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what are the symptoms and causes of low ferritin?
Looking for answers.
I think for such a big general question, you just might do better searching on the net for low ferritin. You should find alot of info there. The effects are felt throughout the body and may include mental confusion, weakness,poor hair quality, etc.Also causes are various and may include poor diet, internal bleeding etc.
You do need to do a specific search on this one. It's too vast and complicated. I think that it is really hard to distinguish the difference between anemia and low ferritin symptoms. I know for me my symptoms are RLS and hair shedding badly at lowest ferritin point and still have fatigue after exercise of any kind. Happy searching. FLFLOWERGIRL:)
[QUOTE=jasmin_a;3208052]what are the symptoms and causes of low ferritin?
Looking for answers.[/QUOTE]
There are no physical symptoms of low ferritin. However low ferritin can lead to anemia and those general symptoms are fatigue, cold skin, pale for your normal skin color, black under eyes like makeup almost, cravings for starch or non-food items, difficulty in balance, loss of appetite generally. There are more but the ones I quoted seem to be universal to anemia.
[QUOTE=Merimac;3210458]There are no physical symptoms of low ferritin. However low ferritin can lead to anemia and those general symptoms are fatigue, cold skin, pale for your normal skin color, black under eyes like makeup almost, cravings for starch or non-food items, difficulty in balance, loss of appetite generally. There are more but the ones I quoted seem to be universal to anemia.[/QUOTE]

There is some information out there that indicates that very low ferritin (without anemia present) can cause symptoms. But is is variable and not yet widely accept by the medical community in the U.S. Of the material that I have read, it seems that countries like the U.K., Australia, etc. are more open to the suggestions that iron deficiency without anemia (low ferritin) can impact general well-being. I think there were studies done to show that female athletes did not perform as well with a low ferritin.
I have low ferritin, but have never been anemic. I've noticed, since taking iron supplements, I have more energy, concentration has increased somewhat, and I feel better overall. Added bonus, no weekly headaches. This was particularly severe during my periods and I haven't had the usual hormonal headaches since starting the iron supplements.
My body is NOT the same with a low Ferritin, and I DO feel SYMPTOMS. FLFLOWERGIRL:)
I suffer from the same syptoms when my ferritin is low (when it drops to about 2) as i do when i actually become classed as 'anaemic', when my hb drops. My heamatologist puts me on infusions when my ferritin is very low, regardless of my hb levels. All countries must differ, but here in the uk it is widely recognised that low ferritin does cause symtoms, my hair fell out just because of low ferritin, i wasnt anaemic at that time!
Anyone who doesnt suffer the effects of low ferritin are lucky in my opinion.
I too wasn't classed as actually being anemic as everything was ok on my blood test apart from the ferretin which was at 8 when we caught it from dropping lower, but it was enough to cause abnormal hair shedding, tiredness, lack of motivation, feeling down/depressed more frequently, dark around the eyes, swelling/puffiness around the eyes, tired/burning eyes, i was hungry all the time though.

Having said that, i cannot say that ALL those symptoms are as a result of simply low ferretin due to the fact that people who have been low in ferretin for a lengthy period of time can end up with their thyroid progressively moving from good to bad. Thyroid can cause hair shedding as well as the tiredness, among other things.

My thyroid didnt get so bad that i needed meds but was bad enough for my doctor to want to step up my ferretin intake to restabilise my thyroid. I have been told by a few medical people who saw me and knew i had a ferretin issue whether i had a thyroid issue too as the puffyness around my eyes looked like it was thyroid related.

Since boosting my ferretin via injections all of the symptoms i have listed have either gone or lessened. My next lot of tests will show how my ferretin and thyroid are doing. If my thyroid has improved i will not know whether the symptoms were solely related to the ferretin or ferretin/thyroid combined. This is why you can't simply focus on low ferretin without your doctor running tests for other things which can cause similar symptoms.

