Underactive thyroid and low iron levels - advice please

[veneeroftheweek]

I've been on 50 mcg of thyroxine for several years but have been feeling really wiped out for a while so I went to the doctor and had a range of blood tests done. I haven't seen the full results yet (will collect next week) but I've been told that I need to increase my thyroxine to 100mcg and take iron tablets.

I've had issues with iron tablets and constipation in the past, so I'm keen to incorporate as much iron as I can into my diet. I don't eat red meat and, although the advice I've read is rather conflicting, it seems that lots of the iron rich vegetables are a bit of a no-no if you have a thyroid issue.
I was thinking that I could get a nutribullet and have a shake with kale, fruit etc but it seems that uncooked veg are worse than cooked.

Any advice about incorporating iron rich veg into your diet with an underactive thyroid? Has anyone managed a similar issue? I desperately want to feel better!

Unfortunately veg aren't a great way to up your iron intake, as you've realised. Spinach, for instance, contains oxalic acid which blocks iron uptake, and you can usually only absorb 2 to 20 percent of the non-heme iron contained in plant foods.

It's worth bearing in mind as well that if you drink tea or coffee, both can severely limit your iron absorption, as can dairy and eggs.

I can't take iron tablets - they give me awful bowel problems. Instead, I have a cup of blackstrap molasses every morning which is rich in iron, and I try to eat plenty of black pudding as well.

Probably not what you wanted to hear, but there you go!

Ferrous fumarate - instead of ferrous sulphate - is well tolerated by most people.

As said above, good advice.

My issue was awful diarrhoea with tablets and I started loosing weight.

I stopped the tablets and gave up milk too (I'd noticed it was worse) and in a month my iron had gone hugely up. So you could try that. (Just milk and soft dairy, hard cheese is fine).

I ate rare venison once a week too (cheaper and nicer than steak at our local butcher) and lots of iron rich foods. Surprisingly quinoa is high in iron though meat is best.

You could try spatone water which is iron rich but the tablets are much higher amounts really.

Also, don't take iron within 4 hours of the thyroxine and vice versa. Nor anything high in calcium near either!

Calcium blocks absorption of both.

Vit c / orange Juice helps absorption of iron.

What was your tsh out of interest? It's well worth keeping a record.

And don't worry too much about the thyroid vegetables either, but as said, they're not going to be as good as meat.

I have a similar problem and the only way I've found to take extra iron without it either interfering with my thyroxine or causing an upset stomach is holland and Barrett "ultra woman" tablets. They have 17mg of iron in them as opposed to the rda usual of 14 and they have tons of extra b and c vitamins in them to help to absorb iron better from this and other sources. I've been on them a while now and feel a lot better. (I am so anaemic when I had my dd I had to have daily iron injections!)

Lots of good advice. Thank you. When I collected my prescription I was glad to see it was ferrous fumerate, which I've not tried before, so I'm hoping this might be easier to tolerate. I've ordered some blackstrap molasses and dried apricots for next supermarket delivery.

What I'm not sure about, is that I need to take the iron twice a day and the thyroxine in the morning on an empty stomach, obviously. How long can I leave after taking the thyroxine and before taking the iron? I don't want one to cancel the other out. Any ideas?

I haven't got the full blood results yet. I just got a call from the surgery telling me to go and collect the tablets. I'm going to pop back for full results next week.

Fairylea - sounds like you had it really badly. I'll investigate those tablets too.

4 hours is recommended, or you could switch to thyroxine last thing at night?

I've read about the thyroxine at night thing, but I don't have an empty stomach then. Does it matter?

To be honest the main thing is consistency- some find they can put it into bedtime routine better e.g. Eat around 8, thyroxine around 9:30/10 but I snack too much! Food only affected it slightly but it could be significant for some of their tsh is on the slightly higher side already.

I think a study found it slightly better at night but as I said it's consistency that is the key thing.

