Functional Medicine Research with Dr. Nikolas Hedberg, DC - The Ferritin Level Test

The Ferritin Level Test

09/21/16 • 16 min

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Functional Medicine Research with Dr. Nikolas Hedberg, DC

The ferritin test may be the most important blood test you ever get, especially if you have a thyroid problem. When I began my training in the diagnosis and management of internal disorders immediately after graduation, one of the first things we studied heavily was blood chemistry analysis. My teachers always stressed the importance of taking a careful look at iron levels in the blood and a rare test known as the ferritin test. What is ferritin? Ferritin is an iron-containing protein and is the primary form of iron stored inside your cells. Even though there is a small amount of ferritin released into your bloodstream, it is an accurate marker of how much iron is actually stored in your body. Iron is primarily stored in your liver, muscles, spleen and bone marrow but if you have too much it can accumulate in your organs and the brain. You either have too much iron, too little or just the right balance in your body and the ferritin test can give us an excellent picture of how much iron is actually stored in your body. Iron is found in your red blood cells but it also accumulates in your organs and tissues. Iron is important for healthy oxygen transport throughout your body so you can see how vital it really is for your health. Too little iron will result in anemia which basically means that your red blood cells cannot carry enough oxygen to your cells and you start to develop signs of oxygen deficiency. Signs of anemia include: Weakness Dizziness Headaches Pale skin Fatigue Low body temperature Memory loss Hair loss Poor brain function Hypothyroidism Adrenal fatigue Spoon-shaped finger and toenails Smooth tongue Burning sensation in the tongue Sores at the corners of the mouth Dry skin Shortness of breath Ringing in the ears (tinnitus) Leg pains Chest pain Pica (cravings for specific substances, such as licorice, chalk, dirt, or clay) Too much iron can have the opposite effect because iron creates a lot of oxidative stress which is basically too many free radicals that create inflammation. These free radicals eat up your antioxidants like vitamin C and E creating deficiencies. Menstruating females lose a small amount of iron every month during their cycle so they tend not to build up too much iron in their bodies. However, iron levels can get too low when your diet is deficient in iron and you have absorption issues due to things like gluten and gut infections. I tend to see low ferritin levels quite a bit in chronically-ill women who are still cycling but it is also common in postmenopausal women who never restored their iron levels before entering menopause. Since men do not have a menstrual cycle, we are the most at risk for accumulating iron. As iron builds-up in a man’s body he may develop the following symptoms as it accumulates in the brain and other body tissues (most of these also apply to women): Brain fog Fatigue Low sex drive and erectile dysfunction (iron accumulates in the testicles) Mood swings, especially anger Digestive problems as iron builds-up in the gut Anxiety Depression Fatigue after meals (insulin resistance) Memory loss Joint pain Weight loss Abdominal pain Hair loss Congestive heart failure Iron is extremely “heavy” in the bloodstream so it forces the heart to work harder as it pumps this heavy metal through your blood vessels resulting in blood pressure changes and more inflammation in your arteries. This is where the ferritin test is so important because it can tell us if there is too much or too little iron in your body. It’s a simple blood test but rarely ordered during general check-ups and standard blood panels however I believe it is one of the most important and overlooked tests in medicine today. This is why I include it in every patient’s blood panel even if it was normal within the last year.

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The Thyroid Adrenal Pancreas Axis

The thyroid-adrenal-pancreas axis is one of the most important connections in understanding and healing your thyroid. In addition to gastrointestinal and blood sugar disorders, adrenal gland dysfunction is one of the most commonly seen imbalance in today’s society. Adrenal gland imbalances are also one of the major factors that cause thyroid hormone imbalance. Stress from work, relationships, electronics, poor diet choices such as consumption of refined carbohydrates and trans fats, infections, and environmental toxins all contribute to adrenal disorders. Let's discuss the thyroid-adrenal-pancreas axis in detail so you can understand this complex connection The Adrenal Glands The adrenal glands are about the size of a walnut and lie on top of the kidneys. The outer adrenal cortex comprises eighty percent of the gland and produces many hormones including cortisol and DHEA from cholesterol. Ninety percent of the cholesterol in the body is made by the liver and only ten percent comes from the diet. Cholesterol converts into the hormone pregnenolone in the adrenal cortex which then converts to cortisol, the stress hormone, or DHEA, the sex hormone source, immune enhancer and anabolic. Cortisol is our “fight or flight” stress hormone. Cortisol slows down digestion, suppresses immune function and raises blood sugar as a survival mechanism when we are under stress. The problem arises when this becomes chronic and over time, elevated cortisol will tear down your body. Cortisol is secreted on a circadian rhythm with highest production in the morning that slowly tapers off as the day progresses. Sleep is when our bodies repair and rejuvenate but high cortisol during sleep will prevent this from happening. Hormones Secreted by the Adrenal Glands DHEA DHEA (dehydroepiandrosterone) is a precursor to estrogens, progesterone and testosterone. DHEA is extremely important for immune system function and anabolic (building up) processes in the body. DHEA levels begin to decline after age thirty-five but cortisol can remain elevated during continuing periods of stress. Low DHEA levels are also found in diseases such as multiple sclerosis, cancer, fibromyalgia, lupus, rheumatoid arthritis, Crohn’s, ulcerative colitis and of course, thyroid disorders. The inner medulla produces adrenalin and noradrenalin also known as norepinephrine and epinephrine. The cortex is under the control of hormones produced in the brain and the medulla is under the control of the nervous system. Healthy adrenal glands are vital for women who are peri- and post-menopausal. The adrenal glands are responsible for producing the majority of sex hormones in a menopausal woman once the ovaries stop functioning. If the adrenal glands are fatigued and not ready for menopause, there will be an exaggeration of menopausal symptoms such as hot flashes, weight gain, sleep problems, bone loss, mood swings, depression, anxiety, loss of sex drive and vaginal dryness. Healthy adrenals ensure an easy transition into menopause and beyond. A vast majority of the women I see in practice approach menopause with adrenal imbalances leading to severe menopausal symptoms and hormone dysfunction. Aldosterone Aldosterone is produced by the cortex and causes sodium absorption and potassium excretion. Low salt diets and high water intake put a major stress on the adrenal glands to retain as much salt as possible as the blood becomes more diluted from the extra water intake. One of the easiest ways to maintain healthy adrenals is to consume a half- teaspoon of unrefined celtic sea salt every morning with a few glasses of water. It’s important to consume half of your bodyweight in ounces of water every day but it must be balanced with salt to remove stress from the adrenal glands. Cortisol Cortisol is also produced by the cortex which increases blood sugar when it is low or if the body is under stress. Cortisol will cause glucose production in the liver or...

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The Gut Thyroid Connection

The gut-thyroid connection is one of the most important and overlooked aspects of healthy thyroid function. Did you know that many diseases can be traced to a breakdown in the gastrointestinal tract? 70 percent of your immune system resides in this area - your gut, and the GI tract has many important functions for your health including digestion, nutrient absorption, elimination, detoxification, hormone metabolism and energy production. 99% of the neurotransmitters in your body are actually created in the intestine (part of your GI tract), and every brain chemical known as a neurotransmitter is found there. This means the GI tract, or gut, plays a very important role in achieving optimal thyroid health. For proper thyroid function, your body must convert T4 into the more active T3 and 20% of this happens in your intestines. In order for this conversion to happen, healthy colonies of beneficial bacteria must be present in the GI tract. An imbalance in the bacteria ratio (of good vs. bad) in the GI tract (dysbiosis) can lead to low thyroid function. This explains why so many patients with thyroid hormone imbalance also have digestive problems but normal thyroid blood chemistry panels. Why do people get Gut Problems? One of the most important things to look at is how many rounds of antibiotics you have taken in your life. The more antibiotics you have taken, the more likely you are to have abnormal gut bacteria as well as yeast overgrowth and parasites. Antibiotics can cause an imbalance in your gut bacteria for up to 13 months after just a single round of antibiotics. Additionally, antibiotics change the DNA of your bacteria which makes some of them more resistant to antibiotics. Stress also causes gut problems because it decreases stomach acid production, bile flow and pancreatic enzyme production. This will significantly impair your ability to digest and absorb your vitamins and minerals as well as protein, healthy fats and right carbohydrates. This will even decrease your absorption of prescription thyroid hormone. Poor dietary choices and food sensitivities are another big factor both of which create inflammation that damages your GI tract. Sugar and processed carbohydrates are like fast food to your gut bacteria which causes them to grow out of balance. Food sensitivities such as gluten, dairy, eggs, soy and peanuts to name the top five, create inflammation and will also spike your blood sugar too much. Additional problems can be created by antacid medications called proton pump inhibitors. They shut down your acid production which is extremely vital for a healthy gut. Birth control pills also cause gut problems because they deplete your body of important nutrients for the gut such as folic acid. Eating to fast or "eating on the run" is common in our society today which is an additional stress to your gut. You should be in a relaxed state focused only on your meal and refrain from reading, texting, watching TV etc. Alcohol and caffeine in excess further stress the GI tract. How to Determine if You Have a Digestive Problem If you are having digestive problems, there is a good chance that it is affecting your thyroid function. Bloating after meals, gas, cramping, loose stools, constipation, burping, heartburn, and inconsistent stool formation can all be signs of a digestive problem. You can begin to see if you have digestive problems by doing an easy test at home. This is known as the transit time test. Performing the Transit Time Test Food should pass through your intestines in 18-24 hours. If it takes longer than twenty-four hours, there is something wrong with your digestive tract. This easy to do test can be done at home to measure food transit time. Purchase a product called “activated charcoal” which is an inert substance that will turn your stool black or dark gray. Swallow four capsules with a meal and write down the day and time that you take the capsules.