Vitamin/mineral results

Results posted on behalf of my partner, she has autoimmune under active being treated. She takes ferrous fumarate, folic acid and vitamin D3 800iu.

Thanks in advance.

Ferritin 17 (15 - 150)

Folate 2.3 (2.5 - 19.5)

Vitamin B12 198 (180 - 900)

Total vitamin D (OH) 24.1 (<25 severe vitamin D deficiency. Patient may need pharmacological preparations)

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17 Replies

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  • Ad1977,

    How much Ferrous Fumarate is your partner taking? Iron is best taken with 1,000mg vitamin C to aid absorption and minimise constipation.

    800iu is a maintenance dose. It won't raise deficient vitamin D. Your partner should supplement 10,000iu D3 daily x 6 weeks then reduce to 5,000iu daily and retest in August. VitD should be taken 4 hours away from Levothyroxine.

    Go to healthunlocked.com/pasoc for advice on B12 and folate deficiency.

  • She is taking 3 ferrous fumarate a day.

  • Ad1977,

    Okay, that's the maximum dose. Suggest she takes each tablet with 1,000mg vitamin C as I mentioned above. Iron should also be taken 4 hours away from Levothyroxine.

  • Hypothyroid sufferers often have problems with leaky gut and not taking in nutrition, which in turn makes the hormonal system work more poorly and take in even less nutrition. In order to treat it fully, the whole spectrum of thyroid hormones and vitamin levels need to be brought up to optimal. I see that you have another thread earlier today with her TSH/FT4/FT3 levels, which show that her TSH is middle of the doctors range (whereas it's best that her TSH is 1.0 or lower), her FT4 is in the lower third of the range and her FT3 is barely in range.

    What types of Ferrous Fumarate and Folic Acid does she take, and what dosage levels?

    Vitamin D3 at 800iu is barely even a maintenance dose, let alone a loading dose to bring up that Vitamin D level. I've pulled this off the internet (http://www.gpnotebook.co.uk/simplepage.cfm?ID=1872363567) which sounds similar to what I was given:

    a loading regimen to provide a total of approximately 300,000 IU vitamin D, given either as separate weekly or daily doses over 6 to 10 weeks

    maintenance therapy comprising vitamin D in doses equivalent to 800-2000 IU daily (occasionally up to 4,000 IU daily), given either daily or intermittently at higher doses

    1) Loading regimens for treatment of deficiency up to a total of approximately 300,000 IU given either as weekly or daily split doses. The exact regimen will depend on the local availability of vitamin D preparations but will include:

    50,000 IU capsules, one given weekly for 6 weeks (300,000 IU)

    20,000 IU capsules, two given weekly for 7 weeks (280,000 IU)

    800 IU capsules, five a day given for 10 weeks (280,000 IU)

    I now take a spray of 3000iu daily as the 1600iu I was prescribed by the doctors was barely bringing my levels up.

    B12 also needs supplementing - it often causes symptoms if the level is under 500, despite the UK range being from 180 - 900. Best treatment is a couple of months of a loading dose (Jarrow Methylcobalamin B12 5000mcg lozenges) followed up by maintenance lozenges at 1000mcg - it's also recommended to take a good B-complex with this to balance the vitamins.

    Vitamin D and Iron also affect uptake of thyroid meds so should be taken 4 hours away.

    Does she eat gluten/soy/milk free?

  • I'd take Clutter's vitamin D advice over mine though - she has much more experience!

  • She takes 3 ferrous fumarate 200mg, 5mg folic acid as well.

  • She eats gluten and soy and dairy, she is undergoing gluten challenge at present due to symptoms.

  • Ad1977,

    If she is doing the gluten challenge prior to a coeliac screen she needs to eat normal amounts of gluten daily for upt to six weeks prior to the blood test. Even if coeliac screen is negative it may be worth her trying g-f because some people are non-coeliac gluten sensitive.

    Unfermented soy is not a good thing to have in the diet as it is very thyroid unfriendly and can prevent absorption of nutrients. Suggest she ditches unfermented soy.

  • Her bloods tests results are still all low aren't they?

