Detective work, part II

When last we spoke, I was working with medical professionals to determine the cause of my ongoing fatigue. The neurologist tried many different medications; some worked to a degree, but all had side effects that seemed worse than the fatigue itself. The naturopath had many suggestions for healthier eating, but she was mostly concerned that my thyroid medication was not at an adequate level.

My primary care doctor decided to explore this possibility by checking not just TSH (thyroid stimulating hormone, the usual test used by Kaiser) but also T3 and T4, the separate thyroid hormones. She also grilled me on how I was taking the medication: Was I taking it first thing in the morning?  Yes. On an empty stomach with plenty of water?  Yes. With any other medications?  Why, yes… all of my morning meds were being taken together. Wait… you are taking thyroid medication with iron? That’s not good. Iron inhibits thyroid absorption. Take it at a different time of day. Why are you taking iron supplements, anyway?  I’ve done it for years, because I have always been anemic.

Fast forward one day. My primary care doctor frantically calls me to tell me to stop taking iron supplements immediately. Besides checking my hemoglobin level (which shows how much iron is in your blood; under 12.0 gm/dL, you are considered anemic, and mine came in at 12.9), she also ran a serum ferritin test, which shows how much iron is actually stored in your body. Normal serum ferritin levels for adult women, depending on whom you consult, are between 10 to 200 ng/mL. In the past, I’d had results ranging from 10 to 33.  This time, mine was 896.

This is bad. Iron is a heavy metal, and iron overload can basically damage all your major organs, and your body has NO mechanism to rid itself of extra iron, except blood loss. (This is exactly how I had poisoned myself with iron, by continuing to take a daily iron supplement for eight years after having a hysterectomy.)

And what, you may ask, are the most common early symptoms of iron overload? Fatigue and apathy.

I started giving blood the next day, and over the past three months, I’ve gotten my ferritin level down to about 600. At this rate, it will be months before I am back to normal. Will it be a cure for my apathy and lack of energy? It’s hard to say, but at least it will be one possible cause eliminated!

Public service announcement: Even with all this iron in my body, I am still borderline anemic. So if you are taking iron supplements because of anemia, make sure you get regular serum ferritin tests. Just because you don’t have iron in your blood does not mean you don’t have iron elsewhere in your body!

iron by Harald Link / CC BY

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