Advice please

I have come from the Thyroid UK forum. Could someone please interpret results for vitamins and minerals. Symptoms are causing me concern at present, goitre, dry skin, constipation, heavy periods, tiredness, joint aches and pains, dry eyes, dizziness, ears ringing, face looking washed out, weight gain, sweating, cold intolerance, pins and needles. Currently taking prescribed ferrous fumarate 200mg once a day and prescribed vitamin D 800iu once a day. Thanks for feedback.

Serum ferritin: 18 (15 - 150 premenopausal females)

Serum folate: 2.1 (2.5 - 18.7)

Serum vitamin B12: 194 (180 - 900)

Total 25 OH vitamin D: 40.6

(<25 severe vitamin D deficiency. Patient may require pharmacological preparations

25 - 50 vitamin D deficiency. Supplementation is indicated

50 - 75 vitamin D may be suboptimal, and long-term may lead to clinical effects. Advise on safe sun exposure and diet. Supplementation may be indicated

>75 adequate vitamin D)

2 Replies

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  • Hi laurenv8 Some of the symptoms you list are those of Vitamin D deficiency and according to your readings you are "bumping along at the bottom" with B12 and deficient in Folate

    Deficiencies in B12 and Folate will also produce similar symptoms to yours..

    Sunshine was mentioned with regard to Vitamin D and it is also obtained naturally from eating animal products such as red meats, fish, seafoods, eggs, poultry and dairy produce which is the same group of foods from which we derive Vitamin B12 so if your diet is lacking in these then that could explain both your low Vitamin D and low B12.

    If you have a thyroid problem this to will impact upon your B12 level

    Folic acid works closely with vitamin B12 in making red blood cells and helps iron function properly in the body. Rich sources of folate include spinach, dark leafy greens, asparagus, turnip, beets, and mustard greens, Brussels sprouts, soybeans, beef liver, brewer's yeast, root vegetables, whole grains, wheat germ, etc and some breakfast cereals are now being fortified with folic acid.

    Who’s at greatest risk for B12 Deficiency?

    Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

    Vegetarians, vegans and people eating macrobiotic diets.

    People aged sixty and over

    People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

    People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

    People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

    People with a history of eating disorders (anorexia or bulimia).

    People with a history of alcoholism.

    People with a family history of pernicious anaemia.

    People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

    People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

    People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

    Women with a history of infertility or multiple miscarriages."

    Do you see yourself as one of the above "people".

    I feel you doctor should be treating your low B12 and Folate

    I am not a medically trained person but there are others on here who will be able to give you good advice and I wish you well

  • Hi laurenv8

    It is going to be a bit difficult working out which symptoms are to do with which low levels / deficiency (or thyroid!) but it looks like you are only being treated of some of them!

    Guidelines for the diagnosis and treatment of cobalamin and folate disorders: pernicious-anaemia-society....

    Your B12 levels are technically within range but are in truth very low, and at a level that you may well have symptoms of deficiency. Unless you have a dietary deficiency in B12 (ie are vegan, eat a diet low in animal products or have an eating disorder) your doctor should be treating you with B12 injections if you have syptoms of a b12 deficiency - even while (just!) in range. The link above and the pinned posts on the left hand side will also give you more info. It is important that your doctor treats your low B12 levels a day or 2 in advance of starting you on folate tablets or similar for your folate deficiency.

    As clivealive says there are many reasons why someone may develop low B12. If you can I'd try to get your GP to check for pernicious anaemia (by looking at levels of anti-intrinsic factor antibodies) - the test is far from perfect but it may be helpful.

    Good luck and feel free to start another post if you have further questions or if your GP is being uncooperative!

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