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4274823 tn?1388529098

Reduced iron stores but no iron panel

Today the doctor said an iron panel isn't necessary because although my iron stores are "reduced" my hemoglobin is OK. He doesn't think an iron supplement is needed. I read that iron is important to thyroid function. I'm a lacto-ovo vegetarian.

I have to wait until January, 2015 for bloodwork regarding my hypothyroidism.
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Avatar universal
Adequate iron levels are very important for hypothyroid patients.  If only one iron related test is to be done, ferritin would be my choice.  I say that because ferritin is reported to be a precursor to serum iron levels.  Many hypo patients are too low in Vitamin D, B12 and ferritin because they do not produce enough stomach acid for good absorption of vitamins and nutrients.  

If you have a long wait til next doctor appointment, you might consider starting to supplement with iron.  Usually it is best to test first, but if not possible until January, then consider that the doctor did say your iron stores are reduced.  
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1756321 tn?1547095325
Excerpts from Patient UK - Non-anaemic Iron Deficiency...

"Iron deficiency is a reduced content of total body iron. Iron deficiency anaemia (IDA) occurs when the iron deficiency is sufficient to reduce erythropoiesis and therefore the haemoglobin (Hb) level falls. However, problems related to iron depletion can develop before this stage."

"Symptoms
There may be no symptoms until significant anaemia develops. Symptoms which may be linked to iron depletion are:[3]

Fatigue.[6]
Poor work productivity.
Poor attention and memory.
Sore tongue.
Poor condition of skin, nails or hair, including hair loss.
Pica (there has been debate as to whether pica is the cause or the result of iron and zinc deficiency).[7]
Developmental delay (see below).
Restless legs syndrome.[8]

Signs
There may be no signs. Possible signs of iron depletion (although more usually seen in iron deficiency anaemia (IDA)) are:

Angular cheilitis or angular stomatitis.
Atrophic glossitis.
Nails may show brittleness, ridging or koilonychia (spoon-shaped nails).
Poor condition of skin or hair."
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649848 tn?1534633700
COMMUNITY LEADER
I agree that low iron doesn't always mean that hemoglobin will be low.  Are you still going from the ferritin that was done a while back or did you have a new one done?  

You've been eating more foods containing iron, so maybe that's helped bring your levels up some.  

Did your doctor indicate that he might be willing to do another ferritin in January when he does the thyroid testing?

You still haven't started on thyroid medication, have you?
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4274823 tn?1388529098
Thanks for your response. The January 2015 bloodwork will include the following: fasting glucose, TSH, Creatinine (eGFR), sodium, potassium, chloride, ALT, Lipid Assessment, Vitamin B12, Ferretin, CBC, and Free T4. Damn it I just discovered that he didn't include Free T3. That's very annoying!  
Helpful - 0
4274823 tn?1388529098
Thanks for your post. I don't have a recent ferretin level so I hesitate to start a supplement at this time. As Barb135 stated, I am increasing my intake of iron through my diet, but I'm a lacto-ovo vegetarian so it's somewhat challenging.
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4274823 tn?1388529098
Thank you for your reply. I have poor skin and hair condition. Tongue not sore, but is scalloped. My legs have been restless in the past, but currently are OK.
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649848 tn?1534633700
COMMUNITY LEADER
We know from past threads that your thyroid levels are low and your low iron levels aren't helping that.  The poor skin and hair condition can be caused by either/both hypothyroidism and low iron.  Swollen scalloped tongue is also caused by hypothyroidism.

Can you get Free T3 added to the lab order for January?  I know, in Canada, they don't like to do that because of your healthcare system.
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4274823 tn?1388529098
You wrote, "Can you get Free T3 added to the lab order for January?  I know, in Canada, they don't like to do that because of your healthcare system."

I hope so!

