This suggests iron deficiency anaemia, was that diagnosed?
If you can't tolerate ferrous fumarate then your haemotologist should be looking at alternatives that are more gentle on the stomach. Iron Bisglycinate is more gentle but I don't know if he can prescribe that.
Also, 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.
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Folate 2.3 (2.5 - 19.5)
Vitamin B12 223 (190 - 900)
- 5mg folic acid
Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so then post these results on the Pernicious Anaemia Society forum here on Health Unlocked for further advice healthunlocked.com/pasoc Also include your iron information.
Folic acid is the right treatment for folate deficiency but can mask signs of B12 deficiency so you may have to think back to before you started taking them.
If you don't have signs of B12 deficiency then your B12 is far too low and you need to raise it.
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 (5000mcg daily to start, then when the bottle is finished change to 1000mcg daily as a maintenace dose) along with a good B Complex to balance all the B vitamins.
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Vitamin D 40.8 (25 - 50 deficient) 800iu D3 daily
Well, 800iu D3 is going to take forever to raise your level. It is hardly a maintenance dose for someone with a reasonable level. I suggest you buy your own D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 3 months then retest. When you've reached the recommended level, which the Vit D Council say is 100-150nmol/L, 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
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
So you need to ask your haemotologist what he is going to do. I doubt 1 x iron tablet is going to help your iron deficiency anaemia much when the normal treatment is 2 or 3 daily.
I have signs of B12 deficiency and had symptoms before starting folic acid.
You should post on the PA forum for further advice then. You may need testing for Perncious Anaemia, you may need B12 injections, they will advise.
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