Hypothyroidism? Hair Loss? Fatigue? Heavy Periods? Check Your Iron

Hypothyroidism & Iron Deficiency

Iron. I’ve been interesting in including an article all about iron and hypothyroidism for some time, but I didn’t want just any article. I wanted the perfect one.

The metabolism of thyroid hormones and iron are inter-dependent. Iron deficiency can produce hypothyroidism and vice versa. This is so important, yet often missed, in the treatment of hypothyroidism. Why isn’t every single person, and I mean EVERY single person, with hypothyroidism given iron testing? The treatment of hypothyroidism by conventional medicine, and all it misses, really baffles me.

Written by Dr. Jolene Brighten, ND

Hypothyroidism & Iron Deficiency + 4 Steps to Boost Iron

Hypothyroidism and iron deficiency have more in common than you might think. From fatigue to hair loss, these two conditions can not only make you feel miserable. They are also intimately tied when it comes to your health. Here’s what you need to know about hypothyroidism and how to raise iron levels.

What is Hypothyroidism?

Hypothyroidism is a condition in which you either don’t make enough thyroid hormone, you don’t convert it into its active form (T3) or you are not using it at the cellular level. That’s right, it’s not just about how well the thyroid itself functions.

Common Symptoms of Hypothyroidism

Symptoms of hypothyroidism includes fatigue, hair loss, cold intolerance, dry skin, depression, anxiety, constipation, and joint pain—to name a few. Similarly, women who are suffering from iron deficiency experience fatigue, can feel chilled, and experience hair loss. They may also experience restless leg syndrome, anxiety, and irregular heart beats.

In America, the majority of cases of hypothyroidism are due to an autoimmune condition known as Hashimoto’s thyroiditis. It’s quite common in women and risk for developing the condition increases with age.

When there is adequate T3 available to the cells in the stomach they produce hydrochloric acid (HCl), which helps in breaking down food and liberating nutrients for absorption. Without adequate stomach acid your body is unable to access the iron stores in the food you eat.

Your gut and thyroid are intimately connected!

Unless your doctor is monitoring your Free T3, odds are you are among the many women without adequate T3, stomach acid or iron. Add that on top of the average 10-15 mg iron that may be lost during menses and you can find yourself iron deficient pretty quickly.

What’s worse is iron deficiency anemia makes periods heavier!

That’s why checking iron status is at the top of the list in women who have heavy periods, fatigue, hypothyroidism, or hair loss.

Testing for Iron Deficiency

I recommend 2 baseline tests: CBC and Ferritin.

CBC is an abbreviation for a complete blood count. It tells us what your white blood cells and red blood cells look like. A red blood cell that is small or a low hemoglobin or hematocrit are signs of iron deficiency.

Ferritin is the storage form of iron. I like to think of it as the savings account. Your red blood cells are the checking account and they are out spending iron. In women, we want to see that number above 50, but closer to the 70-90 range is ideal.

Hypothyroidism & Iron Deficiency? 4 Steps How to Raise Iron Levels

Test! Don’t Guess!

Getting your levels tested will help you understand your risk and if supplementation is necessary. Ask your doctor for a CBC and ferritin.

Your entire supply of red blood cells is completely replaced in about 4 months. This means that if you haven’t had these labs checked in the last 4 months and you are experiencing symptoms, it is time to see what your blood cells can tell you.

A complete thyroid panel, including TSH, free T4, free T3, anti-TPO, anti-Thyroglobulin, and Reverse T3, are necessary to understand your thyroid health.

Dial in Digestion.

There is definitely some testing to be done in this category. If you have hypothyroidism then I definitely recommend reading up on SIBO and talking to your doc about testing. The majority of hypothyroid women in my clinic are positive for SIBO when we test. Read more about my approach to SIBO here.

As I mentioned above, you must have adequate T3 hormone to have a healthy functioning gut. Thorough testing of both your thyroid and your gut are needed to put your symptoms into remission.

In the meantime, start by chewing your food really well. Like 30+ chews before you swallow kind of well. I know it sounds extreme, but this level of chewing will not only get your gut primed to do its job, it’ll also break down more of your food so your gut doesn’t have to work so hard.

For many women, the addition of hydrochloric acid supplements and digestive enzymes will improve iron absorption and support overall better digestive health.

Note: If you’re taking PPIs or oral contraceptives, you are inhibiting your ability to absorb iron.

Increase Dietary Iron.

Sure spinach is full of iron, but you won’t be absorbing much of that if you don’t have adequate stomach acid. The iron found in leafy greens is not as bioavailable (meaning you can’t actually absorb it) as well as what is called heme sources of iron, which includes beef, chicken, pork, bison, venison and other meats.

Does this mean you shouldn’t bother trying to get iron from vegetables? Far from it!

Vegetables contain so much goodness beyond just iron that there is no way we can skip these in our diet. Instead, try combining your leafy greens with citrus, peppers and other vitamin C containing foods. Vitamin C enhances the absorption of iron so it is great to pair with any iron containing food.

Add some acid while you’re at it! Apple cider vinegar, balsamic vinegar and lemon juice can help start the digestive process going when it comes to make those mineral available to your gut for absorption.