If your low ferretin isn't as a result of something obvious like extremely heavy periods or diet related then it's advisable to find out why this is happening.
[QUOTE=Audrey-B;3211488] dark around the eyes, swelling/puffiness around the eyes, tired/burning eyes,

[/QUOTE]

Audrey--I too have this look and I know that it is the typical "Hypo" look. But, what I don't understand about it is, I am being treated with synthroid and my number is within range 3.? Before I was treated I didn't look like this at a 6-9. Now I am treated and watch the numbers closely due to my iron intake. So, is this really thyroid or Ferritin? Does anyone else look like this with only a low Ferritin? Or is it left over from my anemia? You were not anemic though. I've asked the doctors and they say I don't know why. My Hematologist said that it was just a shadow, OMG! I just want to stop looking ill. Anyone have any thoughts on this? I see my ~wonderful~ Endo in Oct, he is the one that tested for Ferritin and anemia. Thanks! FLFLOWERGIRL:)
[QUOTE=FLFLOWERGIRL;3212119]Audrey--I too have this look and I know that it is the typical "Hypo" look. But, what I don't understand about it is, I am being treated with synthroid and my number is within range 3.? Before I was treated I didn't look like this at a 6-9. Now I am treated and watch the numbers closely due to my iron intake. So, is this really thyroid or Ferritin? Does anyone else look like this with only a low Ferritin? Or is it left over from my anemia? You were not anemic though. I've asked the doctors and they say I don't know why. My Hematologist said that it was just a shadow, OMG! I just want to stop looking ill. Anyone have any thoughts on this? I see my ~wonderful~ Endo in Oct, he is the one that tested for Ferritin and anemia. Thanks! FLFLOWERGIRL:)[/QUOTE]

I don't know what to think about it. For the last 10 years, my TSH has been all over the place. It's been as low as 0.06 and as high as 130! I only get the facial swelling when my TSH goes into the upper 80s. That is a common side effect of severe hypothyroidism.

When my TSH is too low and I'm hyper, I get very fatigued and can get that shadowy look around my eyes. In fact, because I'm fair and now getting older (43) and my skin is thinning, my circles are more noticeable. But this is just "my" thing. My mom's got it too and has no thyroid or anemia issues.

When I had anemia I don't think I looked any different than I did with or without low ferritin.
FLFLOWERGIRL - Your TSH is at 3? That's still too high. When on thyroid meds, most folks feel better when their TSH is closer to 1 and, if dealing with an autoimmune thyroid disorder, should be closer to 0 for antibody suppression.

Problem is, ferritin is necessary for conversion from T4 to T3, which is the active thyroid hormone. Its entirely possible that you're not converting properly or are underdosed. Until your iron levels are optimized, ask your dr/endo about supplementation with a T3 med like Cytomel. Also make sure that your FreeT3 is tested, along with TSH and FreeT4.
Nyxie-I am glad that you wrote your post about ferritin and thyroid. I am hypo with hashimoto's. What you said about when you have autoimmune thyroid issue that the tsh should be close to 0 to suppress the antibodies is something I have not heard or read before, but you do have my interest. Can you tell me where you have read this, or did you hear this from your doc or others??It seems my docs have wanted me to be around 1.5 or so. Also what you said about the ferritin is important, and this happened in my case that when I got the ferritin up the t4 and t3 numbers looked their best . I was diagnosed about a year ago.It's been a journey!
Thank you ladies!

I was DX'ed in 2/05 w/Hashi's and we are still trying to get the right dose. I am most likely undermedicated. The doc had just raised my synthroid to 0.075mg, 3 days a wk.when I became anemic and started with heart paps sooooooooo bad. I thought it was the meds, I called and told my doctor I wanted to back down to 0.05mg because my heart was too fast. At the time I really thought that it was the meds, I now know that it wasn't. They went away with the anemia. But my eyes are black in the corners and this is new for me. Like you Christine, I am fair and I have always had rings underneath the eyes and thin skin. You also said somewhere that your hair didn't fall out and mine was really bad when I had 2 Ferritin, it's much, much better at 20. Maybe it's just an individualized thing like symptoms of anemia? I have never been hyper that I know of and the highest I have ever been is 9.02. So, I don't know either.

