Low Ferritin & Hypothyroidism - Chicken and An Egg

Understanding the Correlation Between Low Ferritin Levels and Hypothyroidism

Low Ferritin and Hypothyroid - Is This A Chicken And An Egg Situation?

It is not uncommon to see a hypothyroid case alongside anemia, and anemia to lead to slow thyroid function. So what was first? In the complex landscape of endocrine health, the relationship between iron metabolism and thyroid function is getting an important attention in my practice.

In this blog post, we will explore the scientific data behind this correlation, including case studies and examples that illustrate the significance of ferritin in maintaining optimal thyroid function.

Low Ferritin Is A Marker Of Anemia

What is Ferritin?

Ferritin, a blood protein that contains iron, plays a crucial role in thyroid hormone synthesis. Ferritin serves as the primary intracellular iron storage protein, releasing iron in a controlled manner. It is found in various tissues, including the liver, spleen, and bone marrow, and is a critical component of our body's iron metabolism. Low ferritin levels often indicate iron deficiency, which can have wide-ranging effects on overall health, including thyroid function. Think of ferritin as a cab for your iron, where iron cannot move freely around the body without a cab. If ferritin is low organs crucial for the survival of your body are deprived of oxygen and energy.

The Role of Ferritin in Thyroid Health

Thyroid tissue produces hormones to control the speed of all of the bodily functions. In order to create these hormones we need vitamins, minerals, proteins and enzymes.

One such enzyme, Thyroid peroxidase (TPO) is an essential enzyme involved in the synthesis of thyroid hormones, such as thyroxine (T4) and triiodothyronine (T3). TPO catalyzes the iodination of tyrosine residues in thyroglobulin, a precursor to thyroid hormones - in simple terms, it mixes the ingredients together to craft the thyroid hormones. For TPO to function efficiently, adequate iron levels are necessary. Ferritin, as a marker of iron storage, is directly linked to the availability of iron for TPO activity. In every case of low ferritin we will see a decline in TPO enzyme function, hence a reduction in thyroid hormones being created.

Scientific Evidence

Several studies have demonstrated the relationship between low ferritin levels and impaired thyroid function:

1. Ferritin and TPO Activity:
   

• Study 1: A study published in the journal Thyroid found that individuals with low ferritin levels had significantly reduced TPO activity, leading to decreased thyroid hormone production. The study concluded that iron deficiency, indicated by low ferritin, could contribute to the development of hypothyroidism.

1. Iron Deficiency and Hypothyroidism:
   

• Study 2: Another study published in the Journal of Clinical Endocrinology & Metabolism observed that iron supplementation in iron-deficient women improved thyroid hormone levels, particularly in those with subclinical hypothyroidism. This suggests that addressing iron deficiency can positively impact thyroid function.

1. Hypothyroidism and Anemia:

• Study 3: A study in the American Journal of Medicine found that patients with hypothyroidism often present with anemia and low ferritin levels. The researchers noted that thyroid hormone replacement therapy improved both thyroid function and anemia, highlighting the interconnectedness of these conditions.

Hair Loss, Anemia and Hypothyroidism

Client Story: Low Ferritin and Hypothyroidism

Sarah came to see me for the first time early this year with a major compliant of severe hair loss. She used to get praised on her lush and long hair since high school, it was her pride. And about a year ago her hairdresser stressed to Sarah that she is losing too much hair and recommenced she gets a visit to a naturopath. When the situation became quite dramatic and Sarah was pulling hair out by just gently touching it with her hand she was at my online appointment.

Sarah was 45 years of age at the time, and also presented with the symptoms of fatigue, weight gain, heavy menstruation, and cold intolerance.