In my clinical experience, I haven’t seen anything raise iron stores quite like liver. Eating grass fed, organic liver, beef heart and bone marrow are mega iron boosting foods. I like mixing ground beef heart with ground beef for some nutrient dense burgers.

In women who have heavy periods and are iron deficient we get them going on both an iron rich diet and supplementation due to the increased risk for anemia.

Supplement Wisely.

Iron sulfate at 325 mg daily is the most common prescription for women with iron deficiency anemia. Not all iron is equal and that iron sulfate your conventional practitioner recommended is not only highly absorbable (read – you poop most of it out), but it is terribly hard on your digestive tract—like not pooping for a few days kind of hard.

Instead, I recommend women take a form of iron called bisglycinate. This form is non-constipating, which is good news since that can be a key issue with hypothyroidism. It is also highly absorbable and won’t make you feel nauseous when you take it. This is also why it is commonly recommended for pregnant and breastfeeding women.

In patients who are struggling to increase their iron levels, I often recommend 1 capsule daily of iron bisglycinate along with a vitamin C supplement to enhance absorption.

Wait at least three to four hours after taking your thyroid hormone replacement medication before taking your iron supplement. Iron can interfere with the absorption of thyroid medication if taken too close together in time.

Although iron deficiency can be quite common in women with hypothyroidism, it is treatable and reversible!

Have you struggled with iron deficiency anemia? Share your experience in the comments.

About Dr. Jolene Brighten, ND

Dr. Jolene Brighten is a licensed Functional Medicine Naturopathic Doctor, best selling author of the book Healing Your Body Naturally After Childbirth, speaker, and mother with a practice in Portland, Oregon. Dr. Brighten specializes in women’s health, from fertility to postpartum care, adrenal and thyroid support, autoimmune conditions, and digestive disorders. In her patient centered practice, Dr. Brighten thrives on navigating the space between conventional and alternative medicine, all while working with patients to help them achieve optimum balance, health, and happiness.

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About Dana Trentini

I founded Hypothyroid Mom October 2012 in memory of the unborn baby I lost to hypothyroidism. Hypothyroid Mom is for informational purposes only and should not be considered a substitute for consulting your physician regarding medical advice pertaining to your health. Hypothyroid Mom includes affiliate links to favorite resources including the Amazon Services LLC Associates Program. Connect with me on Google+


  1. I have hypothyroidism, I was feeling horrible fatigue years after the diagnosis. They sent me to a endocrinologist. He was very rude, because I look young. Test came back as border line anemia, and vitamin D deficiency. Wish their were clear answers, so hard to know how to treat this to get my energy back. My energy seems to fluctuate up and down.

  2. Is there combined pill for this illness?

  3. I have high ferritin level of high 400and my simple iron level was 35.14, my UIBC is258.
    How ever my PC doctor wants me to take an iron supplement??

  4. I was diagnosed with hypo at age 16, I am now 35 and have been taking 300mcg of iron supplements for almost 4 years. At the time I thought my thyroid was out of whack, but it ended up my iron deficiency caused my shortness of breath, legs cramps, tired, headaches. I starting feeling great with the iron supplements, now to get my thyroid back on track as well.

  5. Mary Simpson says:

    My mother, hypothyroid has anemia due to red blood cells not generating efficiently. I was to iron supplements do not help with this type of anemia and her numbers werent’ low enough to warrant a transfusion. What can be done about this?

  6. I am enjoyIng a vegan diet and eat a large box of organic veg And fruit weekly.
    Along with all the necessities …nuts and beans.
    I eat lots a of colours.

    How Can I improve my “ just ok” levels ….without taking thyroxine? Would love to improve my heAlth without it.
    My temp. Is low.. and so is my energy.

  7. 76 yr old ,take 112 thyroxine day. Tired, short of breath and heart beats fast when take shower. Temp runs 96.9. Was anemic when younger. Do you think iron would help me?

  8. 54 with Hashimoto’s. I was tested & iron (ferritan) was super low. Dr explained this was part of the reason for my incredible hair loss. I was told to take OptiFerin-C along with a slew of other supplements. Hoping to avoid HRT but not sure if it is possible. I am so fed up with feeling so damn crappy. Is it possible to get well? Have you cured your hypothyroidism?

  9. Hello All, I’m one of the rare men with Hashimoto’s. Glad I found this site!
    My Dr. was open minded enough to switch me to Nature Throid but still won’t check FT3 levels. I’m feeling very hypo and I’ve decided to order my own Tests thru True Health Labs as recommended on this site. Placed my order yesterday. How long does it usually take for True Health Labs to process orders and issue Lab paperwork?
    Thanks in advance!

  10. Hello All,
    I am also suffering from hypothryoid since 2005 and still not feeling well. I have tried all the HRT(currently on Nature Thyroid) still feel crappy, losing hair, heavy period, constipated, gaining weight e.t.c

  11. Please advise me. I would appreciate it.

  12. My rock bottom ferritin has been a real problem. I’ve fixed reverse T3, added vitamin C and ferrous biglycinate, added undefatted desiccated liver pills, all of that and have barely gotten from a ferritin of 11 to 25. My doctor seems to think it’s my gut causing absorption issues as I also have fairly low T4 despite being on 2 grains of NDT (plus cytomel), so now I’m gathering info and planning to do a couple of months of gut healing diet to see if I can get somewhere. On to reading that linked SIBO article!

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