Thyroid and Ferritin Questions

[Plumster]

Hi all,

I got some labs back and am seeking some feedback on these results, because my doctor wants me to start Levothyroxine Sodium 50mcg. What do you think? I have never taken thyroid medicine before.

She is also having me supplement with iron 25 mg daily and says that my thyroid should be functioning better once my Ferritin gets to 100. My doctor is not a specialist on AD, so I value any input any of you may have. I see that some of you recommend a Ferritin level of 50, not 100. I personally believe my iron got low from a case of SIBO this year, which included fat malabsorption. I am in the process of solving this with herbal antibiotics. I am aware of the thread on Ferritin, but I do get restless legs after exercise, so I am supplementing iron for a little bit, though am not sure that 100 is optimal.

Reverse T3: 7 ng/dL
TSH: 3.12 mcIU/mL
Free T4 0.83 ng/dL
Free T3 2.5 pg/mL

Platelets 155 k/cu mm
Transferrin 236 (mg/dL)
Calculated TIBC 330 (mcg/dL)
% Saturation 34 (percent)
Iron 112 (mcg/dL)
Ferritin 20

[SunnySky]

I would not supplement iron. At. All.
Serum iron is over 100 (which is optimal). Our body has an amazing recycling system and once we have sufficient iron, we do not need to add to it. We lose less per day than we take in. If you live in the US or other country that enriches wheat with iron and you eat the foods with wheat (cereal, bread, pasta, etc), then you have more than enough.

Iron is the most toxic metal--once we have enough. BTW, there is more iron in macrophages and tissues than can be measured by a lab test.

Any chance the values are reversed on the Free T3 and the Reverse T3 lab results? I get a ratio of 357.1... which doesn't look right....
https://stopthethyroidmadness.com/rt3-ratio/
Sometimes T3 meds are needed.

[SunnySky]

What are the ranges for each lab? That would be helpful.

[Plumster]

What are the ranges for each lab? That would be helpful.

SunnySky, here are the results with the ranges. My Ferritin is 21, not 20. Also, for context, I am pre-menopausal, vegan, and don't eat wheat and iron-fortified foods:

T3, Reverse 7 (Bredesen range: <20 ng/dL)
TSH 3.12 (Bredesen range: <2.0 mcIU/mL)
Free T4 0.83 (Bredesen range: 1.30-1.80 ng/dL)
Free T3 2.5 (Bredesen range: 3.2-4.2 pg/mL)

Ferritin 21 (Premenopausal 7-283 ng/mL)
Transferrin 236 (200-360 mg/dL)
Calculated TIBC 330 (250-460 mcg/dL)
% Saturation 34 (20-55 percent)
Iron 112 (37-145 mcg/dL)

[SunnySky]

What are the ranges for each lab? That would be helpful.

SunnySky, here are the results with the ranges. My Ferritin is 21, not 20. Also, for context, I am pre-menopausal, vegan, and don't eat wheat and iron-fortified foods:

T3, Reverse, LCMSMS 7 (8-25 ng/dL)
TSH 3.12 (0.30-5.00 mcIU/mL)
Free T4 0.83 (0.80-1.80 ng/dL)
Free T3 2.5 (2.0-4.4 pg/mL)

Ferritin 21 (Premenopausal 7-283 ng/mL)
Transferrin 236 (200-360 mg/dL)
Calculated TIBC 330 (250-460 mcg/dL)
% Saturation 34 (20-55 percent)
Iron 112 (37-145 mcg/dL)

Thanks, Plumster.

On the way to a football game at the moment and just happened to see your reply. I'll take a closer peak later, but attached are one set of optimal iron labs.

Keep in mind we have more iron in our tissues and macrophages than can be measured in a lab test.

[Plumster]

Keep in mind we have more iron in our tissues and macrophages than can be measured in a lab test.

Thanks for your reply, SunnySky!

There seems to be three schools of thought on Ferritin blood levels:

• Fe should be ideally at 90-100. The thyroid functions optimally at this level

• Fe should be no higher than 50 (and some give it a range, 40-60), noting that ferrotoxic diseases like cancer may occur at higher levels

• Fe should be as low as possible in order to prevent most major diseases.

I am perplexed by the last one a little bit. I understand that we have more iron in tissues, but once you've got restless legs, isn't that the body telling you that you are out of iron in your tissues? I have had a summer of restless legs and insomnia, and I'm pretty sure it's because my iron stores got too low, possibly due to SIBO. They were already quite low at 14. I feel much better now that it's in the 20s after supplementation, though the iron deficiency has caused my thyroid to function less than optimally when put in the context of Bredesen's recommended ranges (edited and included above).

