Folate, zinc, Vitamin D

[Jane104]

I've got a printout of my latest blood tests done at the end of May. I know the ferritin is low, but I'm wondering if the folate, zinc, and vitamin D could be better?

Serum folate 7.9ug/l [2.1 - 14.0]

Zinc 10.1 umol/l [10.0-18.0] I don't think I have any signs of zinc deficiency

Vitamin D 86nmol/l [<25 deficient, 25-50 insufficient, >50 adequate]

Is 50 adequate? I've been supplementing for about 18 months, was previously 20 I think.

There are different ranges for ferritin depending on age and gender which I didn't know:

Serum ferritin 37ug/l [female >45 years (that's me) 24-155] [female <45 years 10-65] ??

Seems like such a big difference. I've been taking ferrous fumarate, about 4 weeks now.

FBCs etc all reasonably good and B12 1102 (180-900)

TFTs

Nov 12: FT4 20.3 (9-24) TT3 1.4 (0.9-2.8) TSH 0.03 (0.35-5.5) 175ug

Jan 13: FT4 24.2 TT3 1.7 TSH <0.01 on 200ug

Mar 13 FT4 25.9 TT3 1.6 TSH 0.01 on 175/200ug alt days

May 13 FT4 21.2 TT3 1.4 TSH <0.01 on 175ug

To me these aren't really logical! They were all taken between 9 and 10.00am.

I'm now back on 175/200ug alt days. I had a couple of busy days Fri and Sat and since Friday night have been feeling awful - I actually feel as bad now as I have ever felt, before or since diagnosis. I know it could be a bug - doc would probably say it's 'a virus' - but it feels so like I'm back where I started.

[bantam12]

Your TSH is below range and very low, you could well be overmedicated which would explain how you feel.

Many will say TSH level doesn't matter but to a lot of us it does, if my TSH was that low I would be really ill with what feel like hypo symptoms. Too much Levo can wipe you out big time, I know I've been there a few times.

You may want to ask your GP about reducing your Levo and see if that helps, bet it will.

[Jane104 in reply to bantam12]

In the past I've always felt better with high T4, low TSH. See my reply to Moggie below.

[tuf5ty]

My tsh had to be nearly unreadable for me to ferl slightly human. My free t4 is 22.

[Jane104 in reply to tuf5ty]

I've found the same. Have replied to Moggie below.

[Moggie]

Your ferritin levels are exactly the same as mine (I stated with a ferritin level of 12) and I have been taking the same as you for about 5 months now, so its a very slow process, you should be aiming for a ferritin level of between 70 and 90. Did you get told to take the iron with vitc and with food, if not that's what you should be doing.

Your FT4 ranges are also exactly the same as mine but my TSH is 0.16 and I'm showing signs of over medication with heart palps and bad hair shedding so maybe you should reduce down to 175mcg's daily and if that doesn't do the trick reduce down to 150/175 alternate days and see how you go, obviously you will need to speak to your GP about this.

Your vitD is now fine so I would stop supplementing as too much vitD can cause your body to make too much calcium and lead to kidney stones and you need to ask your GP WHY your B12 is so high - or have you been supplementing?

Moggie x

[Jane104 in reply to Moggie]

Yes sorry was supplementing B12, have now reduced it to a couple of times a week.

Will reduce the Vit D too then - I wondered if like the ferritin, their normal wasn't really adequate. It's hard to monitor when they will only test annually even if supplementing. Have been taking iron with orange juice at dinner time but maybe that's not enough? I wasn't even advised to supplement never mind take it with Vit C!!

I've always felt better with T4 above range and low TSH - T4 used to be 27 and TSH 0.06. That was a few years ago on 150ug until I was made to reduce to 125ug by new GP. Even though endo at that time said it was ok to increase again and have low TSH my T4 never got that high again and I've not felt 100% well. Felt not bad on 200ug but they wouldn't let me stay on it and even at 175ug my TSH seems to be suppressed now and they're very twitchy about it because of my age (perimenopausal). The reason I'd tried dropping back down was because current endo doesn't believe I ever had a thyroid problem. But it didn't take long for the fibro pain and headaches to return, and sleep's been disrupted, so have gone back up. I've never ever had any signs of being hyper. I just know I shouldn't feel like this after a day out - especially four days of doing very little later! I guess I'll have to wait and see if the iron makes any difference. Do you have to do it slowly? 5 months seems a long time to be only half way to your target.

[Moggie in reply to Jane104]

Its not you that has to do it slowly, its the time your body takes to raise its levels that is a slow process. Like you I am on, what is apparently, a high dose (200mcg's) but my ferritin is still low at 34 so its took me 4/5 months to get it from 17 to 34 but what a difference it has made in how I feel.

I have also gone over medicated in the last couple of weeks and am thinking that it is because the iron is allowing my body to utilise the T4 better. Have a look at this exert as see what you think.

Iron deficiency

Iron deficiency is shown to significantly reduce T4 to T3 conversion, increase reverse T3 levels, and block the thermogenic (metabolism boosting) properties of thyroid hormone (238-242). Thus, iron deficiency, as indicated by an iron saturation below 25 or a ferritin below 70, will result in diminished intracellular T3 levels. Additionally, T4 should not be considered adequate thyroid replacement if iron deficiency is present

If you want the full article let me know.

Moggie x

[Jane104 in reply to Moggie]

200mcg? My iron tablets are 14mg !? What is recommended dose?

Thanks for that, I knew ferritin was important but not exactly why, but it's amazing that they don't routinely test, and I have never been told to supplement by GP or endo despite all the problems - but then given the range for under 45s maybe not so surprising. I would like to read the full article, I'll PM you, thanks.

[Moggie in reply to Jane104]

God it will take you ages to raise your ferritin with a daily dose of 14mcg's - are you sure that's right?

Link below to the article but I will warn you that it does take some reading but once you have read it a couple of times it sinks in and then starts to make a lot of sense plus it has been published in the BMJ.

nahypothyroidism.org/deiodi...

Enjoy!!!!

Moggie x

[Jane104 in reply to Moggie]

miiligrams not micrograms

[Jane104 in reply to Moggie]

OK I'm just reading up on this, am I right in saying your 200milligram tablets contain 65mg of elemental iron?

Mine are 14mg elemental iron.

This says building dose would be 3-6mg elemental iron per kg of body weight per day (upto max 200mg elemental iron) for one month to correct anaemia + another 3 months to build stores. So I need to take 14 x what I'm taking! And if yours are 65mg you could take 3 a day?

noc.nhs.uk/oxparc/informati...

[Moggie in reply to Jane104]

Did wonder if I had that right, 14mcg's didn't sound right at all.

Yes I am taking 65mg of elemental iron and have been for 5 months now and my iron is still only at 34 so I may possibly have to supplement for nearly a year on that dose to get to my ideal level of 90.

Is it your GP that has given you your iron supplements of are you buying them?

Moggie x

[Jane104 in reply to Moggie]

I'm buying it, I've never even been advised to supplement. You could take more, but apparently you have to split it through the day. Thought this piece was interesting, (scroll down to 'Some facts about iron supplements')

ods.od.nih.gov/factsheets/I...

[Moggie in reply to Jane104]

Interesting article and according to the figures quoted I was, with a level of 12, Anaemic but according to my endo I was "only slightly low in iron". Wish the medical profession would make up its mind.

I am waiting for the GP to stop my iron supplements as I am now deemed as "no further action required" with a level of 34 but did managed to get another months worth just before my blood results. If they do stop them I will be buying them myself until my levels at least double what they are now.

Moggie x