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6 Signs of Iron Deficiency In Fibromyalgia

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By Jacob Teitelbaum M.D. • • May 20, 2017

6 Signs of Iron Deficiency In Fibromyalgia
Because of iron loss during one's menses, iodine deficiency is especially common in women. In our experience, we find that it is also very common in fibromyalgia.

Optimizing iron levels can have a significant impact on improving how people feel. Here are five signs that you should check the correct iron test, called a ferritin level. Some doctors will consider the ferritin test to be normal if it is over 8. Iron researchers describe using this normal range as being, simply (and this is a quote), "insane."

Most doctors are not familiar with the research showing that the ferritin level needs to be 60 or higher to be optimal. So when your doctor says the test is "normal", that is a pretty meaningless statement. Instead, ask for the actual ferritin result and make sure that it is 60 or higher.

Both iodine and iron are critical for optimal thyroid function. Iron also is critical for making red blood cells.

Here are 5 symptoms that can tip you off that it is time to ask for a ferritin blood test. Basically, I check the ferritin level in everyone with fibromyalgia, also checking a test called an "iron percent saturation" and making sure that that is over 22%.
  1. Fatigue. Iron is critical for making red blood cells, as well as for optimal thyroid function. Even without anemia, suboptimal iron levels are a common cause of fatigue.
  2. Hair loss. Dermatologists at the Cleveland Clinic recommend bringing the ferritin level up over 100 in those with thinning hair.
  3. Unexplained infertility. Ferritin levels under 40 have been shown to be associated with unexplained infertility, with many of these women then getting pregnant as they brought their iron levels up. For a free information sheet on how to optimize fertility, you can email me at
  4. Restless legs. Ferritin levels under 60 have been associated with Restless Leg Syndrome, and you can calm your legs by optimizing iron and magnesium intakes, while also optimizing thyroid and adrenal function.
  5. Cold Intolerance. Iron is critical for temperature regulation. Cold intolerance, along with low body temperatures, are frequently seen from iron deficiency, hypothyroidism, and the hypothalamic dysfunction present in fibromyalgia.
  6. Anemia. By the time you get anemia, the iron deficiency is very severe. In addition, people with fibromyalgia have a decreased blood volume, therefore being anemic despite normal blood counts.

Special considerations in fibromyalgia

Iron is critical for converting the inactive T4 thyroid hormone into the active T3 form. People with fibromyalgia already have trouble doing this, and T3 thyroid deficiency (again despite normal blood tests) is a major problem in fibromyalgia. In fact, proper use of T3 thyroid hormone can dramatically reverse fibromyalgia in a subset of people.

Also, iron is critical for immune function. But this is a double-edged sword. Bacteria also feed on iron, so too much is also unhealthy. So while this is not the case for most supplements, it is important to check iron blood tests (ferritin and iron percent saturation) before supplementing.

Optimizing Iron Levels

Plant-based iron is poorly absorbed, so iron deficiency is an even bigger problem in vegetarians, though common in fibromyalgia in general. On the other hand, too much iron can be toxic. Because of this, iron is a nutrient that I recommend not be supplemented unless one actually checks the blood tests and has a ferritin level under 60 (or an iron percent saturation under 22%). If the ferritin is under 60, I recommend taking 25 - 50 mg of iron along with at least 50 mg of vitamin C (taken at the same time) to boost absorption. I check the ferritin level every 3 - 6 months, and stop the iron when the ferritin is over 60.

 It is normal for iron to turn one's stools black while they are taking it. If it is constipating, add magnesium glycinate 200 - 400 mg a day, which also has dramatic health benefits.

Do not take iron within six hours of taking thyroid hormone, or you will not absorb the thyroid. I generally give iron at bedtime.

Got Fibromyalgia? Checking iron blood testing is critical!

Jacob Teitelbaum, MD, is author of the popular free Phone app "Cures A-Z," and of the best-selling books From Fatigued to Fantastic!, The Fatigue and Fibromyalgia Solution, and Pain Free 1-2-3. He is lead author on 4 studies of effective treatment for fibromyalgia and chronic fatigue syndrome, and a study on effective treatment of autism using NAET. Dr. Teitelbaum does frequent media appearances including Good Morning America, CNN, Fox News Channel, the Dr Oz Show and Oprah & Friends. Web site:

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