I read on this ( and several other sites ) that Ferritin, Folate, Vitamin D, Vitamin B12 need to be optimal and not just in range if one's hypothyroid and taking levo.
How do I convince doctors of this? My Gp refused to test iron saying it's the same as folate.
My ferritin is 29.9 ( 10 - 204 ), B12 617 ( 187.0 - 883.0 ) , Folate 14.9 ( 1.8 - 18.3 ), Vit D 84 ( + 75 ) after being found deficient and supplementing.
I saw a very helpful consultant who agreed that I could remain on my regular dose of lio and levo inspite of my FT3 being out of range.
He also agreed that there are problems with varying strengths of lio tablets - several patients have had this problem prior to me.
But when I raised the issue of my low results above he said that he was unaware of the need for these to be any thing other than in the normal range. He said there is no problem with over dosing on any of them and I should try supplementing. He said to speak to my GP.
My Gp was also unaware - and not very helpful. She is going to write T some one to find out what level my B12 should be and if it is necessary to raise it.
I looked at the BTA site - as I had a quote from them appear on my results print out. Advising that they do not support T3 treatment. That was a waste of time. Reports quoted were dated 2002, 2003 and 2007.
I could find nothing newer - apologies if I missed it!
Has any one any suggestions where I can find something written down that my doctor will accept.
Incidentally, yet again I could not get my prescription of lio due to supply issues.
Written by
dizzy864
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Your GP saying she won't test iron doesn't surprise me. Her saying that iron is the same as folate shocks me and she needs to go back to school. If she'd said iron is the same as ferritin, it would have been stretching the truth a little, but it would have been understandable.
Ferritin is a storage molecule for iron, and one ferritin molecule can hold up to 4500 atoms of iron. Doctors use ferritin as the preferred test for iron levels (they used to use haemoglobin levels - I don't know when it changed or why). It isn't reliable under some circumstances - e.g. if infection exists then serum iron levels are usually kept low and ferritin levels are kept high by the body, in order to prevent iron being used by bacteria or other pathogens to reduce their ability to reproduce.
A full iron panel is usually only ever done in the UK when ferritin drops below the reference range.
Any doctor who says that overdosing on supplements is not a problem is definitely in need of some urgent training. The only nutrient that I know of that can safely be taken without worrying about overdose is vitamin B12.
Iron is poisonous in overdose. The body has no obvious mechanism of getting rid of the excess so it builds up in body tissues such as the heart, where it causes damage. It will also feed pathogens as I mentioned above. People with excess iron due to haemochromatosis have to give blood regularly to keep their iron levels down.
Vitamin D is described as "toxic" when levels get too high. I don't know what dangers it causes though, sorry.
Your ferritin is much too low. With the range you have provided you need to get your levels up to about 100 (roughly mid-range). Your B12 should be about 1000 ng/L, your folate looks fine, and most people feel best with their vitamin D around 100 nmol/L (note that in the US different units are used for lots of measurements - I'm working on the assumption that you are based in the UK and your results all have the standard UK units of measurement.)
Some useful quotes :
"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 (238,239,241,242)."
Jeez. If your GP really thinks that iron is the same as folate, s/he didn't even attend the hour or so lecture on nutrition. Are you sure s/he didn't say "same as ferritin"?
Your ferritin is too low, which generally (but not always) means that your iron is too low
Dizzy864, I haven't heard any reports of supply issues with Liothyronine recently. Have you checked other pharmacies in your area? It may be that the pharmacy you are using is having issues. You can also contact Amdipharm Mercury (AMCo) to find out whether there are supply issues.
BTA doesn't support anything other than Levothyroxine but the latest statement (2015) acknowledges it may be appropriate in individual cases after a raft of other tests and conditions have been eliminated onlinelibrary.wiley.com/doi...
NHS doesn't usually prescribe when vits/mins are within range but you can optimise levels by self supplementing.
Optimal ferritin is halfway through range. Supplement iron and take each tablet with 500mg-1,000mg vitamin C to aid absorption and minimise constipation. Retest in 6 months. Iron overload is dangerous. Take iron 4 hours away from thyroid meds.
Optimal vitD is 75-200, possible toxicity >250. Most are comfortable around 100. Take 4 hours away from thyroid meds.
Optimal B12 is 1,000 according to PAS. 617 is probably fine but you can supplement 1,000mcg methylcobalamin sublingual lozenges, spray or patches and take a B Complex to keep the other B vits balanced.
Folate is optimal half way through range. Yours is good.
My gp referred me to my pharmacist. She suggested I take 200mg ferrous sulphate 2 or 3 times daily with a calcium only tablet as I take a vit D supplement. They did not have a straight calcium tablet so I bought calcium + vit D. I started yesterday after lunch. I have taken three tablets so far. They are making me feel very sick. Is this usual? Is it better to take them with vit C tablets not calcium. I have taken the same calcium tablets before and not had this problem before so it must be the ferrous sulphate that upsets me.
Will it settle down if I give it longer?
With regard to lio supply, my chemist told me that she had phoned 4 different suppliers each twice and none had any stocks. She is going to keep trying. It's not a problem for me just yet as I've learnt to ask for them earlier than I need.
I could not get a prescription back. I thought I had been clever by asking for only lio on this prescription. But my gp had faxed a prescription to the pharmacy and not sent a prescription that could be given to me.
I will give it a bit longer and then contact my doctor and ask for a prescription.
Dizzy, Ferrous sulphate is very hard on the gut. Ferrous fumarate is gentler. Take each iron tablet with 500mg-1,000mg vitC.
I wouldn't take calcium supplements unless calcium is deficient/low. I was prescribed very high dose vitamin D capsules for deficiency. Calcium was neither tested nor prescribed. 18 months later calcium was tested and within range. Your vitD is in the replete range 75-200 so you really don't need to supplement until Oct-Apr and then a maintenance dose 2-3,000iu daily should be enough.
Good luck with the T3. Don't wait too long before getting another prescription. My scrip is sent electronically to pharmacy. It's the same as that printed off in the surgery so I don't understand why it can't be returned to you to take elsewhere or use online. It might still be worth contacting AMCO to find out what's happening.
Thanks for your reply. I will try to buy ferrous sulphate and vit C today. As far as I am aware I have no problem with calcium levels and I think it unlikely. I only got it because the pharmacist recommended it.
I find that I do need to supplement vit D levels all year but at varying levels. My problem is that my body can't store vit D even for short periods so I really need a daily fix even if I've sat in the sun for 15 mins it is not enough.
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