Advice on supplements please

[Katid]

Ferritin 22 (30 - 400)

Folate 3.6 (4.6 - 18.7)

Vitamin B12 244 (180 - 900)

Total 25 OH vitamin D 40.7 (25 - 50 deficient)

Taking 210mg ferrous fumarate for 4 years

Taking 800iu vitamin D for 4 years

Results done 3 months ago

Thankyou

[SlowDragon Administrator]

I would suspect they are even lower than this now as your TSH is so high

If seeing GP ask for retest

Meanwhile see SeasideSusie excellent vitamin supplements advice

E.g.

healthunlocked.com/thyroidu...

[SeasideSusie Remembering]

Katid And here we have more examples of your GP not really knowing what he's doing!

Ferritin 22 (30 - 400) Taking 210mg ferrous fumarate for 4 years

Supplementing iron for 4 years and your GP has done nothing about ferritin still being under range. Unbelievable!

Due to your ferritin being so low, you need an iron panel, full blood count and haemoglobin test to see if you have iron deficiency anaemia. If you've had this done, please post the results, if not ask your GP to do them.

The usual treatment for low ferritin is 1 x ferrous fumarate once or twice daily and for iron deficiency anaemia it's 1 x ferrous fumarate two or three times daily. Ideally you could do with an iron infusion as your ferritin is still below range after four years. You could ask for one as this will raise your level within 24-48 hours whereas the tablets - well they just don't seem to be working! If your GP insists you stay on tablets, then you need more than 1 daily so ask him to prescribe more.

Take each iron tablet 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.

Ferritin needs to be half way through it's range.

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

**

Folate 3.6 (4.6 - 18.7)

Vitamin B12 244 (180 - 900)

Folate deficiency and very low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... 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 as anything under 500 can cause neurological problems.

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 25 OH vitamin D 40.7 (25 - 50 deficient) Taking 800iu vitamin D for 4 years

Again, one wonders why your GP hasn't done anything when you're still Vit D deficient after 4 years of supplementing. Actually, 800iu D3 daily is going to take forever to raise your level. It is hardly a maintenance dose for someone with a reasonable level.

You need 5000iu daily until your level reaches that recommended by the Vit D Council, which is 100-150nmol/L, then you need a sensible maintenance dose which is likely to 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/index.html

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.

[Katid in reply to SeasideSusie]

Complete blood count only flagged up

MCV 78.1 (80 - 100)

MCHC 376 (310 - 350)

Haemoglobin 117 (120 - 150)

Iron panel was in range or is it where they are in the range that matters?

Transferrin saturation 18 (10 - 30)

Iron 8.3 (6.0 - 26.0)

Thankyou again

[SeasideSusie Remembering in reply to Katid]

Katid

MCV 78.1 (80 - 100)

MCHC 376 (310 - 350)

Haemoglobin 117 (120 - 150)

These suggest iron deficiency anaemia. Point this out to your GP and ask him to treat you appropriately.

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...

How should I treat iron deficiency anaemia?

•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.