A large body of thyroid patients have been surprised to discover that being hypothyroid also results in having low Ferritin, or storage iron. Ferritin is an iron-storage protein which keeps the iron in a dissolvable state and also makes the iron non-toxic to cells around it. So when Ferritin is measured via a blood test, it is basically measuring your storage iron, or the iron you have tucked away for future use. You can have “normal” iron serum levels, yet a low Ferritin.
Why do we often have low Ferritin? Because being hypothyroid can result in a lowered production of hydrochloric acid which in turn leads to the malabsorption of iron. It can also lower your body temperature (common for those on thyroxine, as well) which causes you to make less red blood cells. Additionally, being hypo can result in heavier periods, which causes more iron loss.
In turn, having low iron levels decreases deiodinase activity, i.e. it slows down the conversion of T4 to T3
Why is having low Ferritin a problem? First, though the slide into low Ferritin can be symptomless, it eventually becomes the precursor to being anemic. And once the latter occurs, you can then have symptoms which mimic hypothyroid – depression, achiness, easy fatigue, weakness, faster heartrate, palpitations, loss of sex drive, and/or foggy thinking, etc, causing a patient to think they are not on enough desiccated thyroid, or that desiccated thyroid is not working. Excessively low Ferritin can also make it difficult to continue raising your desiccated thyroid, resulting in hyper symptoms when raising desiccated thyroid.
Biologically, insufficient iron levels may be affecting the first two of three steps of thyroid hormone synthesis by reducing the activity of the enzyme “thyroid peroxidase”, which is dependent on iron. Thyroid peroxidaxe brings about the chemical reactions of adding iodine to tyrosine (amino acid), which then produces T4 and T3. Insufficient iron levels, which low ferritin reveals, alters and reduces the conversion of T4 to T3, besides binding T3.
Additionally, low iron levels can increase circulating concentrations of TSH (thyroid stimulating hormone).
Iron, in addition to iodine, selenium and zinc, are essential for normal thyroid hormone metabolism.
What’s the solution? The solution, after you have verified low Ferritin with a blood test (i.e. lower than the 50’s), is to supplement your diet with iron. Foods rich in iron include lean meats, liver, eggs, green leafy vegetables (spinach, collard greens, kale), wheat germ, whole grain breads and cereals, raisins, and molasses.
But most patients and their doctors have found it necessary to supplement with iron tablets, which includes Ferrous Sulfate, Ferrous Glutamate, Ferrous Fumerate, etc.
Ferrous Sulfate is usually the cheapest – just be sure you are taking a good Vit. E with it since there is evidence that it’s depleted with the use of Ferrous Sulfate. And always take it with food. The owner of this site had to take 2 – 3 325 mgs. of Ferrous Sulfate with food and throughout the day, for months to even BEGIN to get her Ferritin up, plus 800 mgs Magnesium.
Ferrous Gluconate may cause fewer symptoms and is milder on stomach. Ferrous Fumerate is often prescribed by doctors as it, too, has fewer side effects, absorbs well, and is easier on the stomach.
Beware of liquid iron that is animal based (heme) – it may be the best absorbable iron, but it can blacken your teeth, as it did to the owner of this site. VEGETABLE BASED (nonheme) liquid iron avoids this, even if less absorbable.
I was contacted by a physician practicing alternative medicine who highly recommends Floradix Iron and Herbs, or Enzymatic Therapy Liquid Liver. Check in your local health food store or pharmacy.
From Canada, there is a chewable non-constipating iron called Hemofactors by Natural Factors, and one patient who wrote me swears by it. It’s Ferric Pyrophosphate, also called SunActive Iron and you’ll want to pay attention to the “elemental iron” amount to get enough.
How much iron supplementation do I need to raise my low levels, and how long do I take it? When Ferritin is low, you have to give yourself many weeks, and sometimes 2 – 3 months, to improve your levels, Patients generally try to take 150 to 200 mg of “elemental iron” daily, spread out with meals. Be sure and read the label to see how much elemental iron is in each tablet.
The general goal is to get your Ferritin to a lab result of 70 – 90, according to our own research. Keep track of labwork to see where your levels are, because you want to get off the iron once you achieve your goal since iron promotes free radicals. Some women who are menstruating may have to stay on low amounts of iron. Check with your doctor.
Should I take anything with the iron to help? Yes, Vitamin C. First, Vitamin C is said to help the absorption of iron. Second, since the introduction of iron in your body can promote the stimulation of free radicals, Vitamin C has a known role of combating those free radicals. How much C? Some take it to tolerance – the amount they can handle before getting too-soft stools. Others are in the 1000 – 2000 mg range. At the very least, drink down your iron tablets with orange juice or a drink like Emergen-C.
Also taking a mineral supplement can assist the absorption, as can B-vitamins. One important B-vitamin is Folic Acid, which promotes red blood cell formation. Adding it to your iron supplementation can be key.
What about the constipation I get from taking iron supplements? If you do find yourself with constipation or very hard stools, talk to your doctor about adding Magnesium Citrate as a supplement, taken twice a day, until you find the amount that softens your stool. You’ll know within a few days if the amount you are taking is enough.…or even too much (i.e. too much will cause diarrhea).
Can I take iron at the same time I swallow my desiccated thyroid? If you swallow your desiccated thyroid instead of doing it sublingually, it’s important to avoid swallowing iron at the same time, since the iron will bind to some of the thyroid hormones and make them useless. If you are doing your natural thyroid sublingually, you are fine whenever you swallow your iron.
What if I can’t tolerate oral iron? If you have problems absorbing oral iron due to a previous stomach surgery or other issue, another option is to use Venofer — an intravenous iron which helps replenish body iron stores. Talk to your doctor. (Thanks go to “Chenille” for this info)
Once I get my ferritin levels back up, will it stay up? Several of us have had our ferritin levels plummet again, so it may be wise to stick with a small dose of supplemental iron or eat iron rich foods, especially if you are female and still menstruating. Once into menopause, your ferritin levels may stay where they need to.