Disclaimer: I am not a medical doctor and this is not medical advice. My goal is to empower you with information. I will not take a position on whether you should or should not get vaccinated. Please make this decision yourself, consulting sources you trust, including a caring health care professional.
Yesterday, I made the case that post-COVID fatigue, trouble breathing upon exertion, and hair loss could result from dysregulated iron metabolism, and might benefit from both iron supplementation and an approach to reduce lingering inflammation.
On Facebook, Anne Tucker asked, “Is this post-infection or post-injection or both?”
Yesterday's article was about post-infection symptoms, but today we will look at whether the same principles could apply to these symptoms following COVID vaccination.
A search of Open VAERS for such terms as “hair loss,” “fatigue,” and “shortness of breath” reveals about 1300 reports of hair loss, over 100,000 reports of fatigue, and over 30,000 reports of shortness of breath following COVID-19 vaccination.
If these could be a result of iron dysregulation, we would expect to see elevated IL-6 and elevated ferritin following vaccination.
As shown in Supplementary Figure S4 in this paper, the day after the second dose of the Pfizer vaccine, men on average have a 50% elevation of IL-6 while women on average have a near doubling. However, the variation is large: one out of the 36 women tested had a more than quadrupling of IL-6, and a little under half of the women had their increase spread evenly between a doubling and quadrupling.
In 40 health care workers receiving the Astrazeneca vaccine, IL-6 rose 73% in the day or two after vaccination. Again, the variation was large: 75% of the subjects fell between a four-fold range from 3.6 to 12.2 pg/mL. The full range isn't given so we don't know the highest levels reached.
It is unclear how long IL-6 can remain elevated after vaccination. Both of these studies are small, and presumably larger studies would have shown even more variation in IL-6 levels, with smaller numbers of subjects reaching much higher levels.
The third and final paper I found on this topic showed that, 8 to 16 days after vaccination, IL-6 was more elevated with mRNA vaccines than with Astrazeneca, but the average in both cases was less than doubling, and the largest increases in both cases were hardly more than doubled.
This study was also small, with 80 participants, and it also sheds no light on how long the IL-6 remains elevated. However, since it looked at IL-6 after 8-16 days while the other two studies looked at it within the first two days, and since it found a smaller increase in IL-6, a picture begins to emerge where IL-6 could be more sharply elevated in the day or two after vaccination, and could be in its descent, yet still elevated, in the second and third week.
None of these studies look at how vaccination affects serum ferritin.
I could only find the ferritin levels in two case reports where vaccination appeared to cause a flareup of Still's disease, which is a rare autoimmune disorder that causes fever, rash, and arthritis.
The first case is that of a 34-year-old woman who had developed Still's disease at the age of 12 but had been in remission for 14 years until she was vaccinated for COVID. A week after receiving the Astrazeneca vaccine, she developed fever, pain in her muscles and joints, sore throat, chest pain, and a salmon-pink rash on her back. After two days she visited the emergency room.
Her ferritin was wildly elevated at 1,367 mg/dL, yet she was anemic, with a hemoglobin of 11.7 g/dL.
(I am assuming the units for ferritin are mistaken and that this is reported in the usual units, which are, interchangeably, mcg/L or ng/mL as if this were actually mg/dL it would be 13,670,000 ng/mL).
This is very consistent with anemia of chronic disease.
Inflammation locked up her iron in ferritin and made it unusable for hemoglobin synthesis.
High-dose glucocorticoids controlled many of the symptoms, but in less than two weeks they reemerged while her CRP increased from 13.96 mg/dL to 20.53, and her ferritin increased 6-fold to 8,522.
She finally was released and stayed in remission with the addition of tocilizumab, the IL-6-blocker. They say her ferritin became “normal” although they do not report the final number. This is very consistent with the pattern I wrote about yesterday: IL-6 raises ferritin, locking up iron from being put to use, and blocking IL-6 restores iron utilization to normal.
