Ferritin/thyroid

[Stellardasher]

Hi!

I just wondered if anyone had any personal experience of what I’ve been going through, or she’s some light whether I’m being unreasonable or not!

history - diagnosed with low b12 in 2019, under active thyroid in 2020, take levothyroxine 125mg pre pregnancy

currently in my second pregnancy, 15 weeks tomorrow and had awful tachycardia in the beginning and felt exhausted. Finally had blood tests uploaded from mid October and shows ferritin as 4, hb as 120.

had a 48 hour ecg and showed heart rate reached 148bpm, often 110bpm but average 85.

thyroid still at 4.2 on 125mg levothyroxine and have antibodies so assuming it’s the auto immune disease.

all of these were loaded to my patient portal, and have been trying to get a doctors appt since Monday, no one will talk to me about them just listed them as normal.

AIBU thinking all of these are probably linked, and that the low Ferritin might be what’s making me feel awful despite HB being ok?!

Any advice would be appreciated, and thinking of complaining to the surgery as keep being dismissed as all these things being ‘normal’ so overreacting, despite the fact I feel terrible!

Ferritin under 30 is supposed to be treated according to nice guidelines, although don’t take at the same time as thyroxine as it affects absorption. I thought thyroxine was supposed to be increased in pregnancy?
Could you speak to your midwife about the ferritin?

You definitely need to up your levothyroxine - speak to GP

And yes that ferritin will make you feel awful especially combined with TSH of 4+

Have you been referred to an endocrinologist? I have an under active thyroid and was referred by my GP as soon as I was pregnant. My understanding is it’s usual practice to increase thyroxine dosage during pregnancy, aiming for TSH of under 2.5 and tested every 4-6 weeks.

No wonder you feel terrible and you’re absolutely not being unreasonable!
The British thyroid foundation has some useful resources - https://www.btf-thyroid.org/Handlers/Download.ashx?IDMF=a55ffa2c-9e4a-40f7-9b7c-19cd0d615b48

Also NICE guidelines - https://cks.nice.org.uk/topics/hypothyroidism/#:~:text=Referral%20to%20an%20endocrinology%20specialist,be%20adjusted%20on%20specialist%20advice).

Go back to your GP and ask why they’re not following these. Good luck and I hope you’re able to get the support you need.

Thank you so much for your response.
I’ve called the Gp every day this week and the receptionist won’t give me an appt as apparently these results are all flagged as ‘normal’. I’ve asked them to leave a message with the GP and hoping they will call me back, but just keep feeling like I’m being dismissed.

think I might try a pharmacist today regarding the ferritin as usually they are very good!

i also had an antibodies test for my thyroid which showed 118 but doctor won’t give an auto immune diagnosis he said it’s irrelevant as treatment is the same.

I just feel so forgotten about and like I’m overreacting which keeps upsetting me!

thank you all for your responses and will keep pushing gp, and give my midwife a call on Monday!

That’s really poor of the receptionist, how dare they refuse you an appointment.

As a pp said, TSH needs to be lower in pregnancy than when not pregnant (and frankly many non pregnant people would feel crap on 4.2 anyway). And that ferritin is absolutely not normal.

Even if your results were totally normal they still should be willing to see you!

If and when you do see a doctor please complain about the receptionist, he/she is wrong medically and should not be gatekeeping in this way.

Does your doctor’s surgery have an email address? Can you email saying you need to see someone as your thyroid levels although “normal” are not ok for pregnancy? Hopefully someone sensible will see it?

As you’ll see from the British Thyroid link a pp posted, it is common to increase thyroxine dose a little immediately on pregnancy even before tests. In your shoes, knowing I was at 4.2, I personally would start taking 150 instead of 125 while I waited to sort a doctor appt. But obviously I am not a doctor and this is your call.

Good luck - I’m cross on your behalf!

If your GP won't see you, given you are pregnant with those levels, especially ferritin. I would rock up at a&e and explain your symptoms. Then you will be seen by an endocrinologist. Your GP should be referring you to one anyway due to the antibodies! Also make a complaint to PALS

This is awful. I can't believe they won't see you. I got prescribed ferrous fumerate with a ferritin of 14! I felt dreadful even though hb was normal. Three weeks in and it's honestly like the sun has come up on my life again.

I have since discovered you can buy the same dosage tablets - 210mg ferrous fumerate (3x daily) - over the counter In chemists. If I were you I'd check the safety in pregnancy issue and then just buy some. If you are asked why you need them you can tell them your ferritin level, but i wasnt asked. Don't bother with the iron they keep with the multivitamins on the shop floor - it won't even touch the sides.

I am also hypothyroid and on 125 levothyroxine. If my tsh goes over 4 I feel tired. I'd get the iron sorted and then walk into the surgery and insist the receptionist makes you an appointment. It's appalling that they don't recognise that you need to adjust the dosage in pregnancy.

I feel so cross on your behalf! It’s outrageous that they won’t offer you an appointment. Please don’t doubt yourself - you’re not overreacting at all. I would speak to your midwife to see if they can offer any advice, and find out how to raise a complaint with your GP. I would also consider a PP’s advice to go to A&E if you can’t make any progress. So sorry you’re going through this.