We did a thorough blood test to know exactly what we are working with and to leave the "guess work" out. Some of her laboratory tests revealed the following results on the thyroid and ovarian function alongside iron studies:

• Thyroid Function Tests:

• TSH: 6.0 mIU/L (Elevated)

• Free T4: 12 ng/dL (Low)

• Iron Studies:

• Ferritin: 10 ng/mL (Low)

• Iron: 6 g/dL (Anemia)

• Hemoglobin: 112 g/dL (Anemia)

• Sex Hormones:

• Estrogen: 360 pmol/L (day 21 of cycle, estrogen dominance)

• Progesterone: 4 ng/mL (day 21 of cycle, estrogen dominance)

That day Sarah was diagnosed with subclinical hypothyroidism, perimenopause and iron deficiency. We not only found out that she was depleted in crucial nutrients but also the reason why. Sarah's body was in perimenopause, which often leads to significant estrogen increase and progesterone decrease causing substantial blood loss during menstrual bleeding.

We started her treatment with nutrients essential to address blood loss and hormonal imbalance, for healthy thyroid function, and iron supplementation. I've given Sarah specific herbs to take daily to support her endocrine organs. And she received specific dietary recommendations to support the nutrient deficiencies and improve the absorption rate.

Over the course of six months, Sarah's TSH levels normalized (TSH: 1,2 mlU/L), her ferritin levels increased to 50 ng/mL, and her estrogen (210 pmol/L) and progesterone (23 ng/mL) were now balanced.

Shara noticed improve energy levels and lifted brain fog, her cycle was now regular and light again. Her hairdresser noticed new baby hairs, which she was excited to tell Sarah about.

This case illustrates how addressing low ferritin levels can play a crucial role in managing thyroid dysfunction and alleviating symptoms of hypothyroidism.

Do you want similar results, and individualized approach to your pathology analysis and treatment? You can book your appointment with me here.

Scientific Reaseach On Thyroid Function and Iron Studies

Empirical Data and Statistics

• Prevalence of Low Ferritin in Hypothyroidism:

• Approximately 30% of individuals with hypothyroidism exhibit low ferritin levels, which can exacerbate symptoms and hinder treatment efficacy.

• Impact of Iron Supplementation:

• Iron supplementation in iron-deficient hypothyroid patients has been shown to improve thyroid hormone levels in 60-70% of cases.

• Gender Differences:

• Women are more likely to experience low ferritin and hypothyroidism concurrently, particularly during reproductive years, due to menstrual blood loss and increased iron requirements.

The Interplay Between Ferritin and TPO

Ferritin's role in thyroid health extends beyond just being a marker of iron stores. It is directly linked to the functionality of TPO:

• Enzyme Efficiency:

• Adequate ferritin levels ensure sufficient iron availability for TPO, facilitating the iodination process crucial for thyroid hormone synthesis.

• Autoimmune Considerations:

• Low ferritin levels may exacerbate autoimmune thyroiditis, such as Hashimoto's thyroiditis, by impairing TPO activity and triggering increased thyroid antibody production.

We can now see that in some cases iron is at the base of thyroid dysfunction, and in other cases lack of iron further hinders poor thyroid hormone production, at times impacting autoimmune conditions like Hashimoto's thyroiditis.

What to do next?

If you suspect you have anemia and/or thyroid dysfunction, it is important you:

1. Perform thorough Iron studies, Thyroid function test, and hormone and inflammation blood tests. If you are unsure what tests you need, please email me on info@valtality.com.au or book a FREE 15 minute discovery call to discuss your individual case.

2. Discuss your blood results with a health care provider (or myself), to understand your Optimal range, not the general reference range.

3. Use dietary changes recommended by your health care provider to support your condition and lead you to health.

4. Use adequate therapeutic grade supplementation prescribed by your practitioner to speed up your results by 3 fold.

5. Monitor your health markers at 3 and 6 month intervals to assess the effectiveness of treatment and adjust accordingly.

References:

• Zimmermann, M. B., & Kohrle, J. (2002). The impact of iron and selenium deficiencies on iodine and thyroid metabolism: biochemistry and relevance to public health. Thyroid.

• Hess, S. Y., & Zimmermann, M. B. (2004). The effect of micronutrient deficiencies on iodine nutrition and thyroid metabolism. International Journal for Vitamin and Nutrition Research.

• Dabbaghmanesh, M. H., et al. (2011). Iron status in women with and without thyroid peroxidase antibodies: effects of iron supplementation on thyroid autoantibody levels in iron-deficient Iranian women. Thyroid.