[Emily C]

Hi Plumster,

You wrote:

I got some labs back and am seeking some feedback on these results, because my doctor wants me to start Levothyroxine Sodium 50mcg. What do you think? I have never taken thyroid medicine before.

She is also having me supplement with iron 25 mg daily and says that my thyroid should be functioning better once my Ferritin gets to 100. My doctor is not a specialist on AD, so I value any input any of you may have. I see that some of you recommend a Ferritin level of 50, not 100. I personally believe my iron got low from a case of SIBO this year, which included fat malabsorption. I am in the process of solving this with herbal antibiotics. I am aware of the thread on Ferritin, but I do get restless legs after exercise, so I am supplementing iron for a little bit, though am not sure that 100 is optimal.

**

I also have thyroid and iron issues and would like to relay a few things I learned in working with a great doctor on these concerns for the past year. First, you might want to go to a specialist if you can, such as an endocrinologist. Did you start on the Levothyroxine yet? Just an FYI, there are options out there. I take Armour Thyroid, a natural alternative, and it works well for me. Your TSH level does not seem overly alarming in my opinion (I believe optimal is between .5 and 2.5) so you might not want to rush into taking the medication because once you start, I believe it is not something you ever stop taking. A specialist might even suggest monitoring your levels for now if you are feeling ok. A book I found very helpful was Hashimoto's Thyroiditis: Lifestyle Interventions for Finding and Treating the Root Cause (2013) by Izabella Wentz.

Your iron issue resonates with me too. I took iron supplements for years (decades!) due to borderline anemia. This was a mistake, I learned, and I see that others here have posted already about being wary of supplementation. A book that I found helpful is Dumping Iron: How to Ditch this Silent Killer (2016) by P.D. Mangan. One big revelation I found from this book and other research is how detrimental tea and other caffeine sources are to iron absorption. I was a big tea drinker and was stunned to learn that black or green tea should not be consumed with meals. (caffeine should be stopped at least an hour before and after a meal) Conversely, Vitamin C aids iron absorption, so adding red pepper to iron-rich food is helpful (such as spinach). If you google iron absorption and caffeine you will find links to studies and strategies. These kinds of strategies (such as not drinking green or black tea around mealtimes) have had a positive effect on my iron deficiency. I have stopped taking iron supplements altogether and I no longer have this concern.

Finally, the problem of restless leg syndrome. This is going to sound very crazy, but have you heard about putting a bar of soap under the bottom bed sheet (near the leg area)? I do not have restless leg syndrome, but my dad did and this remedy worked. This strange remedy has been touted over and over again in People's Pharmacy writings, a well-respected organization (see peoplespharmacy.com). If you go to this website and type in restless leg syndrome in the search bar, the first hit takes you to a discussion of soap as relieving RLS. This is one of those things that it seems there is no harm in trying!

Best wishes!

[slacker]

Interestingly, restless leg syndrome (RLS) can be driven by iron insufficiency; here's info from Johns Hopkins.

[Plumster]

Thank you, Efcole, for sharing your experiences and thanks, Slacker, for the info!

I took the Levothyroxine Sodium 50mcg for one day and had a bit of an overdose experience immediately: headache lasting all day, my mood darkened for the ay, tightness at the throat, heart beating fast for hours. I spoke to my doctor the next day and told her I would not continue the medicine, even at a smaller dose, but would consider a different kind in the future after first waiting a few months and checking my thyroid again. There's also lactose in these pills and I'm lactose intolerant so that would be like mini poisoning myself every day. She agreed and we will retest in two months. I am hoping that my thyroid levels will return to something more normal by then. I asked her if the medicine would be for life and she said no, it can be temporary.

Restless legs: It stopped once my Fe got in the 20s. Of course, I also stopped running so that I wouldn't lose more iron. I'd like to start running again. I do know about the tea (I drink 2 cups of black tea in the morning) and adding vitamin C. In fact, I tried for months to get my iron higher through foods only. But it didn't work.

Iron supplements: My current thought is that I'd supplement for another month or two and then stop. I am not at all confident about this decision. But I'm thinking a Fe level at 40 would be good? My doctor says that as women we would never have to worry about too much iron. I certainly do worry!

[slacker]

Here's an older thread that discusses Ferritin and Iron, with many members weighing in.