vitamin/mineral test results - advice?

hello all.

i've just been to collect my blood test results and i was wondering if i could get some insight on them -

serum total protein 81 g/l (60-80) "high"

serum albumin 45 g/l (35-50)

serum calcium 2.43 mmol/l (2.20-2.63)

serum inorganic phosphate 1.12 mmol/l (0.80-1.50)

serum alkaline phosphatase 49 u/l (30-130)

serum vit d3 level 63.5 nmol/l (50.0-220.0)

serum ferritin 131 ug/l (25-350)

serum vitamin b12 240 ng/l (180-1000)

serum folate 3.5 ug/l (> 4.00) "low"

my main symptoms are -

back ache

facial flushing

chronic fatigue

need naps in the afternoon

wake feeling tired

heat intolerance (always sweating even in the winter)

constantly have a 35.xx base temperature

facial swelling (moon face? can't see my ears from the front on)

dry mouth

dry eyes

sensitive to light

dry skin

dry itchy scalp

chronic itching

alcohol intolerance (IBS, facial flushing, palpitations)

i have posted my thyroid results in a past topic. they seemed ok although my t4 and free t4 were at the low end.

i appreciate any responses, so determined to get to the bottom of how i feel.

thank you.

10 Replies

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  • Carpsy, vitD is a little low and would be better high in range. 2,000iu D3 softgel caps daily should be sufficient. Ferritin is good so no need to supplement iron. B12 is low and should be high in range. Supplement 1-2,000mcg methylcobalamin sublingual lozenges, spray or patches. Folate is deficient and your GP should prescribe folic acid or you can supplement folic acid or methylfolate.

    Low vitD, B12 and folate can cause fatigue, low mood and musculoskeletal pain and correcting this will improve those symptoms but I doubt they are the cause of most of your symptoms.

    If you use Amazon please use the TUK affiliate link thyroiduk.org.uk/tuk/go_sho...

  • i'm going to get the jarrow methylcobalamin 1,000mcg lozenges so i'll take two of them daily.

    have you got any experience on purchasing methylfolate? i see jarrow also do 400mcg methylfolate so i'm guessing that's a good choice? also could you explain why some people take 5mg of folate while others take 400mcg - isn't that a massive 12x the dosage? seems really odd.

    could you also recommend a good vit d3? preferably off amazon as that's where i'll most likely order the other two products.

    i know you can't take too much b12 but how would i know when to stop supplementing folate or d3, or is it a life long thing?

    lastly - seeing as how i'm going to be self supplementing would it still be possible to go to my gp in a few months and request a blood test to see how i'm doing or because i've essentially took matters into my own hands are they likely to just tell me to get lost?

    sorry for all the questions!

  • I can't help you much on all the others although my total protein is often just a little higher than yours and I'm none the wiser in what this signifies - if anything.

    Re the Folic Acid supplements - I used to take 25mg per week when I was taking a drug called Methotrexate because this drug is a folate antagonist so folic acid is prescribed at a high dose to compensate. Perhaps there are others who take higher doses for similar reasons?

  • Thanks twitchy.

    Do you know if 400mcg of folate per day would be enough for me? I have seen clutter and a few others say that if you're deficient in folate you should take 5mg.

  • Carpsy, NHS prescribe folic acid x 5mg. I'm not sure you can buy that OTC but I think you can get 4mg. Whether to supplement folic acid or methylfolate is a matter of personal preference and tolerance. Some don't like folic acid and others don't tolerate methylfolate. My folate deficiency was resolved after 4 weeks x 5mg folic acid although the PIL recommended a 4 month course. As folate was in range the prescription was stopped.

    Any vitD3 softgel caps should do. I'm taking Doctor's Best 5,000iu but was also happy with Now, both of which are available on Amazon. My vitD was deficient in November and I was prescribed loading doses and maintenance doses for 2 months which built up my levels. I stopped supplementing and after 4 weeks joint pain started up again so I resumed supplementing which resolved the pain. I haven't been able to tolerate the heat and sun so I'm not converting vitD naturally.

    Labs often decline to test vitamins and minerals more frequently than 3-6 months. I haven't retested since Jan but may ask for tests in Dec/Jan if I can't persuade the endo to request them when I have a thyroid function test. If you don't ask your GP for the tests you won't get them. If GP refuses you can order private tests which may be less expensive than supplementing life long unnecessarily.

    If you want baseline B12 and folate ie non supplementation levels you need to stop supplementing for 4 months to allow the red blood cells to die off and renew. Otherwise you can continue supplementing B12 until your level is high in range. You can't OD on B12 as excess is excreted but equally there's no point in peeing out expensive supplements either.

    VitD3 should be taken Oct-Apr when light levels are too low to promote vitD production. If you test in Feb/Apr and levels are good you can stop supplementing if you are able to get a few hours of sun on your face and arms during the week.

