Vitamin and mineral levels

[Topaz6]

Taking 800iu only

Thanks

Ferritin 16 (15 - 150)

Folate 3.4 (4.6 - 18.7)

Vitamin B12 208 (180 - 900)

Total vitamin D 25.8 (25 - 50 deficiency)

[SeasideSusie Remembering]

Topaz

Ferritin 16 (15 - 150)

This is dire. You need to ask for an iron panel, full blood count and haemoglobin test to see if there is any iron deficiency anaemia.

Ferritin should be half way through it's range with a minimum of 70 for thyroid hormone to work.

Ideally you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours. If given iron tablets, take each one with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

If diagnosed with iron deficiency anaemia then the treatment should be 1 x Ferrous Fumarate two or three times a day, for low ferritin it should be 1 x Ferrous Fumarate once or twice a day. With your level you probably need the maximum.

Eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet will also help apjcn.nhri.org.tw/server/in...

**

Folate 3.4 (4.6 - 18.7)

Vitamin B12 208 (180 - 900)

Folate deficiency and very low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so pop over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice, quoting these results, ferritin/iron results and any signs of deficiency healthunlocked.com/pasoc

If no signs of deficiency then you need to raise your B12 level.

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

That's good enough for me and I keep mine around 1000. Sublingual methylcobalamin lozenges are what's needed to supplement B12 yourself, starting with 5000mcg daily then when that bottle is finished buy some 1000mcg as a maintenance dose, along with a good B Complex to balance all the B vitamins.

You might wish to ask your GP why he's ignored your folate deficiency and if he's going to do anything about it.

**

Total vitamin D 25.8 (25 - 50 deficiency) Taking 800iu only

Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.

NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

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 has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount to bring your level up to what's recommended by the Vit D Council which is 100-150nmol/L, and then you'll need a sensible maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3

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 to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too.

**

Let us know what your GP is going to do, if he doesn't prescribe enough we can make suggestions for appropriate doses.

[Clutter]

Topaz6,

Ferritin is bottom of range which may indicate iron deficiency anaemia. Ideally your GP will do an iron panel and full blood count to check.

Folate is deficient. My GP prescribed 5mg folic acid for a couple of months to correct deficiency.

B12 is very low. If you have symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice before you start taking folic acid.

Vitamin D is deficient and 800iu is totally insufficient to treat deficiency. Your GP should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults cks.nice.org.uk/vitamin-d-d...

Alternatively you can buy vitamin D3 without prescription. Either follow the NICE guidelines or supplement 10,000iu D3 daily for 6 weeks and then reduce to 5,000iu daily and retest in 3-4 months. Vitamin D should be taken 4 hours away from Levothyroxine and T3.

If you buy on Amazon please use the affiliate link healthunlocked.com/thyroidu...

[Topaz6]

MCV 75.8 (80 - 100)

MCHC 368 (310 - 350)

Only things flagged up from complete blood count

Iron 7.1 (6 - 26)

Transferrin saturation 12 (10 - 30)

Not sure what this means?

[SeasideSusie Remembering in reply to Topaz6]

Topaz

MCV 75.8 (80 - 100)

MCHC 368 (310 - 350)

Along with your low ferritin, this points to iron deficiency anaemia. Has your GP not said anything? Point this out to him and ask for appropriate treatment.

NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):

cks.nice.org.uk/anaemia-iro...

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day. ◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

[Topaz6 in reply to SeasideSusie]

No nothing has been said about below range MCV or high MCHC I will do this Monday

[SlowDragon Administrator]

Do you also happen to have vitamin tests for when you were on T3 and well? As a comparison

What does your GP advise to improve these dire results?

Suggest you look up your local CCG website and search Liothyronine. See what the guidelines say, they may be (just like many other CCG's ) bullying endo's into withdrawing T3

With Hashimoto's the majority do find gluten free diet gives significant benefit

thyroidpharmacist.com/?s=7+...

amymyersmd.com/2017/02/3-im...

Bone broth is also very good

thyroidpharmacist.com/artic...

[Topaz6 in reply to SlowDragon]

Yes

Ferritin 103.5 (15 - 150)

Folate 10.1 (4.6 - 18.7)

Vitamin B12 538.5 (180 - 900)

Total 25 OH vitamin D 72 (50 - 75 suboptimal)

[SlowDragon Administrator in reply to Topaz6]

So go back to GP and show him the different results as part of the proof that you need higher dose

You were well and stable on T3

Now they have upset your levels

Ask for T3 to be reinstated

As you have Hashimotos you really need to try strictly gluten free diet

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...