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jlt18 - i'm in the same boat as you. Suffered with extremely low iron and took 2 years to raise it and that was when i found out that i had Hashi's.

A lot of thyroid sufferers have low iron problems. It is also very common for thyroid sufferers to have very low Vitamin D. Your doctor should check that also. Both iron and vitamin D malabsorbtion can be cause by gluten intolerance. Has anybody checked whether you are gluten intolerant? It's a simple blood test. Once again, us thyroid sufferers often have varying degrees of gluten intolerance.

With the vitamin D, when i was told to take it i began taking the basic 1000IU measurement (one gel capsule) as per instructions on the container. Next blood test i hadn't moved much and then my doctor issued me with some vitamin D drops which i drop 7 drops (4500IU) of onto my tongue each night after dinner. My vitamin D has moved up a little bit faster after taking a higher dosage. My doctor said taking vit D at night after dinner is more beneficial as its more likely i would have eaten meat and the vit D absorbs better. maybe this is due to the protein. He said vegetarians have a harder time absorbing vit D (and it has to be D3, not the other D).

I also have problems retaining iodine in my body. I lose more than i ought to and iodine is necessary for a healthy thyroid too.

I too have the adrenal issues. My doctor put me on Cortate tablets to help with my low morning cortisol levels and i'm so much better now. Are you only taking vitamin type supplements to help with your adrenals or are they actual medication what you are on?

If you were taking your iron along with the T4 you were on before that would make the T4 less effective and would also mean the T4 wouldn't be giving you the full benefit of making you feel better. You can take iron and other supplements alongside T3 med's but not T4. I believe i was told to not take iron or other vitamins 2 hours prior and 4 hours after taking your T4 meds. This is going to worry me next week as i've only been on a T3 med (triiodothyronine) and as of monday my doctor will be starting me on a little T4 (thyroxine). I'm juggling enough med's and supplements as it is and it frustrates me having to spread things out so that one thing doesnt inhibit another.

My medicinal listing and time frame is fast resembling a train time table :D It's ok if you are at home all day, but i work full time and remembering and taking time out to take this, eat food prior to taking certain things, take one thing and wait before you can take another is driving me nuts. The thing is, nobody at work understands. They simply think thyroid issues are like a headached, you pop one pill and hey presto problem solved. They don't realise how much stuff i actually take and how tired i sometimes get. maybe it's because i'm so good at hiding how i feel and just put on a happy face!!

Just incase you didn't know, zinc should not be taken until either 2 hours prior or after taking your iron, just like caffeinated beverages, red wine and dairy products inhibit iron absorbtion.

I'm not sure what Betaine is. I was taking a formula which my doctor's chemist especially made for him and its not a commercial brand, but there are a variety of commercial ones which people on these boards have a had decent success rates with. If your iron constipates you there are stool softeners you can buy. If it causes irritable bowel then you can take iron phosphate which calms the the stomach/bowel.

It's quite a long road and so many of us have been room mates here on the anemia board for quite some time (a number of us have thyroid issues too). So be prepared to bunk down for a while, but you are in good company :D
Thank you Audrey and Flflowergirl. I was glad to see I am in good company. I was reading here and found many others like me.

I am going to get labs drawn and plan to ask for Vit D 25-OH they ran the wrong vit D last time. I am sure I need to take more iron. Just have trouble finding which one I can tolerate. I like the Floradix it is suppose to absorb well, just not sure how much I need of it. It is expensive. I just ordered Blood Builder, anyone hear of that? Suppose to be food based. The sublingual iron stained my teeth. Sometimes I think an IV would be easier. I will have ferritin tested again.

Thanks for the reminder of when to take stuff and which to avoid. It is hard when you work. I put some in my pocket. I take Armour sublingually so I pop those throughout the day. I take hydrocortisone for my adrenals. Started with isocort over the counter and needed to go with the RX of HC. I started iodine after doing the iodine load test and have had some trouble tolerating the 50 mg. My adrenals got stressed. So I pulse dose.

I have a NIS defect which means I have trouble with receptors getting the iodine in my cells. I also have MTHFR defect which has to do with being able to absorb folate.

I also have trouble converting T4 to T3 thus stopped the T4 only meds. I see a correlation of absorption/converting issues. Never thought of that before. I wonder how many others have this too? MTHFR is inherited. I was on heparin for my second child.

I read that low estrogen can cause hair loss. I will retest that. Any other ideas for labs: my list is free T3, T4, TSH, antibodies, ferritin, Vit D, cholesterol, sex hormones and DHEA.

How long before I should expect hair loss to improve? It has been 7 months of loss. This is not new to me but usually ends by now.

Audrey, your doctor sounds great, what kind of doctor, ND? I see a PA and my compounding pharmacist makes recommendations that he will follow. So far it is working for me...

Any good books to read on anemia, low iron? I buy books and read all I can to understand. I am in the medical field so it is pretty easy to absorb/digest.

Thanks!! I am glad to have a place to get support!

Takes a bit of catching up when you haven't been on the net for only 2 days!!!! :)
Cant recall exactly who said what so i'll just lump everything together if that's ok.

First of all for all those Hashimoto's groupies out there, the inability to absorb things, particularly iron and vitamin D has VERY strong links to Hashimoto's. Most of us suffer with that. I saw my doc today and he also said the higher your vitamin D the better your T3 will become. It basically helps your T3 along.

Make sure you check for gluten intolerance as that will diminish the ability for nutrients to be absorbed too. On my gluten intolerance test i got and 18 and 15 was the max. My doc classed me as being a 'little' intolerant but even so advised me to ease off all things gluten or just eat very few gluten products. I found this cafe which does the yummiest gluten free orange/almond cake YUM :D

Hair........... well we all want our hair back and it seems to be the most stressful thing to lose. I'd trade less energy for some real hair growth. Even though my ferretin got to 61 after 2 long years of trying, i still had hair loss (didn't know i had Hashi's then). Suddenly my hair stopped falling out for 1 good month. I couldn't believe it. I thought this was it, the end of hair shedding. Then after the 1 good month my hair began shedding all over again. I couldn't work out the mystery. Why stop shedding for 1 month then start again. Some months late it hit me..... Iodine. It had to be the iodine my doctor had given me 3 months earlier. I had used it for a few months and never got a repeat bottle of iodine as my levels had come up nicely.

Well i didn't know at that time that i was Hashi's and didn't know that if i stop taking iron,iodine and vitamin D that my levels will drop either due to my thyroid or something else. My thyroid doctor has begun supplement me with iodine again as he did an iodine load test where you drink a certain amount of iodine and then collect your urine over a particular amount of time. They can then measure how much iodine you lose in a 24hr period. This test showed that for the time being i have to stay on my iodine drops till further notice. My hair is shedding closer to normal now, but i don't know whether it's due to the iodine or all the other things i've been doing in the last 3 months since having my thyroid treated. With hair you wont notice immediate results anyway. It usually takes 3 months or so to begin noticing a proper hair growth cycle after whatever has been fixed.

As for reflux treatment and inhibiting iron absorbtion. A guy i work with had a reflux issue and one of his doctors finally put him on some prescription enzymes and his reflux has gone.

I'm also on prescription digestive enzymes as my pancrease doesn't make sufficient enzymes to digest protein so it sits, ferments and inflames my thyroid. I've been on the enzymes since mid april and my stomach is better, no more bloating and i'm hoping that things are digesting better and i'm getting more nutrients.

My previous doctor who treated my anemia and my thyroid doctor have both said that quite often malabsorbtion of necessary vitamins/minerals and digestive issues are connected to thyroid patients and they nearly always see low iron in particular and low vitamin D, digestive issues, metabolism issues eg: most often slow metabolism, hormonal issues, messed up monthly cycles, hair shedding, chronic tiredness and adrenal issues.

My doctor did say that the hair shedding can be due to a hormonal imbalance (i have too much estrogen and a little too much testosterone), but it can very possibly be related to my digestive system not digesting protein, it can also be due to insufficient T3 for my thyroid. I've been on a T3 med since april and he started me off on a slow dosage and i'm responding well to it. Right now he has added a tiny bit .05mg of a Thyroxine tablet to the mix and in 6 weeks i'll have a blood test to see whether i'm responding. He said some people respond best with only T3 med's and don't do well when a T4 med is added, while others do best on a combo of T3 and T4.

My doctor also has me drinking isolate whey protein every morning with breakfast to kickstart my metabolism and to add badly needed protein to my diet. Eventhough i was a big meat eater my body wasn't absorbing it due to the lack of enzymes i mentioned. You don't have to eat red meat every single day. 3 nights per week is good. Other nights you can have white meat or fish. You can get protein from pulses and nuts.
A nice lentil soup is good. Also almond, brazil nuts and cashews when eaten together are a complete protein, just like meat. Iron from meat is likely the easiest for out bodies to absorb and we dont just get iron from meat, but a lot of other essential things.

