessness, and probably others I can’t remember or ones I didn’t have but others do. At those levels, some people also feel something called “derealization “ - kind of like depression/anxiety where you feel really distant from the world and nothing feels real.
Also - there is a knock on effect to thyroid, since your Transferrin Saturation % needs to be a minimum or 25-30% for T3 to be able to do its job well at the cellular level. So low iron will ding your thyroid function, giving you actual hypothyroid symptoms.
No the iron was tested prior to being given the supplement. I've been on one tablet a day for approx 2 weeks. I have felt heavy recently and I definately get huge anxiety/depression and derealization. Wow thats really interesting, so hopefully if i can get my iron sorted my thyroid could improve/symptoms?
Iron is needed for so many body/cellular processes.
And make no mistake - both your circulating iron (iron and saturation) and your storage (ferritin) is rock bottom.
There’s no way your body has enough to draw on from your blood.. and then there’s none there, but it has none in its storage cabinets to draw on (ferritin).
Talk to a doctor. If anyone should qualify for an infusion it’s you. But as you know navigating the healthcare system is a whole other battle.
But you can confidently ask and push for one and if they say no - you should dig deeper and keep pushing.
Again I don’t know anything about you but if the answer is no - I’d live to know what good reason they give for denying you.
My daughter had ferritin at 5… I had it at 7. I wish I’d pushed for an infusion then. It’s been a year or so and we’re up to optimal circulating iron and ferritin around 30-40. It took over a year. Still not enough.
You may try to get a CBC (complete blood count, which reflects the impact of low iron - red blood cell count and size, how much hemoglobin you have.) Those measures move more slowly (like every 3-12 months) so they are lagging indicators of the low circulating iron and zero ferritin stores you have. You fix those, and the CBC will improve).
The CBC defines “anemia” vs just iron deficiency.
I bet you have both.
Actually - do you have a recent CBC you can share?
edit- also, one 305 mg supplement is standard but also very naive. Step lightly around your doctors ego or lack of interest in a personalized medicine approach for you.
Poor gut function with Hashimoto’s can lead leaky gut (literally holes in gut wall) this can cause food intolerances.
Most common by far is gluten.
Dairy is second most common.
A trial of strictly gluten free diet is always worth doing
Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential
A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
Similarly few months later consider trying dairy free too.
Approx 50-60% find dairy free beneficial
With loads of vegan dairy alternatives these days it’s not as difficult as in the past
This is very interesting and something i'd thought about but no I've never went gluten free. I was dairy free when breastfeeding but only for a few months as my daughter had cmpa.
"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."
I'm surprised you can still function with such poor levels of iron and ferritin (iron stores).
I'm not a doctor but your iron levels and iron-related levels are so poor I would have thought that an iron infusion would have been appropriate. But doctors rarely offer to refer patients for iron infusions on the NHS. It would be worth asking I think.
The fact that your doctor gave you an 8-week course of iron is not impressive. Did he suggest that you get repeat testing after that 8 weeks? Or that he would give you a repeat prescription? Did he mention future treatment at all? There is a possibility that he just expects you to require treatment to get you into the reference range and that is all. If that is what he does please be aware that self-treatment is possible. I found it such a relief when I found out I didn't need to beg for supplements from doctors all the time and I could just buy them. Supermarket iron supplements are useless by the way.
Some people get iron infusions done privately if they can afford them. I've never had one myself, but if I had my time over again I would save up and pay for one to speed up the process of raising my iron. My doctor gave me a prescription for eight weeks worth of iron and her attitude made me think I wouldn't get another one, but it took me seven years to optimise my iron results. Some people just don't absorb iron well. My iron was so low because I'd had a GI bleed for five years that it took three hospitals to find the source of.
This is just one iron clinic I know of but there are others around the UK :
Your doctor's choice of treatment might work for you, but the people on this forum have found that there are other options available that work better, absorption-wise, for most people.