The second case is a 20-year-old woman with Still's disease who developed macrophage activation syndrome six days after dose one of the Pfizer vaccine. Macrophage activation syndrome is a severe complication of Still's disease and has a mortality rate of 10-20%.
This woman had been diagnosed in August 2020 with Still's and had a relapse in February 2021 with a ferritin reaching 17,092 µg/L. Prior to getting vaccinated, she had been stable for three months on a regimen of Anakinra, an immunosupressant, and prednisolone, a steroid.
Six days after vaccination she developed fever, muscle pain, sore throat, nausea, sweating, and dizziness. Her ferritin shot up to 136,680 µg/L, and she was anemic with a hemoglobin of 10.4 g/dL. Again, consistent with anemia of chronic disease.
Intravenous antibodies, higher doses of her usual drugs, and the addition of ciclosporin, a second immunosuppressant.
The treating physicians advised her to avoid getting the second dose of Pfizer and instead to wait for Novavax to be approved (I am stunned they are taking this gamble given what they describe with Pfizer…) That hasn't happened yet, so on the drugs and avoiding any second dose of the vaccine she has so far remained in remission. This was published at the end of December, when her time in remission represented four months without relapse.
While such severe reactions are rare, the authors suggest that macrophage activation resulted from the vaccine stimulating interferon-gamma (IFN-gamma). Dramatic elevation of IFN-gamma is actually a normal response to the Pfizer vaccine. The second dose elevates it 20-fold.
While it is difficult to demonstrate causality in case reports, the second case is plausibly a result of the vaccine and the first case seems obviously a result of the vaccine. The reason the first case seems so obvious is that the woman had been in remission for fourteen years until her COVID vaccination.
Overall, then:
The COVID vaccines do stimulate an inflammatory response that includes a significant elevation of IL-6.
IL-6 would be expected to trap iron in ferritin and create a functional deficiency if it is elevated high enough for long enough. It is unclear how often this occurs after COVID vaccination but presumably it occurs sometimes.
The cases of vaccine-induced aggravation of Still's disease involve ferritin levels that are expected to be extremely high in flareups of the disease, with clear complications of functional iron deficiency and anemia of chronic disease. They will not represent the typical response of iron metabolism to COVID vaccines, but they demonstrate proof of principle that iron metabolism can become extremely dysregulated following COVID vaccination.
Putting these together, I find it very plausible that hair loss, fatigue, or trouble breathing upon exertion following vaccination could be a result of dysregulated iron metabolism. I believe the approach to testing and supplementing that I described yesterday should be tried in such cases. This approach can be broadly used for any symptoms possibly related to iron deficiency or hypothyroidism that follow inflammatory illness or vaccination for any disease since the dysregulation of iron metabolism is a common feature of inflammation.
My Testing Nutritional Status: The Ultimate Cheat Sheet has more details on interpreting iron-related lab work, and my 1.5-hour podcast on iron covers all aspects of iron in comprehensive detail.
Please post your experience with any of the lab work or supplements listed here in the comments!
How to Share it and Show It Love
Here's how to share this content:
If you received this on my email list, please forward it to anyone who might find it useful.
Repost it on GETTR.
Share it on Gab.
Foward it on Telegram.
Retweet it on Twitter.
Share it on Facebook.
Like it on Instagram.
Please Support This Service
You can support this service by sharing my work with others to spread the word, and by purchasing one of my information products. The most popular are:
The Vitamins and Minerals 101 Cliff Notes
The COVID Guide (free with a paid subscription to my Substack)
Testing Nutritional Status: The Ultimate Cheat Sheet
There are many other ways to support this work, some at no extra cost to you, listed at chrismasterjohnphd.com/support.
I am currently devoting my analytical skills to critical questions around COVID risks, vaccine safety and efficacy, and the full spectrum of vaccine alternatives, due to the imminent massive job loss occurring as a result of vaccine mandates. If you would like to support me doing this work you can also make a donation in any amount using this button: