Iron (or the lack of it) is often a problem when it comes to treating low thyroid conditions (the other common one being adrenals). If you add enough thyroid hormone, either Natural or T3, to do any good and the patient's iron levels are too low then they gets lots of nasty intolerance effects and think it can't be thyroid hormone that they need. There is information on iron on this external link.
Instead it's Iron AND thyroid hormone that are needed. The symptoms of low iron are similar to some of the nasty adrenal symptoms that you can get and may well be adrenaline induced. They can include anxiety, panic feelings, and uneven heart beats. These may well be symptoms that the patient already has at lower levels and hence they are surprised when they get worse treating the low thyroid condition.
Iron forms part of the mechanism that transports thyroid hormone into the cells, and lack of it can lead to pooling of thyroid hormone and leave you metabolically hypo even if you have a good level of Free T3 in the blood stream, this is yet another form of resistance to thyroid hormone but has the disadvantage that you can't add more T3 to overcome it as the intolerance symptoms build up
Iron has traditionally been measured in thyroid circles by measuring Ferritin levels (storage iron), experience has shown that if it's below 70 you may well end up with intolerance symptoms. This link is the STTM page on Ferritin and explains why hypo people often end up with low iron., it's not a coincidence, low thyroid makes it hard to hang onto iron, and low iron makes it hard to treat thyroid, a classical "Catch 22" situation.
Recent work has shown that there are circumstances where Ferritin can be at a good level and yet there is still low iron in the patient. These are mainly because inflammation can cause false highs in Ferritin.
There are other components of the iron panel which can help with this and we now recommend that you get a full iron panel done and post the results in the Yahoo group for interpretation.
Some pointers in addition to Ferritin of 70 to 90 are:-
Saturation % should be between 35% and 45%, if it is lower than 35% you need more iron
Serum Iron should be at least 90
When TIBC and/or UIBC are low, you MUST not take much iron so if you are still low in Ferritin a maximum of 18-27mg daily of elemental iron ONLY should be taken. As long as serum iron and %sat are good you should be able to tolerate thyroid. Possibly slowly raising the thyroid may bring the Ferritin up.
I have put together a separate page on treating iron deficiency
A recent posting on the RT3 list from Val about iron:-
Here is my current iron panel done the beginning of this month, and I will use it as an example of PERFECT iron levels:
Vitamin B12 1094 High pg/mL (211-946)
Iron Saturation 36 % (15-55)
UIBC 165 ug/dL (150-375)
Iron Bind.Cap.(TIBC) 259 ug/dL (250-450)
Ferritin, Serum 90 ng/mL (13-150)
IN the last year I have learned that for HYPOTHYROID people the Ferritin is the LASTS thing we should be looking at as MOST of us it will be falsely elevated due to the inflammation caused by hypo. Mine certainly was as there is no other reason mine came down from 159 to 90 except I am not hypo now. Dr Holtorf says that % sat should be at LEAST 35% and not more than 45%. When that is accomplished, TIBC will be VERY low but not under range. Where MINE is. TIBC and UIBC should be in agreement. BOTH low in range. VERY low in range. While you look at iron panels from the HIGH iron standpoint I look at them from the Hyperthyroid LOW iron standpoint and there is a GREAT difference of opinion between the two standpoints. As folks here and particularly this woman's labs that started this discussion are struggling to get iron UP we need to use the hypo low iron standpoint as a gauge. A little HIGH for her, is a good thing, a little low, even a TAD low is not.
There is more on this on the adrenals group web site iron page