Nyxie, I know what you are saying about the TSH numbers. I just thought that it didn't make a difference because the old 5 range, thought that at 3 I would be the new high:). I never gave it much thought. Don't like to take meds. Maybe this is why I get a leg rash for up to 9 months at a time, itchy! Even that is gone now. My last Free T-4 was 1.16 range 0.93-1.70 and my TSH, 3rd generation 3.160 range 0.270-4.200, Thyroxine T-4 10.9 range 4.5-12.0. I have no clue what those mean. I've only watched the TSH, never understood the other, I let the doc do that. This doesn't sound like me either, I might add. I just thought it was no big deal. I even have a popular autoimmune disease book, if you know what I mean. Does it look like my numbers are messed up from the low Ferritin? My next apt is Oct. 4th. I already hate getting older, this is just no fun.

Osteo--I've always heard that it was a 1 when people feel their best. my doctor always asks how I feel and not just lab results. I hope he is doing me justice. Please let me know what you all think of my numbers, I can take it.
I never realized that Ferritin had anything to do with this. Thanks for your replies. Glad to hear your numbers are better than mine. FLFLOWERGIRL:)
I too am confused as to whether the 'dark eye' issue is thyroid or anemia/low iron as both illnesses share a lot of the same symptoms. The fact that my eyes where puffy is what caught the attention of a few medical people as people with thyroid issues can have puffy or bulging or combination of both type eyes. What bothered me was that before i began the iron injections i got so bad that my entire eyeballs actualy hurt and if i touched around my upper eye lids my eyeballs felt swollen and often i would get that burning eye sensation when i closed my lids. I got to the point i wanted to simply take my eyeballs out and sit them in a cool glass of water!!

Now after the injections i still have slightly puffy eyes and darkish circles, but not as bad as before the injections. I will be 41 in Dec so do know that part of it is likely age related.

FLFLOWERS, you said that you take Synthroid but that your hair shedding is improving. I was just curious as i was doing a bit of research and read that some people who are on Synthroid end up with hair loss due to this medication as it's a side effect for some people or some long term users and that some users feel better on a drug which is a combination of T3 and T4, instead of just T4 which i think it said Synthroid was. It is odd that a certain drug is supposed to make you feel better and even help a symptom such as hair loss but an actual side effect of the medication can cause hair loss in some people.

I also read that taking evening primrose oil was of benefit for people who had hypothyroidism as the symptoms are similar to people who lack essential fatty acids in their system. The evening primprose oil is supposed to help with the hair loss symptom in particular. I thought it couldn't do much harm to add EPO so am adding that to my daily diet and we'll see whether there is any difference in perhaps 3 months or so. I have come across people on the Healthboard who highly recommend taking supplements with Omega 3's and 6's, saying it has helped their skin, hair and nails to no end.
The dark eye circles could also be a sign of adrenal fatigue. Various stages of AF can also cause hypoglycemia, low blood pressure, dizziness when standing, and a whole slew of other things including cravings for carbs, salt, sweets, and protein. Its not unusual to have adrenal fatigue if you've had a long-term untreated or undertreated chronic health problem. While most drs will run ACTH and cortisol blood tests, the best way of finding out what your adrenals are doing would be a 24-hour cortisol saliva test.
Osteoblast - I've read the TSH suppression for autoimmune thyroid disease somewhere. Trying to find the source (have so many pages bookmarked that it isn't even funny). Its also the mantra on several other forums I'm on. Glad you're feeling better and your numbers are better now that you're iron's up! :)

FLFLOWERGIRL - When you see the doc next month, talk to them about getting your FreeT3 tested as well. You might have to cry, beg, scream, whatever. Get it done. Its really the best way to find out just how your body's converting the T4 you're taking into the active thyroid hormone. Your TSH is definitely too high and your FreeT4 is below mid-range. Most folks feel better when both their FT4 and FT3 are in the upper 1/3 of the ranges. Also, I hope your dr has you on a magnesium/calcium supplement. T4-only meds can cause osteoporosis after long-term use.
Thanks Nyxie - i do now recall my doc telling me that my adrenal glands were working over time to try to keep my thyroid functioning at a decent level and all of this he blames on insufficient ferretin.
[QUOTE=Audrey-B;3213765]
FLFLOWERS, you said that you take Synthroid but that your hair shedding is improving. I was just curious as i was doing a bit of research and read that some people who are on Synthroid end up with hair loss due to this medication as it's a side effect for some people or some long term users and that some users feel better on a drug which is a combination of T3 and T4, instead of just T4 which i think it said Synthroid was. It is odd that a certain drug is supposed to make you feel better and even help a symptom such as hair loss but an actual side effect of the medication can cause hair loss in some people.

