Help with supplements please

Latest vitamin and mineral results and taking 800iu vitamin D3 only is this enough? Symptoms include pins and needles anxiety hair loss tiredness puffy eyes and ankles constipation and weight loss Thank you in advance.

Folate 2.3 (2.5 - 18.5)

Vitamin B12 241 (190 - 900)

Vitamin D total 53.1

(<25 severe vitamin D deficiency

25 - 50 vitamin D deficiency

50 - 75 vitamin D suboptimal

>75 adequate)

Ferritin 22 (30 - 400)

3 Replies


Folate 2.3 (2.5 - 18.5)

Vitamin B12 241 (190 - 900)

You are folate deficient (your GP should have picked up on this) with low B12. Do you have any signs of B12 deficiency If so please post on the Pernicious Anaemia Society forum for further advice, quote B12/Folate/Ferritin (and any iron/full blood count results) and any signs of deficiency

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."


Vitamin D total 53.1

The recommended level is 100-150nmol/L according to the Vit D council. It will take a very long time, if ever, for 800iu D3 daily to raise you to this level.

My suggestion would be to buy some D3 softgels like these and take maybe 3000-4000iu daily for 3 months then retest. When you've reached the recommended levvel, 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

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.


Ferritin 22 (30 - 400)

Your ferritin is below range. You need to ask your GP to do an iron panel, full blood count and haemoglobin test to see if you have iron deficiency anaemia.

Ferritin needs to be at least 70 for thyroid hormone to work. I've seen it recommended to be half way through it's range, also seen it said that for females it should be 100-130. Whichever is correct you are a very long way off and need supplementing.

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.

However, if you are prescribed iron tablets then 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.

Hi I have iron panel which says

Iron 9 (6 - 26)

Transferrin saturation % 18 (10 - 30)

Complete blood count

Red blood cell (RBC) count 4.46 (3.80 - 5.80)

White cell count 6.15 (4.0 - 11.0)

Haemoglobin 120 (115 - 150)

MCV 78.1 (80 - 98)

MCHC 376 (310 - 350)

MCH 28.2 (28 - 32)

Haematocrit 0.410 (0.370 - 0.470)

Haemoglobin 120 (115 - 150)

MCV 78.1 (80 - 98)

MCHC 376 (310 - 350)

MCH 28.2 (28 - 32)

These suggest iron deficiency anaemia, point this out to your GP.

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.

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