  • thank you so much for your helpful responses clutter, i appreciate it.

    i have some more questions though if you don't mind.

    you say your folate deficiency was rectified after 4 weeks. how did you know this if the labs don't test vit/min that frequently? or because your gp prescribed it are they obliged to test you more often to check your levels?

    it's a bit worrying how they never contacted me over my low results, if i didn't request a copy of them then i wouldn't know any different. i think i'm going to book an appointment to discuss the low folate and b12 and see if the doctor will prescribe before i self supplement. it's just annoying as they already think i'm crazy and when i suggest that my b12 is much lower than a satisfactory level i just know she's going to roll her eyes again and start accusing me of reading too much into it. she will no doubt say it's fine as it's in range.

    should i ask her to find out the cause of why i am low rather than just throw me a prescription? there doesn't seem to be many causes apart from either - body can't absorb it through the diet or it's just simply pernicious anemia. i've had a read around and i can't even find a difference between low b12 and pernicious anemia.

    i'm going to order a saliva cortisol test i think to hopefully rule out cushing's. would taking b12 and folate interfere with this test or is it ok to take them?

    and lastly, i stopped taking 50mcg synthroid about 5 days ago now. i'm still having aching chest, headaches, blurred vision and feel more tired than usual. is this normal do you know? i would have thought because i only took them for a week i would have been back to normal after stopping them. having said that, i have these symptoms all day every day it's just the synthroid seemed to worsen them.

  • Carpsy, GP requested the tests as part of ongoing treatment. Lab will have agreed as previous results were deficient.

    I don't understand some GPs. There is surely a difference between someone having levels at the bottom and top of range but some GPs don't concern themselves when results indicate deficiency or excess levels either.

    NHS don't often prescribe when levels are within range but they should when they are deficient. If you are low in range you usually have to self supplement.

    Pernicious anaemia causes B12 deficiency but there are other reasons for B12 def too. Intrinsic Factor and gastric parietal antibody tests determine PA, although IF isn't 100% accurate.

    50mcg of Levothyroxine for 5 days isn't usually enough or long enough to feel any effects. It takes 7/10 days to be absorbed into your cells and start improving symptoms. Most of what you've taken will be out of your system so it seems unlikely that the Synthroid is responsible for how you're feeling.

  • Hi Carpsy

    I'm sorry you have had a rotten consultation with your GP. It is helpful to fill in your Profile with your history so that members have an idea of your medical history. So I have copied your previous thyroid hormone results:-

    TOTAL THYROXINE(T4) 84 nmol/L 59 - 154

    THYROID STIMULATING HORMONE 1.37 mIU/L 0.27 - 4.2

    FREE THYROXINE 14.5 pmol/l 12.0 - 22.0

    FREE T3 5.5 pmol/L 3.1 - 6.8

    IMMUNOLOGY

    THYROID ANTIBODIES

    Thyroglobulin Antibody <10.0 IU/mL 0-115(Negative)

    Method used for Anti-Tg: Roche Modular

    Thyroid Peroxidase Antibodies 5.0 IU/mL 0 - 34

    Method used for Anti-TPO: Roche Modular

    *****

    This is from thyroiduk.org but doctor's wont take notice of it as they have been told that the patient has to reach 10 in the guidelines.

    thyroiduk.org.uk/tuk/testin...

    thyroiduk.org.uk/tuk/testin...

    thyroiduk.org.uk/tuk/about_...

    The swelling on your face and the other symptoms do sound hypo but I think you will have to go private but, as said on a previous post.

  • thanks for the advice.

    because a lot of my symptoms pointed towards a thyroid problem (and i had low ft4 levels) i actually started taking synthroid two weeks ago by myself. i started on 25mcg for the first week as i'm normally really sensitive when it comes to meds. i just felt extremely tired and my skin seemed much dryer. after reading around and coming to the conclusion that 25mcg is barely even a proper dose i decided to up it to 50mcg. i took this for a week and became even more tired than usual, had headaches and worst of all i had palpitations, shortness of breath, hot sweats etc. quite scary really. i was determined to fight through it because i know it can take weeks to feel a benefit and the side effects got a little better towards the end of the week but i was still exhausted and every time i stood up my heart would race and i'd feel dizzy. also, i thought that after a week on that dose i would feel at least a slight improvement but i never so i discontinued it about 3 days ago and now i'm still experiencing the symptoms that came with taking it. is this normal even though i was only taking it for a week or so? i would have maybe thought about going up to 75mcg but because of the heart side effects i was too scared.

    is it possible i might not benefit from the synthroid because i am low in b12 and folate? would armour benefit me even though my ft3 is mid range despite my ft4 being low?

    i'm not sure if my face is swollen as such as it is just quite literally round like a moon. hard to differentiate between swollen/puffy/moon face. my face and a lot of my other symptoms match those of cushing's syndrome aswell so i'm thinking about ordering a cortisol test, but i've read that doctors don't even acknowledge these so i wouldn't even know what to do next even if my cortisol was high.

    what happens when you see a private gp anyway? obviously you pay to see them but if you need several blood tests or prescriptions wouldn't they be something silly like £100 each aswell?

    thanks.

  • I recently had a private vitamin D test and it was £152! Mine was very low at 26 last September though - and a few months ago it was up at 59 - which is the low end of normal. Well worth the expense to know how much to supplement however I won't be doing it again next year at this price!

    I did confront my GP with last year's results and he defensively agreed it was deficient and prescribed AdCalD3 which lifted me out of depression.

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