I have also become concerned about getting enough Omega-3 as a vegetarian.I went to a couple recent free health talks at Goodness Me and I learned there's a plant based product (algae, etc) that's suppose to be as good as fish oil. This is suppose to be good for the skin ...
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649848 tn?1534633700
COMMUNITY LEADER
We've heard from numerous others in Canada that the healthcare system does not think FT3 is important/relevant to thyroid care.  Talk to your doctor about it.

Well, the best sources of Omega-3 come from fish - no better source.  The problem with algae is that it's algae and not as good as fish, no matter what they tell you.  Omega-3 is very important for keeping cholesterol levels down.

Are you putting lotions on your skin and it still remains dry? Aloe vera is very good at moisturizing the skin...

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4274823 tn?1388529098
Thanks for your post.
Skin issues including acne (face and body) and strange scalp condition not typical dandruff. At one of those two talks I attended it was suggested that when the skin is dry the body tries to moisturize it by overproduction of oil resulting in various conditions due to imbalance. Over the past few years my skin has become more sensitive, less clear, and more dry especially in winter.
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649848 tn?1534633700
COMMUNITY LEADER
I've never seen anything to indicate that the body tries to moisturize the skin by overproducing oil.  I'd have to see scientific studies in order to buy into that.  

It's normal for the skin to dry and become more sensitive and less clear as we age.  It's also normal for skin to become drier in the winter because we're in heated homes/buildings, where moisture is removed from the air by heating systems.  Dry skin and other skin problems are also common symptoms of being hypo.

The skin on some parts of your body can tend to be oily, while it can be dry on other parts of your body... for instance, my face has a tendency to be oily, but my legs/arms are always dry and often feel like alligator skin - because in summer, we use the air conditioner and in winter, we use the furnace; both remove moisture from the air.
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4274823 tn?1388529098
Thanks for your post.
Excerpt from http://en.wikipedia.org/wiki/Acne_vulgaris
"Acne more often affects skin with a greater number of oil glands; these areas include the face, the upper part of the chest, and the back."
"Menopause-associated acne (known as acne climacterica) occurs as production of the natural anti-acne ovarian hormones estradiol and progesterone fail, permitting the acnegenic hormone testosterone to exert its effects unopposed."

Of course skin becomes drier in winter because humidity is low, but I'm referring to a significant change such as areas of skin that crack and bleed or doesn't respond to moisturizer. I wonder to if perhaps the possible onset of perimenopause is also a factor.
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649848 tn?1534633700
COMMUNITY LEADER
Yes, I fully understand that the body has more oil glands in some areas than others and I may have more oil glands on my face than  you do, etc.  What I'm questioning is the assertion that this happens because the skin is so dry that the body is trying to moisturize it by over producing oil.

It's normal for skin to change as we get older and yes, perimenopause can be a factor in that, as can winter, spending more time the sun, being in drier air or any number of other factors.

I had areas of skin that cracked and bled, because I was low on vitamin B-12.
Helpful - 0
4274823 tn?1388529098
Thanks for your post. I've been taking a B12 supplement for quite some time.

Perhaps I misunderstood what was said.

Do you use any specific skin care products that you are pleased with? What is available in the US may differ somewhat from what's available here in Canada.
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4274823 tn?1388529098
I talked with a registered dietitian by phone today she suggested only taking an iron supplement on a doctor's advice. I've had two ferretin bloodwork lab results in a row for "reduced iron stores", but the doctor didn't advise an iron supplement because my hemoglobin is OK.
Helpful - 0
649848 tn?1534633700
COMMUNITY LEADER
Most any good quality products containing aloe vera and/or vitamin E are good for dry, cracking skin.  Also, those with mineral oil, olive oil or coconut oil are good.  Note that skin care products need not be expensive to be good quality.  You can even use just plain olive or coconut oil, if you want, with a drop of your favorite scent.

