Reduced iron stores but no iron panel

[VitaminB12]

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.

[Barb135]

I totally agree that ferritin isn't always the best way to measure iron levels... My ferritin actually came back way too high, at 216 and when we did an iron panel, everything was right where it should be.  Ferritin is also an inflammation marker, which is what it was indicating in my case.

I, too, feel fine with my thyroid levels where I need them, and high ferritin, so we leave it alone.

It's important to note that hemoglobin is not always a good indicator of iron status, since serum iron can fluctuate on a daily basis.

It's always an individual's choice whether or not to begin thyroid replacement hormones and if one is okay with modest positive change vs optimal health that's their option.   I've always failed to understand willingness to take supplements, but unwillingness to take thyroid replacement hormones that are identical to what the body produces.  

[VitaminB12]

Thanks for sharing. I asked my GP for an iron panel, but he won't do it because hemoglobin is OK. So what. I am interested in knowing what my blood level of iron is not just my level of iron stores. As I said in a previous post I was only taking 1/2 recommended daily dose of liquid iron supplement to start. I will try the whole dose for a time. I am vegetarian so my iron intake through food alone is not high so I don't expect that I could overdo it in the short term. Thanks again. My point is since I have been taking the iron supplement I have experienced a modest positive change in some of my hypothyroidism symptoms.

[ahmee]

I had hair loss, dry skin and scalp, brittle nails, heavy periods, plus more symptoms while hypothyroid. My endocrinologist insisted skin, hair and nail problems especially were due to my low ferritin more than thyroid levels, but I ended up reaching the right dose of thyroid hormone first anyways and found that all of those symptoms resolved entirely after a couple of months of thyroid meds! I was surprised but pleased, to say the least.

My ferritin levels, however, remained low and never budged higher than 30 despite daily iron supplementation. My circulating iron level and percent saturation eventually became too high while supplementing and yet my ferritin actually dropped to 21! I was confused by this and couldn't find any info on the internet. My primary care doc just said to discontinue supplementation. I know that high circulating iron levels are bad and induce oxidative stress. I was later told by the same endocrinologist mentioned above that ferritin may not be the best way to measure iron in my case and that the only true way to discern actual iron levels is via bone marrow if you want to get exact about it. And honestly, I feel just fine with my thyroid levels in the right place and low ferritin. Just thought that was interesting, and a reminder that sometimes lab results aren't the end-all be-all of treatment guidelines.

[VitaminB12]

Thank you for your thoughtful response. Please note I wish to see how where my ferretin (iron) level is at after I've been taking a full dose of Floravit for a reasonable amount of time. If in 6 months when I have bloodwork done and my thyroid numbers haven't budged despite more iron then I will reconsider taking conventional medication. I have been living with this for years so I am sure I can hang in there until mid 2015 just in case low iron is the reason MY thyroid is underactive. Nothing was said by the doctor's office about thyroid replacement meds at this time as my GP believes it is just on the high side of normal even though I understand the reference range is outdated. Yes, I still have hypo symptoms, but I do feel they are not quite as intense as before. I still feel cold especially when sitting or when I go to bed. My tongue is noticeably less scalloped and my scalp condition seems to have improved some. When my hands are dry and sometimes red I haven't had any cracking and bleeding fingers yet this winter which is a good thing.

I am taking a daily Vitamin D supplement and haven't had it tested recently. That's something I have to pay for out of pocket. July 30, 2013 was Vitamin D 92 with a reference range > 50 nmol/L.

July 24, 2014 Vitamin B12 was 746 with reference range of >220 pmol/L.
Like I said before I thought this was going to be tested again, but I don't see it listed on the lab report! I continue to take some sublingual B12 and there are B vitamins in the Floravit.

[Barb135]

Just getting ready to head off to bed when I noticed your post...

I don't see a significant change in any of the labs you posted.  

TSH is affected by a lot of variables so a change from 5.95 to 5.74 is totally insignificant.  Also are the changes in FT3 and FT4 small enough to be insignificant, but all of the results are enough to indicate hypothyroidism, even though the FT3 and FT4 are, technically, "in range" they are so low, you can't be be getting much benefit from them.  

Your FT4 is only 20% of its range (rule of thumb is mid range - 50% ) and your FT3 is only 39%, where rule of thumb is upper half to upper third of its range. Rule of thumbs are where most of us find that we feel the best.

Even though you're "petite", apparently, you should probable take the full dose, because your ferritin is still too low. Just because you're petite, doesn't mean absorption is optimal.

What about vitamin D?  Was that tested?  

What symptoms are you CURRENTLY having?  This thread has been going on for a while, which is okay, because I can go back and look previous labs, etc, but you need to keep updating symptoms along with labs.  

Your thyroid labs indicate that you're hypo... If you have hypo symptoms (you did 6 months ago and a year ago), and your doctor offers you Synthroid again, I'd suggest that you take it, because you've seen that you might have to wait another 6 months to a year before you get all these tests again and you also see that supplementing doesn't change your blood test results all that much, so unless your symptoms have been relieved enough on the supplements to allow you to train for some short marathon or really make you feel better, I can't stress enough about accepting/asking for thyroid replacement meds.  I know you know  don't want to put synthetic drugs into your body, etc, etc, etc... sometimes, anything becomes better than nothing...

[VitaminB12]

I see my new ND Jan. 28. Bloodwork through GP.

January 16, 2015

TSH 5.74
Reference range 0.35 – 5.00 miU/L

Free T4 14
Reference range 12 – 22 pmol/L

Free T3 3.8
Reference range 2.6 – 5.7 pmol/L

Ferretin (iron) 58 (have been taking Floravit since Nov. 6/14 1/2 daily dose as I am petite)

Reference ranges 31 – 79  ug/L reduced iron stores, 80 – 300 ug/L normal iron stores

I couldn't find Vitamin B12 even though I was sure he ordered it.
I wasn't provided with the reference ranges so I am not posting the other tests at this time.

compared to

July 24, 2014 8 am (bus to lab)

TSH 5.95
Reference range 0.35 – 5.00 miU/L


Free T4 13
Reference range 12 – 22 pmol/L


Free T3 4
Reference range 2.6 – 5.7 pmol/L


Vitamin B12 746
Reference range >220 pmol/L


Ferretin/iron 37
Reference ranges 31 – 79  ug/L reduced iron stores, 80 – 300 ug/L normal iron stores