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Monday September 16th 2019


Shelves Are Bare: Iron + Hypothyroidism

Post Published: 21 July 2011
Category: Guest Bloggers
This post currently has 20 responses. Leave a comment

In my medical practice, the main mantra I hear from my patients is this: “I’m depleted. I need my vitality. Can you help?”

When sleuthing the root cause of my patient’s low vitality, I notice certain clusters of health problems. Recently, I noticed that many of my patients with underactive thyroid glands also have low amounts of iron in their body. Turns out this is well documented.

How do I know my hypothyroid patients are also low in iron? I measure ferritin, the most sensitive indicator of iron storage in the body. You need a ferritin of 70 to 80 to rock your hormones.  You need a ferritin of 40 to make new hair on your head, according to my dermatologist who prescribed red meat to me three times per week (and didn’t know I’m a vegan). Low ferritin is the first stage, and if persistent, can lead to anemia.

Why do we hypothyroid types have low ferritin? Several reason. First, some women with undertreated or undiagnosed hypothyroidism have heavier periods. When the faucet is wide open, you lose a lot of iron. Second, some people with hypothyroidism make less hydrochloric acid, which causes you to not absorb iron from your diet. All those leafy greens may be going through your system without dropping off the goods.

What are the symptoms of low ferritin, and eventually, anemia? Interestingly, the symptoms mimic hypothyroidism: fatigue, mood problems especially low-grade depression, low sex drive, hair loss, palpitations, and brain fog.

What’s a girl to do? All women with hypothyroidism should know their ferritin. If you don’t, ask for a ferritin test from your doctor with your next blood draw. There are many ways to boost your iron stores if your ferritin is low – please share your count and what has worked (and not worked) for you.

Written by Dr. Sara Gottfried

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20 Responses to “Shelves Are Bare: Iron + Hypothyroidism”

  1. Cassie says:

    wow- great great info! thanks, just goes to show, you can never research enough with thyroid disease. i had no idea that u need a ferritin of 40 to make new hair!!!!! im looking forward to that! my ferritin was at 11 :((( ive been taking 72 elemental mg a day with juice for 2 months now- my palpitations are gone, but im still losing hair. im getting labs again next month-> i guess i just have to patient and now that i will get there.

    thanku again!

  2. Den says:

    Just had mine checked and my level is 31ug/L (range of 30-300) he already had me start ferris/folic tab with 250/300 split. Also on 135 mg NDT, and 5mg prednisolone. Just started the iron this week and got the results yesterday.

  3. Den, you are so ON IT! Great job. Hopefully your doctor mentioned that iron should be taken at least four hours before/after (usually after if you are dosing your thyroid hormone once/day) your thyroid medication. Plus vitamin C improves absorption. All the best, SG

    • Den says:

      Hi Sara, no he didn’t other than to tell me to take with meals in evening. I am on thyroid hormone twice a day 1.5 grains in morning and then 3/4 grain at noon. Take my iron in the evening with my dinner so always more than 4 hours after last thyroid med thankfully. Had totally forgot about that as had read it before. He also has me on a tablet that has olive leaf, vitamin c, zinc and echinacea which I am taking quite a bit of to try and help my immune system as I have had 2 colds and the flu in the space of 2 months. My doctor runs a holistic md practice and tries to cover all bases, am lucky to have found him I think.

  4. Rebecca says:

    Thank you for this info. Why has no one in 22 years of Hashimoto’s EVER suggested I get this test. That drives me nuts. That’s why I love you Dear Thyroid – LOVE!!

  5. gigi says:

    Hi. I am vegan (4 years) I just reviewed my blood work and my ferritin levels are only 16. I live with CFS and my connective tissue muscle disease comes up positive. Can anyone suggest plant based ways to increase my ferritin levels? I might feel a lot better. None of my doctors pointed it out to me. Thanks so much!

  6. Gina says:

    I have had low ferritin since I’ve had Hashi’s. I am however, the queen of vitamin and mineral deficiencies. When I first had blood work done with my new doctor (who is amazing and listens to all my complaints!) I was told I was low not only in ferritin but also vitamin D, B-12, magnesium, zinc and selenium. I didn’t know that someone with a fairly healthy diet could be so deficient. I now take giant vitamins twice a day with an extra vitamin D in the morning. I’m working on taking those iron pills too but no matter what form they always make me constipated. Every 3 days seems to work for me though. It’s nice to hear that my doc is up to date and testing for all the right stuff. A note about magnesium, if you have muscle twitches frequently, get on magnesium, the twitches will clear up in a few days!