[/QUOTE]

Audrey--My hair has been lightly shedding for years, don't know why. Thought that it was natural, later, thought thyroid when I was DX'ed with Hashi's. I wonder how many years this was going on before Dx.

When my Ferritin went down w/anemia I got scared. I have read about the hair and synthroid too. I was already doing this before the meds. It just got really bad with the anemia/Ferritin. And thank goodness that I have lots of hair, it is very fine but thick. I can see a little difference with the way it looks. It was really bad, in my food and all over the house.

Sounds like I need to possibly change medications. I have heard that changes also cause hair shedding? I really hate to change anything in my body right now. I may not feel better until I do. Thanks! FLFLOWERGIRL:)
Nyxie--Thank you for all the information, I really appreciate the help. So, an Endo would be the one to check for adrenal fatigue, right? Although I don't have any of the symptoms that you mention it's worth checking. My eyes have always been dark underneath due to allergies we thought. Now the problem is in the corners, may be anemia/Ferritin. Guess I will be able to tell when the Ferritin goes even higher. How does the 24-hour cortisol saliva test work, what do you do?

If you have time, can you give me a list of what should be tested and the corresponding numbers that patients feel best at?

No, my doctor does NOT have me on magnesium/calcium supplement. I remember reading about the osteoporosis. I didn't think to supplement now, it only makes sense. He did say there can be S/E to synthroid. Thanks again for all your help and suggestions. FLFLOWERGIRL:)
Audrey - Glad I could be of some help. :) The way I've figured it (and am probably not right, but it makes sense, at least to me) is that our low iron has caused thyroid dysfunction. The thyroid dysfunction, in return, causes our adrenals to work overtime, causing the adrenal fatigue. Its a sort of domino effect. There are also other stress reactions that can cause adrenal fatigue. In my case, years of chronic insomnia (due to nerves), as well as PTSD, 2 years of agoraphobia (over that now), depression, and anxiety and panic attacks. Fun, huh?
FLFLOWERGIRL,
Any doc can test for adrenal fatigue. Like I said before, most will just do a one-time ACTH and cortisol blood test, which should be done prior to 8am. The saliva test, while giving a better overall picture, isn't always accepted by conventional medical practitioners, in spite of clinical studies that support its legitimacy.

The saliva test itself: Get a kit either from your dr or order one from an online lab. Pick a day to do the test. Some labs prefer that you do the test on a certain day of your menstrual cycle. You spit into the little tubes they give you - once when you wake up, at noon, at 4pm, and again right before you go to bed. Believe me, coming up with all that saliva isn't as easy as you'd think, but there are tricks. Send the kit in and 1-2 weeks later you get your results.

Now as to optimal levels - These are a general rule of thumb that I've gathered from various forums (I'm on about 8 of them, altogether). Your mileage may vary, as our bodies are all different. Many of the forums I'm on are run by patients who have had to resort to self-treatment due to inadequate care by conventional medical practitioners. These optimal results are from years of patients experimenting, finding out what works best for them, and compiling the results from there.

TSH - Close to 1, closer to 0 if dealing with an autoimmune thyroid disease. Now, a word about TSH. While this is the gold standard for most endos and conventional docs, its a [I]pituitary [/I]hormone, not a thyroid hormone. TSH levels can be affected by medications, illnesses, time of day the test was taken, and even the time the test was done during your menstrual cycle. Its not the end-all and be-all that most docs are making it out to be. Prior to the 3rd-generation TSH tests coming out in the 70s, docs actually had to [I]listen [/I]to their patients and diagnose by [I]symptoms[/I].

FT4 - This is the unbound T4 in the body that's available to be converted into T3. Optimal levels are generally the upper 1/3 of the range.

FT3 - This is the active unbound thyroid hormone your body actually uses. Optimal levels are generally in the upper 1/3 of the range.

Serum Cortisol - This should be at the upper end of the range (20-25).

ACTH (Adrenocorticotropic hormone)- This is a pituitary hormone that stimulates cortisol production. This should be double the serum cortisol level (40-55).