I've never got on with it at bedtime as I would forget if too tired.

I took thyroxine first thing around 7, then iron after 11 with half a Sainsbury's berroca (but at least 30 mins or more away from food either way, and again either in the later afternoon or evening.

I then took calcium and magnesium at bedtime when I was bf and t help me sleep ( not sure if helped or not!)

If you keep being anaemic and there is no explanation (diet, heavy periods etc) I would push for further tests. I was fobbed off for 10 years before it turned out I had celiac disease. This is common in people with low thyroid.

I think I'll try the evening thing. It's definitely worth a try while I'm on the iron. I've read that some people really benefit.

Coeliac is v tough. I have a friend who was so, so ill before it was diagnosed. I suspect in my case it's related to my diet. I don't eat red meat at all and my eating has generally been a bit rubbish recently, partly due to me feeling so sluggish I think. I just haven't had the energy to look after myself as much as I should.

I'm still slightly worried about the veg. Especially as I want to eat better. Do other people avoid things like kale or broccoli because of their thyroid or is the effect minimal as long as it's cooked?

www.btf-thyroid.org/index.php?option=com_content&view=article&id=150&Itemid=214

This was from the btf in 2012, I do think I remember seeing some more info in their magazine more recently but I still don't think it's a massive issue. I think it could be in iodine poor countries possibly?

I can Check that source tomorrow.

Thank you violetsunflower. That's really useful.

Did the link work? I've clicked today and just got a menu.

I just clicked and it worked. Very useful and I've just shared it to a relative who has this condition. Thank you.

It didn't work on the app but did on the regular site.

Ive just been diagnosed a severely anaemic (haemoglobin level of 7) and have been taking the ferrous fumanate tablets 3 times per day. Though I normally react badly to iron tablets these have been fine, no constipation at all. I am a bit windy but the GP said this will settle down in a week or two.

Can't help the black poo though!!

That's good to hear. Are you starting to feel any better?

Sadly the British thyroid foundation are loosing numbers due to other internet sources. When I was first diagnosed they were a fabulous help.

I attended meetings too. They're the charitable wing of the British thyroid association of endocrinologists and over seen by very good endos (their medical advisor is great, treated a friend of mine).

They do give very good info based on current research and are moving towards supporting t3 combo - they reported about trials of a long lasting t3 not so long ago. I find the quarterly magazine very helpful (I'm a member) and you can ring volunteers.

I think you can read previous magazines via the website?

They've been tuning the campaign for better pregnancy care too.

And in that note, the nice guidelines changed last year. If I could post here to get others to share and spread the info!

*running the campaign.

Scroll to bottom of whole page for specific advice.

cks.nice.org.uk/hypothyroidism#!scenario:3

(Sorry to hyjack op!)

I'll dig out another document that may be helpful regarding iron too when I find it.

Feb 2016 magazine from btf:

Seems it's calcium that's more of the issue than iron, 2 hours for iron.

Regarding brassicas, I think in my hazy memory it is to do with iodine deficiency and has been an issue in countries where iodine is very low.

Ironically, dairy (milk, yoghurt) is our main source of iodine then oily fish. So it's worth thinking roughly how you pattern food across the day but not let it rule you!

I think dairy in eve/ night if on thyroxine (morning dose) and iron is the best way to go, also helps you sleep. But just do what works best and be consistent.

Yes I'm starting to feel much better thanks. I was SO tired and SO breathless but I just put it down to being busy and unfit! I feel like tiredness is something we're not supposed to complain about so I left it for ages, then when the bloods were finally done the GP took one look and said "How are you even managing to walk around?"

Glad to hear it's working Hunting. I've noticed that I'm a bit breathless too. I got my blood results today which are a bit of a mystery. I'll post them on a new thread to see if anyone can help me make sense of them. Thanks for all the advice everyone.

Sorry placemarking! I too have under active thyroid and feel permanently exhausted xx