The ferrous fumarate you've been prescribed is one of the iron salts that doctors usually prescribe. There are two others - ferrous sulfate is one, the other is ferrous gluconate. All I can say about ferrous sulfate is Avoid! Avoid! Avoid! Very, very few people can tolerate it and for me and many others it is like swallowing a strong acid. I have no personal experience of ferrous gluconate but some people do find it tolerable if you want to try it. Some official info on the iron salts from the British National Formulary (BNF):
One thing you need to know for future reference ... All the NHS-prescribed iron supplements can be bought without a prescription from pharmacies in the UK with a pharmacist's permission. Theoretically you could get refused - it happened to me once. But I just went to another pharmacy and got what I wanted there with no problems.
Another thing that is important is that people can buy finger-prick tests to do iron panels. The one I've always used is this one :
There may be other companies that do iron panels - there are more testing companies coming into the market all the time. So you should ask in a new thread if you want to find a cheaper company. Don't spend any money until you are sure that you've found a reliable company with a reliable test. Some companies are useless - they just send results that say "Normal" or "Abnormal" and that is NOT helpful to monitor anything.
Another iron supplement that some people have had great success with is Three Arrows which is imported from the USA. Given that people tolerate this iron supplement much better than the iron salts, and their iron levels rise faster than with the iron salts, this is the one you should try as soon as possible (in my opinion).
Note that the higher the dose of iron an iron supplement contains the less well tolerated they are, particularly with the iron salts. Your iron supplement with 305mg of ferrous fumarate per tablet is a high dose. If you find yourself in the situation of not tolerating Three Arrows for some reason you would probably tolerate a lower dose of ferrous fumarate (if necessary). I took Ferrous Fumarate 210mg to raise my levels. I didn't know about any Heme Iron products at the time so I was using iron salts. I tolerated it, but only with food. This is probably why it took me so long to raise my iron/ferritin levels.
Thank you so much for all of this. I was told an 8 week course and there was no indication of a retest or repeat prescription afterwards. I will discuss with gp, get retested after 8 weeks and if no improvement push for a plan or buy my own.
Hello, I'm 56 with same issues until I changed to a animal based diet. My hair is no longer falling out, my gingivitis per the dentist is gone, my bp is lower, my energy is back, ringing in my ears is gone, etc. Many people do a 30 or 60 day straight carnivore. I did not. I changed breakfast to eggs and bacon for two weeks, then lunch steak and butter or hamburger and butter for two weeks then leftovers from lunch for dinner two weeks and gave my gut time to get used to so much protein and fat. Women need healthy fats for hormones. I KNOW it sound radical. It goes against EVERYTHING I had been taught and applied to my life. I ate lean chicken and salad most my life with avocado (healthy fat). But I dried my body out with no fat. Check out Elizabeth Bright she is tyroid expert and Ken Barry and Anthony Chaffee online. I know it sounds crazy--BUT I have NEVER felt better and am almost 60. Good luck with your journey and God Bless You!
Hello, I watched a video of Jordan Peterson on Joe Rogan and one with his daughter Mikayla Peterson talking to a panel--she had arthritis very young, a few surgeries as a teen maybe one before etc. Her mom cooked organic veggies etc. She found from trial and error she only felt better with meat. There is a carnivore community that I ordered a few books from because it sounded too crazy I needed to read on it before beginning. Paul Saldino and Shawn Baker's books. I actually lost weight and this is why most people do it for a bit and then they feel so great they stay with it. When traveling or on vacation I do have a few nonanimal based meals but they are not as satiating and usually make me want to take a nap. If I have gluten then my rashes immediately return and stay longer. I have too much energy and a clear mind to go back to the SAD Standard American Diet even what we think is healthy because I was all lean protein, nuts, salads, olive oil, avocado, most organic and realize now I had too many oxalates and phytic acid. It's crazy but the more you read about it or listen to doctors on youtube it makes sense. I also went to youtube with one health issue at a time and starting listening to doctors. Example, "Carnivore for hashis." and did this with each issue I had. There are communities you can join and doctors you can work with. Good luck!
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