Hepcidin, Weight Loss, Thyroid, Ferritin and Iron

January 26, 2015

Hepcidin, Weight Loss, Thyroid, Ferritin, and Iron 

 References: Nemeth Annual Review of Nutrition, Ahmed WJG, Paoletti 

 Are you trying to lose weight and can’t? Think it might be your thyroid?   You feel tired all the time.   Your doctor doesn’t measure your ferritin or your iron.   Is there a link and connection you should know about? Yes! Hepcidin is the link. Ever heard of it? It was discovered in about 2000. It is a peptide hormone that is used to regulate iron. It’s output is increased in inflammatory states.   

When you are overweight, you start out behind the eight ball because fat cells spew out inflammatory markers 24/7.   Serum iron falls due to iron trapping in macrophages and decreased gut absorption.   The protein ferroportin is present in gut cells and it is turned off by hepcidin. If you have severe enough inflammation, you can even become anemic because your body will simply reject any iron.   It’s hard to measure hepcidin, but a C-reactive protein is a pretty good surrogate marker.   Your ferritin is lower in your blood because you just don’t have any iron absorption.   And what is ferritin? It’s your storage form of iron that is inside cells and in blood.   It reflects your total body iron. But it’s function is more basic, it converts the Fe+2 ferrous ion into the F3+3 form which protects your body from the dangerous “Fenton” reaction that creates hydroxyl ions. 

 How does all this fit together? Pretty elegantly.   Iron deficiency promotes fat storage. And the effect of that on your thyroid is slightly indirect but perverse.   Low ferritin and your thyroid doesn’t function as it should. There are some 80 proteins inside the cell that need iron in part of their structure to process the gene signaling that T3 starts.   When you have low ferritin, your iron is low, and your gene signaling will be disrupted. Ironically, if there is severe inflammation, ferritin can be elevated as an “acute phase reactant”, but that would be a red herring in this case. Most of the time, folks with normal TSH and T4 but with all the symptoms of hypothyroidism like being cold, weight gain, lousy hair will have a low ferritin and a modestly high CRP (as a stand-in for the unmeasurable hepcidin.) Does that sound too confusing?   Read Byron Richards summary. He adds some insight into inflammatory diets and yeast overgrowth setting off inflammation. That’s another topic for another day. 

 WWW. What will work for me?   If you want to lose weight, your first step might be to get off of carbs and have lower nutrition for the yeast in your gut. Then, get your ferritin, iron, and CRP checked.   The picture will emerge that you really did need a bit more thyroid.   It may not be any more complicated than that.   And if your doctor won’t allow it, you can always just but the test at “AnyLabTestNow”.   

 Pop Quiz

  1. Hepcidin is your iron-controlling hormone. T or F.                          Answer:  That’s it
  1. It regulates the amount of iron your absorb, store, tuck away or activate? T or F.               Answer:   If this is all you learned, I’m happy.
  1. In response to inflammation, hepcidin goes up, and iron goes down? T or F.           Answer: True. Now you are on a roll
  1. When iron (ferritin) goes down, your thyroid can’t work right. T or F                  Answer:   Bingo. Ready for the bonus round?
  1. So, once you are overweight, your first step should be to turn off inflammation, which tones down hepcidin, which allows iron to rise, which allows your thyroid to work.   T or F.    Answer:    Whew. Now you have got it perfectly.