Saliva Cortisol - Optimal levels will vary, based on which lab you use, and most include a chart along with the test results. Ideally, it should be in the upper half of the range, with high levels in the morning, declining at noon, raising again in the afternoon, and then at its lowest level at night.

There are other tests that can be done, such as DHEA (a hormone precursor produced by the adrenals, which then converts into testosterone, estrogen and estridiol), aldosterone (a hormone produced by the adrenals which regulates sodium and potassium levels), and renin (which is really kinda complicated to explain, but impacts the aldosterone levels).

Hope this helps. :)
Nyxie--Thank you so much for responding to my post. It really helps me in understanding what's going on. My doctor always tests the TSH and F T-4 and that's all that I know of. He's really good about running any tests that I ask for, so the ACTH shouldn't be a problem. Perhaps he will add more to all this since I have been so sick. Like I said, I just never gave the thyroid too much thought. My mistake, I will never do that again. Thanks again.
FLFLOWERGIRL:)
Thanks for that concise explanation Nyxie :) i don't even think that my ex-gp could have explained it that well, hahahaha, sometimes i wonder whether his University Degrees on his wall were a DIY job b/c he certainly never seemed to know anything and when i would convey to him what i had learnt off the internet health forums he would say "interesting" and actually start making notes of what i was saying. Oh well, at least i can laugh about it now!!

I must correct what i said earlier. The Trichologist i'm seeing said that my pituitary gland was working overtime due to the lack iron and throwing my thyroid out rather than the adrenals working over time, but considering i've been low for so many years i wouldn't be surprised if my adrenals are out of line too.

It makes me wonder now whether my hormone imbalance is somehow tied into this low iron business. Each time i have a new blood test done the Trichologist orders a blood test for my hormones too. I'm taking a herbal mix and this has got my monthly cycles in order, but when i go off this they get somewhat disrupted again and no amount of tests have revealed why. I'll wait and see how things are in a few months time when my body has had sufficient time to settle after the iron injections i got recently.
Nyxie-thanks for all the information. What a hard road you have had. It does indeed get pretty tough out there.Besides working on the ferritin, thyroid , adrenals etc. have you tried any body mind techniques??I started tai chi about 5 months ago and I think it has changed my life. Of course it's only been 5 months but I find it so helpful. There is something about these ancient movements and getting out of my head and into trying to learn a movement I have never done and balancing at the same time--it has been a vacation from some worries and has really helped. Tai chi is ancient, there is a reason why people keep doing this-and I think it is that it is because it feels good. Maybe you could give it a try or perhaps some other form of body mind movement that appeals to you?
This last year has been medical hell for me, but I am hoping that things are now getting somewhat better. It has been very hard for me to get the kind of doctors on my team that I wanted to work with and it is a work in progress. But at least the pcp part is settled and that has made alot of difference.And, now I have more familiarity with the issues and know things I can improve- like the ferritin, vitamin d etc. I am so thankful to the wonderful and informative people I have shared with on these healthboards, I have really learned alot here and also been sort of stabilized by the sharing.After being on the boards for awhile- you know you are not alone going through this stuff!
I don't know if it was improvement in ferritin , vit d level or thyroid just having more time on correct dose and /or the tai chi- but I don't seem to be so in the dooomsday scenario camp . I have to say too that getting worked over , through various diagnositic procedures can really wear on a person. And, not to forget, I will have my colonoscopy chapter to write in about 3 weeks. Again Big Thanks to the wonderful people on this board who spoke about osmoprep and who told their story--very helpful information!!!!! This is a wonderful community here at the anemia board!
And last but not least I will have my ferritin checked again in the next few weeks. I got it up to 47 , I know this seems so high to those on this board who are starting from 8 or so. Well, I will see if after 2 months no iron supplements whether it has declined. I had to stop the iron for a bit because I was going through a bad gi disturbance and the doc felt the ferritin was ok and wanted me to just stop anything that might hurt the intestinal tract. The weird thing was that apparently it was a viral thing that damaged the lining of my gi tract and then made me lactose intolerant. They think the lactose intolerance will diminish in time. But for now , I am getting my calcium through supplements and have gone back to 18mg ferrous fumarate a day.
Sorry to go on so long- you would think I was hyper which I know I am not at this time
Audrey - At least your ex-gp was willing to learn and didn't seem to mind you educating yourself. That's more than most docs. I have a running gag going with my ENT. Him: You've been reading again, haven't you? Me: Yup! *big grin* He, of course, returns with a scowl. I guess he wants nice little zombie patients who don't question the nice all-powerful doctor. Ha! Like that's gonna happen with me! He probably cringes whenever I make an appt.

