after years of T4/T3, Dr switch me to Nature Thyroid in Oct. amazing first wk. then backwards. They upped it, same results, then added 25mcg T4 to it. Again great then NOT. Jan switched me to T3, cont with the T4. Amazing week, then backwards to not good.
upped T3 , same again. Reverse T3 lab says 9.
Stopped T4 march 10th.
I continue to feel extremely bad.
headaches, heavy head. Cognitively off, dizzy nausea even
( I did have mild concussion in Jan, but had many days I felt great when first raising T3)So bit of conundrum on it being from the fall as so many good days after it Sorry for that twist.
I just learned my Ferritin came back in Low end of Normal 36
according to great work by Paul Robinson, I’m thinking , hoping maybe this is missing piece
See iron panel attached.
Any guidance on HOW to best raise Ferritin I’d be so grateful.
tricky as needs to be not near dosing and currently I take multiple dosing a day of T3
Currently 20/15/15mcg ( 6am, 11am, 4pm)
Although feeling terrible w heavy head. Brain fog, even vision disturbance
Sorry for all this. Any insights so deeply thankful
Written by
SheeshKabab
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What you're describing - feeling good then not so good, increase dose and pattern repeats - is perfectly normal. That's the way it works. And starting to feel bad again is just an indication that you're ready for your next increase in dose. And this will continue until you reach your sweet-spot and symptoms disappear.
Well, that would depend on the individual case and what they're taking.
Someone on T4 only, for example, if they have to keep increasing their dose until the FT4 is too high, it would mean that either they're poor converters and need some T3 added to their T4, or that they are having problems absorbing the hormone into the cells, so they would probably need to be on T4 mono-therapy. There's no solution that fits every case.
Iron Binding Capacity 287 (250 - 450) 18% through the range
% Saturation 35 (16 - 45)
You haven't mentioned which country you live in. In the UK NICE (the National Institute For Health And Care Excellence) has declared that a ferritin level less than 30 is indicative of iron deficiency. If you don't live in the UK you won't be able to read the following link...
Serum ferritin level is the biochemical test that 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. However:
Ferritin levels are difficult to interpret if infection or inflammation is present, as levels can be high even in the presence of iron deficiency.
Ferritin levels may be less reliable in pregnancy.
Despite this, many labs in the UK are still using reference ranges for ferritin which are deficient at the low end. In your results the lab is saying that ferritin results of 16+ are "normal", which is deficient according to NICE.
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Do you have recent test results for Folate and Vitamin B12? If you do could you post them in a reply along with their reference ranges. If you don't have recent test results you should get them tested.
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The pattern of your results is suggestive of an MTHFR problem. (In percentage terms your ferritin, which is 9% through the range - is lower than your iron which is 49% through the range - it would usually be the other way around.) If you were to take iron supplements to raise your ferritin it would most likely be your iron that rose rather than your ferritin, which is very undesirable. This can be overcome by optimising Folate and B12 with the correct type of supplements, which are methylfolate to optimise Folate, and methylcobalamin to optimise B12.
The people with MTHFR problems need more "methyl donors" to overcome their problem. With methylfolate I am not sure which part of the substance causes the side effects that people get. Is it the methyl part of the methylfolate or the folate part?
If you want to try alternatives to methylfolate to boost the number of methyl donors you take in then here are some of the ones I know of :
If I was going to try any of the above I would go for the one with *** next to the name but it would be worth your while to research any of the compounds I've given before supplementing any of them. All of the ones I've named are available without prescription in the UK, and can be found on many websites that sell supplements.
You could try taking iron and see how it affects your results after a month. If your serum iron shoots up while ferritin doesn't really change, then taking iron would not be a good idea until you've found a way of changing the ratio of iron to ferritin.
Some members of the forum with MTHFR problems have taken methylfolate, have built up their dose slowly, and have found that low ferritin with higher iron will "switch", and they have higher ferritin and lower iron, which is more "normal". Then they can take iron supplements and it will raise their ferritin without sending their iron levels into orbit which is what you need to avoid. Lots of iron in the bloodstream is not good because it can feed pathogens and help them to reproduce, and high levels of iron can also damage the liver. Ferritin doesn't feed pathogens like serum iron can do.
A couple of links worth reading which are old and in the internet archive but are still useful in helping understanding for some people :
Since you don't tolerate methylfolate in "normal" doses, have you tried low dose (200mcg) tablets and cutting or breaking them up and taking a crumb, and seeing what happens? And building up in dose very slowly? Or you could try a product intended for kids. For example, from UK Amazon, but there might be a USA alternative :
I think most people I've talked to with MTHFR problems have eventually found ways of improving their folate and B12, but I don't know how they've done it. Or perhaps they just gave up, I don't know.
The thing that worries me about people with MTHFR problems is that, as far as I know, methyl donors are required for all sorts of biochemical reactions in the body. And if they can't find something they can tolerate then are they doomed to feel awful all the time?
I'm one of those people who might have MTHFR problems - I've never bothered testing - but I do well with active versions of folate and B12 without problems. I think the main problem I had was that I couldn't convert inactive B vitamins into the active ones required for good health. And once I stuck with supplementing the active B vitamins I felt a lot better. The inactive B vitamins - folic acid and cyanocobalamin and others - do absolutely nothing for me. Here's a list of the active and inactive B vitamins, just for info :
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Is Low Ferritin and Vit D preventing T4-T3 conversion? Should I add T3?
odd labs after stopping levo/on T3 only?
Further brain improvement on T3 only
Hypothyroid with 2x Dio2 mutation High Dose T4 
Is there a connection between hypothyroid and low ferritin?