A lot of people also lack selenium in their diests. Too much selenium or too little can cause hair loss, but apparently 4 brazil nuts per day is all the selenium you need. The ones from brazil are actually supposed to be the best.

With all things, whether it's vitamin D, iodine, selenium etc etc don't just start taking it of your own accord as overdosing on it can be as bad as not having enough. Get a blood test first and take it from there.

There is always a reason for low ferretin. It is NOT normal for ferretin to take months or years to fix. Once you begin supplementing with iron and you do not see it rise considerably in the first month or 2 and it's taking forever to go up, then you have a BIG problem. Low iron that takes forever is always a symptom of something else. You need to find that something else.
wow Audrey that was helpful!

My question is how to test for gluten intolerance? Just the allergy test? I know about the celiac antibody test. I personally am trying to decrease gluten in general.

The good news is I am on Vit D, selenium, iodine, armour and iron. In my iodine load test I was severely deficient in my spot test but then peed out a lot of the iodine I took, which means a NIS defect. So hard for iodine to get in. I seem to see a correlation of not converting T4 to T3, this defect on iodoine receptors and difficulty absorbing foods. Plus I have MTHFR defect which means I cannot break down folate. Suppose to be on B's for life to decrease risk of stroke, clots, etc. So it sounds like I dont break down or convert well. Enzyme issues. Speaking of enzymes I should probably add that to my list, right!

I am going to have sex hormones checked to see if estrogen, etc okay.

I eat lots of almonds, other nuts in my diet. I really avoid processed food. I am trying to eat what my body needs. The meat actually tasted good last night. I will try to keep that up 2-3 xwk.

I agree having low ferritin and not raising after supplementation in a decent time frame means a bigger problem.

Your doctor sounds great! What kind of doctor? I see a PA who will prescribes Armour and believes in treating adrenal fatigue. The supplement part of my treatment I get guidance from a compounding pharmacist and read a lot. I am a bit on my own...

A big thanks! I feel like I am on the right track and that is is common with Hashi's to have these issues. We are so lucky!!
Your heart problems could be adrenal fatigue which can be caused from T4 drugs over time, plus many other causes. I took them for so long and pooped out my adrenals. I was very sick. Heart racing, palpitations, panic in the middle of the night...I went to the cardiologist and all tests came back normal. That is what began my research for the answer. If you don't convert T4 to T3, which is common with Hashi's - all that T4 stays in your blood and doesn't get in your cells. You feel "wired tired". It is awful. I would be hyper one day and lethargic the next...I had terrible pain, heat intolerance, dry skin, all the symptoms. Read a little about adrenal fatigue and see if you have symptoms. You need to be sure your adrenals are good before starting T3. I just know that most people do better on a combined hormone treatment. Our thyroid glands produce T4, T3, T2, T1 and calcitonin. If you take synthroid it is a storage hormone. If you can't convert to T3 you will not get rid of your symptoms but your labs may come back normal. I tried the levoxyl and cytomel combo and got very hyper on it. I can't tell you the world of difference I felt on Armour. Endo's don't generally prescribe it. Bad stuff is being said about it by pharmaceutical reps. Synthroid is who sponsors many of the the endocrinology conferences. TSH is the gold standard too. Just know that your doctor may not treat by symptoms and may not use Armour. If you don't begin to feel better just know there are options. I suffered for 15 LONG years and would love to help someone avoid that...I have told my brother all of this and he continues to feel bad and not try something different(TSH=96, antibodies=924). It takes a lot of work to get what you need. You have to be willing to change doctors until you find one that will help. Audrey is right that doctors have to be careful. The gold standard is to keep TSH in range. The medical board could come down on doctor for prescribing meds to someone subclinical (TSH normal but all the symptoms). This way of treating is how it needs to be but not taught that way in school. Sometimes calling a compounding pharmacist can be helpful to get a recommendation of a good hormone doctor. This has helped me get what I need. I have 7-8 books on thyroid, adrenals, iodine. Knowledge is power. Keep reading and asking questions and you will get there. You can feel much better!!!

