Ferritin 78 (30 - 400)
Ferritin should be half way through it's range
MCH 28.7 (28 - 32)
MCV 73.4 (80 - 100)
MCHC 396 (300 - 340)
These alone suggest iron deficiency anaemia. Your GP isn't treating you for this so you must ask him to do so immediately and point out the following
NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):
Have a read through but this is the treatment:
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.
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.
Folate 2.2 (2.5 - 19.5) - taking 5mg folic acid once a week
Vitamin B12 338 (190 - 900)
You are correct, folic acid should be 5mg daily. Ask your GP to increase your prescription.
As for Vit B12 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." Check for signs of B12 deficiency here b12deficiency.info/signs-an... and if you have any then post on the Pernicious Anaemia Society forum here on Health Unlocked healthunlocked.com/pasoc
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 along with a good B Complex to balance all the B vitamins. So if you have no signs of deficiency then you may wish to supplement to increase your level, maybe 5000mcg to start, followed by 1000mcg as maintenance. A B Complex is recommended to keep all the B Vitamins balanced.
Vitamin D 60.9 (50 - 75 suboptimal) Taking vitamin D 6000iu from 800iu GP prescribed, am I wrong in thinking the 800iu wasn't enough?
You are absolutely correct, 800iu isn't even a maintenance dose for someone with a reasonable level.
The recommended level is 100-150nmol/L so you could continue with your 6000iu daily if you wish, or you may want to reduce it to perhaps 4000iu daily, but once you reach the recommended level 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
Check out the other cofactors too.