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Hashimoto’s Thyroiditis: Is Ferritin a Reliable Biomarker for Issues?

re: Hashimoto’s Thyroiditis

Elle Russ in The Paleo Thyroid Solution @AMAZON, discusses the role of iron in Hashimoto’s, prompting me to take a look at my numbers. Maybe it’s a red herring, but the number do seem to be low, and to have trended subtantially lower the past two years (see chart below).

Ferritin and Hypothyroidism

Dr. Nikolas Hedberg

The ferritin test is a simple blood test and it is one of the most important tests you should have if you have Hashimoto’s disease, Graves’ disease, and hypothyroidism. Ferritin is a storage form of iron and the ferritin level test can tell you if your iron stores are low and need to be increased. The ferritin test is rarely ordered by conventional doctors so many patients are left with the signs and symptoms of hypothyroidism when it is actually their low ferritin levels that are causing their health problems. The first issue with iron is that iron deficiency may be quite severe but blood markers such as hemoglobin and the red blood cell count may be normal. This leaves many patients, especially women, misdiagnosed as not having anemia.

...Once ferritin gets below 30, this is considered iron deficiency despite the fact that the lower end of the laboratory cut-off range is usually 10-20. However, even the ferritin level can be normal, around 50-100, and the patient may still actually be iron deficient. This makes the diagnosis somewhat tricky in certain cases.

According to Dr. Esa Soppi of the Eira Hospital in Helsinki, Finland, optimal ferritin levels for hypothyroidism are >100 and iron therapy should be continued until symptoms have resolved. He also recommends that the ferritin level should be checked regularly to be sure the levels stay normal.

He also states that if someone has restless leg syndrome and their ferritin is <75, then they should be considered iron deficient.

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.


WIND: my left leg in particular has driven me crazy lying in bed, for around two years—maybe that is restless leg syndrome from low Ferritin? It comes and goes. And it goes away by standing up or walking. I had thought it might be related to peripheral neuropathy I had been gifted by doctor malpractice via Metronidazole, but now it seems that iron could be involved.

I don’t know how to interpret my iron levels and/or whether more might be good vs harmful.

Sutter Health, 2022-08-01 @ 08:00:

Ferritin: 69
Hematocrit: 44.66% range 40.0 - 52.0
Hemoglobin: 15.3 g/dL range 13.5 - 18.0

UPDATE, 2023-04-05: my Ferritin has returned to normal range (123).

Ferritin levels
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