Audrey, I agree with everything you say...we seem to be reading the same information and are getting what we need. I feel bad for all the sufferers out there. I am a physical therapist and see many patients, especially elderly, struggling with low thyroid symptoms despite being on meds. The TSH standard is not working!!
I second that......... Thanks for starting this thread jlt18 :) I think the anemia section needs a thread like this for those suffering from both thyroid and low iron levels.

My doctor didn't actually explain that hypo can lead to lowered acid levels, which leads to malabsorbtion and lowered body temperature etc etc. My Trichologist and my thyroid doctor only stated that they have seen a lot of ladies with a thyroid condition which accompanied difficult to raise ferretin, as well as digestive issues which particularly concerned digestion of protein. Getting the right amount of protein is important for the thyroid, iron, hair/skin/nails, and the liver, which are the areas i'm familiar with and having problems with.

A lady in a healthfood store guessed that my blood group was type A. She said type A's tend to have less stomach acid for digestive purposes and you need those if you are a meat eater in particular. My current doctor guessed prior to any testing that the majority of my hair loss was due to a form of malnutrition due to the lack of certain vitamins/minerals due to the malabsorbtion issues. He said a lot of people have this and don't know it.

I do know that my hair shedding wouldn't have been solely related to one thing, but taking into consideration the protein issue (as well as my low iron and low iodine) it's likely no wonder i was losing so much hair. It's slowed in the last couple of months, but it has done that in the past during the coldest part of winter and then resumed shedding once the weather hotted up. Very unusual that it stops during winter. Will see what happens once we get into spring. I have had a lot of new growth and my mother says my hair looks like someone took a pair of siccors to it and took a few strands here and there and chopped them off into various lengths. I don't need a hairdresser to layer my hair. It kinda managed to do that all on it's own :D Makes me look a bit wild an woolley at times :D

Not sure if i mentioned it on here or the thyroid board, but a guy i work with had reflux issues and his doctor put him on some prescription enzymes and he said it fixed his reflux issues.

I found learning about anemia much easier than learning about the thyroid as the thyroid encompasses so many other areas and it gets very technical. On the thyroid board i tend to feel like a fish out of water. No matter how much i read i tend to find it hard going. Are any of you on adrenal med's for low or high cortisol levels? I've got low cortisol so am taking medication to help my adrenal fatigue as this also tends to go hand in hand with Hypo. Last night i decided to look up a little more information on the adrenals and refresh my mind on what can go wrong if your Endo has simply stuck you on thyroid meds and not checked out your adrenals and it is SCARY!!!!

Marilla - i'm not sure about Hashi's being in/curable. I think it depends on your doctor, how much he/she knows or is willing to do for you, what situation your thyroid is in at the moment and a heap of other things. I'll be seeing my doctor in about 4 or so weeks time for a new blood test. I'll ask him about some Hashi's success stories.

FLFLOWERGIRL - fingers crossed you get a positive outcome with your test results. I know how VERY important it is and how it's such a BIG thing. I don't think anybody but a fellow sufferer can know just how big a deal it is to have these repeat tests done and how much we pray for an improvement on past results. Be brave and wear that little bandaid with pride once it's over :D
Hi there
I just read Audrey B. posting and wanted to say thanks for all the info. I posted some of what I am about to say somewhere, so if I am repeating I apologize-not to sure if it is on the same board. I have Hashimotos and have had a ferretin of about 4 for almost a year now. Iron supplements do not help. They have done a colonoscopy and endoscopy and stool test and all negative. What I do not understand why my endo, after he found the iron so low (he had gotten my Hash. and thyroid under control as it was underactive) just sent me back to my gp as he says he does not deal with iron issues. When I read your post Audrey, I read so many things that were done with you(iodine issues and tests) to find the problem. It is almost a year, I barely function but yet. it seems not much is done. I think my absorption is ok- not sure-says my saturation is low(not sure if that is different than absorption) my iron, ferritin, RBC and HCT is low. My gp sent me to an oncologist, (this was before I did the colonsocopy and endoscopy)-I did not even really know why, the oncologist said that we have to first do the colonoscopy and endoscopy to see if something is wrong there. The oncologist felt it could not be cancer as I am not loosing weight- she did however say that if the colonoscopy and endoscopy is negative I should come back but now my gastro. first wants to do the camera endoscopy. Meanwhile, I just live with a very low ferritin. I have always been a big meat eater, just thought I should mention that.
Sorry for the venting, just that the fatigue and other issues sometimes get the better of me and any insight or comments will help. THANKS

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