Advice

[karenms]

Hi there.  I am confused and need advice.  I have been hypothyroid for many years.  My TSH is not right at the present time.  I have been on a new dose for 1 week.  My Ferritin and Vitamin D are also low.  Do you think that all 3 need to be worked on at the same time, or do I need to work on the thyroid first, and then maybe the D and then the Ferritin.  Also, does anyone know if low ferritin and d can really cause symptoms?  In other words, should I just worry about the thyroid and hope that the ferritin and d will correct itself.  Thank you in advance.  Current labs below:

TSH  4.19   (.45 - 4.5)  (this is before the increase in Synthroid from 100  to 112 mcg.)
Free T3 2.5   (2.3 - 4.2)
Free T4  1.06 (.61-1.76)

Ferritin  10   (10-291)

Vitamin D  25  (32 - 100)

[gimel]

bump

[BobJohnMD]

Your thyroid function tests are essentially normal.  Some endocrinologists like to aim for a TSH closer to 2 because it is associated with decreased morbidity.  This is likely why he chose to increase the dose slightly.

It sounds like you have been feeling tired recently as that's what most of these labs indicate you may have been being worked up for.

A ferritin that low is virtually diagnostic of iron deficiency anemia (if your hemoglobin is also low) although Iron levels and total iron binding capacity are often checked as well.
If you are >50yo, you should have a colonoscopy to screen for cancer as a source of blood loss.  If you are premenepausal (30.  This can be increased w/ sunlight exposure or oral supplementation of vitamin D.  Low vitamin D levels can cause you to feel tired as well.  This is usually more important in postmenopausal women in regards to bone density and osteoporosis.

Your thyroid function seems to be fair, I would work on your Iron deficiency anemia next and worry about the vit D later if it were up to me.

[BobJohnMD]

some of my post was truncated, i was saying if you are premenopausal, this can be related to menstrual blood loss and supplemented w/ oral iron.

Vitamin d levels have been 'in fashion' recently in  medicine and low levels have been associated w/ fatigue, depression and join pains among other things.

[thelma201]

To me your thyroid test looks like TSH is too high, and free's are a litle too low...this can have an effect on iron..B12 too.i had these problems when i was first DX'd...you got a recent increase? see if that helps before jumping into other things :)