  7. Jeni says:

    I’ve been trying to raise my ferritin levels for 8 years now (ever since I realized my hair was falling out), and I think the highest I’ve ever got it was 50. I take one or two iron pills a day with vitamin c and L-lysine (ferrous fumarate, or ferrous gluconate, and I’ve tried other types of iron). Lately I’ve been forcing myself to eat more red meat. Basically nothing helps – my ferritin ranges from 17-40, and a few times I managed to get it up to 50. My hair is of course still shedding like crazy. All the doctors say my iron/ferritin levels are great…

  8. Judy says:

    My ferritin is sky high but I have all the symptoms you mention along with being hypo. I found out my iron saturation and iron serum levels are too low causing my T3 (I take 100 mcgs of Cytomel a day) to “pool” in my blood and not get into the tissues/cells where the thyroid can actually utilize it. So I’m taking iron that many hypo patient say don’t constipate. One is Blue Bonnet and the other is Solgar Gentle Iron. I have taken as much as 200 mgs per day but lately am taking 75 mgs a day because I have total body inflammation, a high C-Reactive Protein level and high ferritin. So it turns out my inflammation was prevented the iron supplements from increases my serum and saturation and has actually been converted into more ferritin and raising my CRP instead. So now I take 2 to 3 grams of krill oil each day to address the inflammation. My iron serum and saturation have now been slowly increasing, and CRP is decreasing. I also found a teaspoon of unrefined, organic coconut oil is helpful for the constipation and low energy.

  9. Judy says:

    Any other suggestions to lower the CRP and increase my iron sat and serum?


  10. Jacqui says:

    Just an idea for those with low iron levels ,eating dried apricots will help raise your levels .i learnt this from a midwife years go when I was pregnant and couldn’t take iron cause it made me nauseous .It totally worked when I was retested my levels were up.

  11. Kim says:

    Thank you, thank you, thank you for this!! I had NO idea, and of course in yewrs and yewrs of Hashi’s & vitamin D deficiencies, and showing up anemic twice, no one has EVER told me this is something that should be monitored. So grateful! Thanks again!

  12. Barb says:

    Because I have Ulcerative Colitis and can’t digest iron very well, I do injections of iron every 10 days along with B12/complex. Helped me tremendously…

  13. Brandy says:

    I have learned so much in just the past few months about my thyroid and hypothyroidism and I was diagnosed 20 years ago. I have recently in the last 2 years suffered some nasty heath problems. Come to find out it was due to my thyroid and my iron and ferritin being almost nothing. Can’t quite remember what my iron level was but my ferritin level was 4! I ended up at an Oncology doctor trying to figure things out and he ended up giving me iron transfusions 2x a week for a few weeks and got my levels back up. I now have to go every 6 months and have my levels checked just to make sure they stay up. I can not take iron supplements but am now on a b12 shot monthly and b12 by mouth every day and also vitamin D. Once I got my levels up I was surprised how much better I felt. Im not one of the walking dead anymore.

    • Lesa says:

      Hi Brandy, I have had low b12 levels last year, 93 was the level. Hematologist said one of the lowest he has seen, they found out at the same time my thyroid Level, TSH, was above 5, & I was hospitalized with a blood clot in my lungs, for the second time, with pluriesy. The first time I had 2 blood clots in my lungs with low folic acid. It is good they caught your B12 levels before they got so low they could cause even further damage. I take blood thinners for life, B12 shots twice a month, vitamins B1, iron, selenium, D, & calcium on a daily or weekly basis. So sorry to hear about the iron deficiency, so glad you are feeling a little better!

  14. Laura says:

    I’m in rough shape at the moment – TSH 83.9, ferritin 5.5, low calcium, low vitamin D, etc… It’s so interconnected and has a monumental impact on how able (or unable) you are to function in day-to-day life. How is it that so many of the endocrinologists I’ve seen haven’t addressed this/brought it up in response to my explanation of symptoms? Blarg. 🙁 I’m taking 87 mg of chelated iron twice a day, along with lots of other supplements. It’s hard to keep it all organized and not take anything with other supplements that might impact each other. This is especially tricky when splitting thyroid hormone twice a day. But so worth it if it will lead to feeling even a little better. Great post – thanks!

  15. Lesa says:

    Recently had my dr do all vitamin testing. I ended up in hospital last April with another pulmonary embolism & low B12 levels. Had had 2 previously with low folic acid levels. This time they found low B1 & iron levels, not yet anemic. I’ve started taking a a high dose iron supplement, but I only take it 2 a week. The problem I have in taking it with my dinner is that o end up staying up a long time on those nights, sometimes all night. I might try a different iron supplement. Any suggestions? I am so thankful for sites like this one…I think it is important to educate people about thyroid problems since there seem to be so many and are varied by person, especially as you age! Menopause is when I started having blood clots and thyroid problems. I’ve often wondered if there is a link between the two!

  16. Gabriella says:

    Thanks for the information! Does the hypothyroid cause low ferritin or vice versa? I have had low ferritin that only rises with iron pills but immediately drops as soon as I stop the iron pills. Can I have hypothyroid? What are normal levels so I can check my bloodwork?

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