Well the rest of the story is that I started taking iron supplements in Dec when I noticed ferritin was 90 and then doubled the dose in early Jan. My Jan results were 226 for ferritin but nothing else was checked. I was off iron for 5 days before these last tests.
I am finishing up a RT3 program and my temps are close to normal again. I hope those labs will be in soon and expect them to confirm this. However, I want to keep RT3 low and need to fix the things that caused it. Low iron can do that so getting those other levels up is important. My concern is that the supplements seemed to have raised my ferritin but the other levels are low. Unfortunately, I don't know what they were prior to this latest report.
Assuming nothing is really wrong with me (likely). How do I best get % Sat and serum iron levels up some so my thyroid works best?
Your somewhat low ferritin serum level may not be a problem at all. Most ferritin (and associated iron) resides in the liver, spleen and bone marrow, not in plasma. Supposing that it is low, it could be secondary to either iron deficiency or to hypothyroidism. There is a positive feedback loop between iron deficiency and hypothyroidism because hypothyroidism reduces iron absorption and low iron interferes with conversion of T4 to the more active T3. None of your levels are really low. They resemble those of my wife who does happen to be on supplemental thyroid.
Low ferritin would not be due to inflammation because it usually rises in response to inflammation or infection and it need not indicate iron deficiency. TIBC normally rises in response to true iron deficiency to make most efficient use of the available iron and your TIBC is not unusually high.
There are good reasons to avoid supplemental iron unless prescribed for diagnosed anemia. Free iron is a pro-oxidant. Ferritin exists at least partly to sequester it. One can reliably increase ferritin by consuming supplemental iron but that may be a defense against iron toxicity. Life-Extension Foundation (LEF.org) concluded that recent news reports of women having shorter lifespans when taking supplements could be explained merely by their consumption of supplemental iron.
I tend toward high ferritin saturation (55%) without supplemental iron and with low intake of red meat. For longevity reasons, I donate a pint of blood every 6-8 weeks and would prefer numbers similar to yours.
It is interesting that you mention RT3 and thyroid function as if that might be your primary concern. RT3 often increases along with a decrease of T4 and T3 under starvation, injury or major infection, a condition called “sick euthyroid syndrome” in which the healthy thyroid does not produce sufficient T4 but the pituitary also does not secrete more TSH to stimulate the thyroid. For those who are not starving or very sick, such “central hypothyroidism” suggests a disorder of the pituitary, hypothalamus, or hypothalamic-pituitary portal circulation.
That only applies to “normal” people. The pituitary detects starvation via circulating insulin level. Muscles absorb glucose in response to insulin or in response to contraction. Exercise-induced hypo-glycemia can inhibit insulin secretion enough to trigger a starvation response in the pituitary. Reduced insulin from a low-carb ketogenic diet can do the same. People who combine exercise with a ketogenic diet can reliably trigger reversible central hypothyroidism.
I did that about ten years ago and discovered it because my physician requested both T4 and TSH assays. They normally move in opposite directions and mine were both below the normal range. Unfortunately, a confirming RT3 assay was not available in those days. Simple resumption of carbohydrate intake restored both T4 and TSH levels.
I only suggest this possibility to you because both exercise and ketogenic diets are popular on this site.