For cleansers, try to find moisturizing cleansers - I find that liquid bath gels tend to be less drying than bar type cleansers. Again, they need not be expensive to be good quality.
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4274823 tn?1388529098
Thanks for your post. I prefer unscented products whenever possible.More later.
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Avatar universal
You said that, "I talked with a registered dietitian by phone today she suggested only taking an iron supplement on a doctor's advice. I've had two ferritin bloodwork lab results in a row for "reduced iron stores", but the doctor didn't advise an iron supplement because my hemoglobin is OK."   So even though some of your tests have indicated low iron, you should only take iron supplements on the advice of the same doctor that has been unsuccessful in treating you so far?   How does that compute?

Have a look at this quote.

"Research has shown that a large proportion of women reporting hair loss had low ferritin levels, compared with the levels generally found in women without hair loss, and interestingly in men. The main reason for this difference is due to the loss of blood during menstruation, which is just enough to cause a gradual depletion of iron stores, particularly in women who eat little or no red meat.

Low iron intake has been known for some time to be a potential problem for millions of women, but it is only now that it is recognised that this factor can contribute to increased hair shedding, and that this condition is really quite common.

In fact, in a recent survey of 500 women, it was found that a staggering 33% reported hair loss. This was observed as an increase in the amount of hair shed or a reduction in the length grown, both of which contribute to a reduction in hair volume if the problem persists for any length of time.

So if you believe your hair has less volume than it did a few years ago you can at least console yourself with the fact that 1 in 3 women also consider themselves to be in the same position. If your diet has little or no red meat and/or you suffer heavy menstrual bleeding then this increases the likelihood that a dietary imbalance is causing the problem.

Correcting the imbalance can increase the length of hair growth
Research has shown that if the iron deficiency is corrected and the serum ferritin level is raised to a certain 'trigger point' then hair growth will start. In fact, what actually happens is that the growing stage of the follicles is lengthened so there are, at any one time, more hairs in the growing stage.

This means that hair volume will start to increase and any excessive shedding will reduce. But this takes several months because ferritin levels can only be raised gradually and once the 'trigger point' is reached and hair growth starts, it takes 2-3 months for the shedding to reduce and another 3-6 months for the new hair to reach a length that contributes to hair volume."

And here's a good link.

http://www.thyroid-rt3.com/iron.htm

And another good link and quote from the source.  

http://www.nahypothyroidism.org/deiodinases/#iron%20deficiency

Iron deficiency

Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (238-242). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present (238,239,241,242).


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649848 tn?1534633700
COMMUNITY LEADER
Isn't it also correct that iron stores can be low for some time, before hemoglobin levels start dropping significantly?
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Avatar universal
Yes, from what I have read, low ferritin levels are often a precursor to iron anemia.  Here is a good link and a quote from the link.  


http://www.irondisorders.org/iron-deficiency-anemia

"Iron deficiency without anemia can occur when a person has a normal hemoglobin, but below normal serum ferritin and/or transferrin saturation. Iron deficiency with anemia can occur when a person has low values of both serum ferritin and hemoglobin."
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4274823 tn?1388529098
Thank you Barb135 and gimel for the info.
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4274823 tn?1388529098
Thank you very much for all of the info. I must reply in more detail later as I have an afternoon commitment.
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4274823 tn?1388529098
Yeah, I'm not happy that my doctor refused to do an iron panel after two consecutive ferretin tests indicated "reduced iron stores" and iron is important to thyroid function. He knows I have hypothyroidism and I wish to try to address anything related through diet or supplement before I resort to thyroid medication. On top of that he is making me wait until January 2015 to test my ferretin again. I said I was trying to consume more, but it is a challenge as I am a lacto-ovo vegetarian. No meat red or otherwise. I wanted to know if increasing my intake was making any difference or if it might be an absorption issue or a combo.
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4274823 tn?1388529098
Sorry I forgot to address the issue of hair loss. I have thick, naturally wavy hair. I have been wearing it very short for the past few years. When I comb it I do notice some comes out, but I have plenty to spare. It's just strands not clumps.
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