    I was prescribed the same Vitamin D 800 but I am seeing GP tomorrow about my low Ferritin, low (below range) Folate and low B12 which is 500 and I will ask for stronger Vitamin D tablet.

    She may want to query supplements I think the advice on here is that we should have Vitamin D 4000.

    Someone who is more qualified than I to advise you will give you full information.

    I'm just going through similar myself at the moment but I was diagnosed with Hashimoto's five and a half years ago.

    🐥

  • Ad1977

    Ferritin 17 (15 - 150) - how much Ferrous Fumerate has been prescribed? It should be one tablet two (or possibly three) times a day. Was she tested for iron deficiency anaemia as well - that would be an iron panel plus full blood count.

    She should take each tablet with 1000mg Vit C to aid absorption and help prevent constipation, and take it four hours away from thyroid meds and two hours away from any other medication and supplements as it affects their absorption.

    If she is not vegetarian then include liver in her diet once a week, either as a stand alone meal or minced and 'hidden' in casseroles, cottage pie, curry, bolognese, as any other meat dish.

    **

    Folate 2.3 (2.5 - 19.5)

    Vitamin B12 198 (180 - 900)

    Was she tested for Pernicious Anaemia? With folate deficiency plus such a low level of B12​ it would have been a good idea. Does she have any signs and symptoms of B12 deficiency - check here b12deficiency.info/signs-an...

    I would suggest that you take these results over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice.

    **

    Total vitamin D (OH) 24.1 (<25 severe vitamin D deficiency. Patient may need pharmacological preparations)

    If she is taking 800iu D3 a day then her level will not rise. She needs a loading dose in accordance with treatment guidelines.

    NICE treatment summary cks.nice.org.uk/vitamin-d-d... states:

    "For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

    Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

    Each Health Authority area has it's own guidelines but they will be very similar. Speak to the GP and insist he treats according to the guidelines.

    Or it may be better to do it yourself with better quality supplements bought online and guidance from members here.

    Whatever you do, there are important cofactors needed when taking D3 which your GP won't know about because they're not taught nutrition, read -

    vitamindcouncil.org/about-v...

    D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

    D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

    Magnesium comes in different forms, check here to see which would suit best and as it's calming it's best taken in the evening, four hours away from thyroid meds -

    peoplesrx.com/the-best-kind...

  • She takes 3 ferrous fumarate a day, her periods are extremely heavy and clot. Are there cofactors for vitamin D that are easy to swallow? Thanks

  • You can get K2-MK7 in softgels which I always find easy to swallow, check out Healthy Origin's K2-MK7 and Jarrow's MK7 here bigvits.co.uk/products.php?...

    You can get some magnesium in powder form, I use Natural Calm magnesium citrate powder and make into a drink with orange juice amazon.co.uk/Natural-Calm-S... or there is magnesium oil spray (too messy for me) and Epsom salt baths.

  • SeaSideSusie

    Should vit K2 be taken at the same time as Vit D? I suppose it would make sense but best to ask... Thanks.

  • JGBH I have read conflicting advice about this. One article said to take them at different times because they are both fat soluble and would complete for the fat in the meal to be absorbed. The other said they could be taken at the same time.

    If you have softgels which contain oil, then there is already fat there to aid absorption so my opinion is that it wouldn't be a problem taking them together.

  • Thank you for such a prompt reply SeaSideSusie!

    Am taking note... as I have been on D3 for at least 3 years (1000 units, after a loading dose as my levels were low - 23 -) but have never been taken the Vit K2 - MK7. How much of this should I take?

  • The usual dose in a K2-MK7 supplement is about 90-100mcg and the recommended dose is one a day. I believe this is fine for D3 doses up to 5000iu.

    Have you checked your Vit D level recently? It's recommended to test once or twice a year when supplementing. GPs don't seem to retest but you can do a fingerprick blood spot test for£28 with City Assays.

  • Thanks again Susie. GP had not retested since the deficiency was discovered.... so last week I asked her to issue a blood test form and will get results this week. It will be interesting to see where my vit D levels stand within the ranges...

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