You should take these results over to the Pernicious Anaemia Society here on Health Unlocked for further advice. Also quote your ferritin and iron results and any signs of B12 deficiency healthunlocked.com/pasoc
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 along with a good B Complex to balance all the B vitamins but I believe you may need further investigation so see what the PA forum says.
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Serum ferritin 56 ug/L (30 - 400 ug/L)
Ferritin should be half way through it's range.
MCV 77.1 fL (80 - 98 fL)
MCHC 386 (310 - 350)
MCH 28.1 (28 - 32)
This is suggestive of iron deficiency anaemia and the appropriate treatment is ferrous fumarate two or three times daily. Point out to your GP that you think this indicates iron deficiency anaemia because your MCV is below range, and ask for an increase in your iron tablets.
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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Vitamin D total nmol/L (25 - 50 nmol/L vitamin D deficiency. Supplementation is indicated)
You've missed out your result.
However, as you've put the deficiency range of 25-50 your 800iu daily isn't enough. Tell us what your level is and we can suggest an appropriate dose of D3.
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
OK, so that's just above what the guidelines say need loading doses and that your GP should prescribe just 800iu daily.
The recommended level, according to the Vit D Council, is 100-150nmol/L so you need to aim for that level. My suggestion is to buy some D3 softgels like these bodykind.com/product/2463-b... and take 10,000iu daily for 2 months, reduce to 5000iu daily for one month then retest with vitamindtest.org.uk/index.html
If you're worried about taking 10,000iu daily, then just take the 5000iu daily but it will take longer to raise your level. When you've reached 100-150nmol/L you need to find 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.
Don't forget the cofactors and to keep D3 four hours away from thyroid meds.
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.
Just as an example, my level was severely deficient at 15. I didn't bother with my GP, I did it myself with guidance from here. I got mine up to 202 in 2.5 months with loading doses then dropped to 5000iu. I have now found that my maintenance dose, to keep within the 100-150nmol/L recommended by the Vit D Council, is 2000iu daily for 7 days a week. If I lower it to 5 days a week it goes to low. So we all need to find our own maintenance dose, but I doubt anyone's would be as low as 800iu daily, so there's no way that amount can raise a deficient level.
Unfortunately, doctors know nothing about symptoms, because they don't 'do' them in med school. A lot of your symptoms are due to your thyroid, even though quite a few are due to your terrible nutrient levels. Loss of eyebrows, for example. But, sometimes, they don't grow back, even when you are on the right dose. High cholesterol is also a low T3 symptom. Did it stay high, even when you were on 200 mcg levo and 20 T3?
You might want to try magnesium, too. Not only is it a cofactor of vit D3, but it's also good for muscle cramps and constipation.
But, a word of warning, do not start taking all those different supplements at the same time. Leave about two weeks in between starting each one, so that you know how your body reacts to it.
Thanks I have only ever had cholesterol checked the once and yes it was high. 5.6 (<5.0) I think it was total cholesterol? I was taking the T3 and Levothyroxine combi at the time.
5.6 isn't really high. Since the push to get everyone on statins, so-called normal levels have been reduced several times. You need cholesterol to make hormones. It's oxidized LDL that is the problem.
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