I tend to give GPs a little slack because they can't possibly have time to know everything about everything. Specialists? No slack given. They're supposed to be experts in their field and I've found most to be living and practicing in the past, worshiping at the altar of Big Pharma.

Your Trichologist sounds like a really good doc. While I absolutely adore WonderDoc (my Holistic MD), I still have to manage my own healthcare and would love to find someone who was more assertive (in a good way).
Osteoblast - I'm giving serious thought to either Tai Chi or yoga. I haven't done much of that in the past, largely due to either my schedule or just not wanting to leave the house. While I'm over the agoraphobia, I still don't like to leave the house unless I have to. Its my nest. My safe place. The outside world can't touch me here unless I want it to. Dunno if that makes any sense, but that's what it is to me.

Glad to hear you've got a good GP on your side and are getting better! Keep us posted about the upcoming colonoscopy and your results. And good luck on the ferritin test. Keeping my fingers crossed! :)
Nyxie-I like being at home too. :) No question a safe nest is very important to physical and mental health . Although I must add that I love my nature walks as well. We have a national wildlife refuge not far from where we live and generally go there weather permitting all day at least one weekend day if not two. It is my opportunity to merge with beautiful natural surroundings and wildlife. That is very helpful too.
A great way for you to either do tai chi or yoga would be to check out dvds from your local library. Just be sure to get several at a time, because in my experience there are usually more that do not work for me than do . So out of say 5 , maybe 1 or 2 or none. I would love to hear how it goes for you. My all time favorite tai chi dvd is with Scott Cole. And, though I did yoga for years, I never felt so at one with the experience as I do with the Scott Cole dvd. You could look at the reviews on Amazon , this guy is really popular. Half the workout is at the beach in hawaii , the other half in the studio. Very beautiful, and soothing.Another tai chi dvd totally failed with me,I couln't follow it at all. So , be sure to give yourself a number of opportunites with various dvds before thinking that either tai chi or yoga will not work for you.

I hope the ferritin comes out ok. I would be ok taking the 18mg ferrous fumerate forever since it causes no issues. I have decided to go see a naturopath and have her check out my supplements to try to optimize what I am taking and be sure that things are balanced. I have just been following bits of advice here and there. I am though totally convinced that the iron and vitamin d have helped greatly. And, probably the fish oil too.
Hi Nyxie - i too agree that gp's can't know everything, but what upsets me most is how a lot of gp's seem to think that ALL health concerns are not worth worrying about so long as the blood test falls any old place within the 'range'. They also hate their patients having a few brain cells and to have the audacity to speak up with ideas/suggestions. My ex-gp ended up with a lap top connected to the net not long before i left him. When i would come in to consult him about my issues he would most often say "let me look that up". How hilarious would it be if he were a member of a healthboard and was getting his ideas from there. Truly makes you wonder. I had no confidence in the end with him so changed to a new gp. It worries me most that when a gp can't put a patient on the right track regarding low iron levels then what use is he for a far more serious health concern!!

As for the yoga, i did that for a few months just over a year ago. There were classes held once per week in a community hall close to my house and we were taught by an elderly Indian couple. I found it interesting as our instructor informed us on why we were doing each position, it's name in Indian and what it meant in English, which part of our body or bodily organs it affected, whether it had a medicinal value eg: helping cure diabetes. Each week we received literature on what we had learnt so that we could practice at home.

The main draw back i found was that i had never done gymnastics at school and wasnt very 'flexible' so sitting in the lotus position and a couple of other positions was a bit hard going. The other issue was as the course progressed, a lot of the positions he had us doing were apparently good for people who lacked appetite. The last month of the course i was eating like crazy and no amount of food was enough. I don't know whether it was mere coincidence or whether his appetite inducing positions were that effective!!





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