Vitamin levels

[Katalina2]

Ferritin 11 (15 - 150)

Folate 2.3 (4.6 - 18.7)

Vitamin B12 183 (190 - 900)

Vitamin D 20.6 (<25 severe)

Thanks

[SeasideSusie Remembering]

Katalina2 What has your doctor said about these results? Have you been prescribed anything? You are deficient in everything and no thyroid hormone can work until these levels have been improved, preferably optimal.

Ferritin 11 (15 - 150)

Have you had an iron panel and full blood count done to see if you have iron deficiency anaemia? If not ask for one.

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.

If you have iron deficiency anaemia confirmed then the treatment is 1 x ferrous fumarate 2 or 3 times a day. With your ferritin level then the maximum would be preferable.

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 should be half way through it's range with a minimum of 70 for thyroid hormone to work.

**

Folate 2.3 (4.6 - 18.7)

Vitamin B12 183 (190 - 900)

Check for signs of B12 deficiency b12deficiency.info/signs-an... then go to the Pernicious Anaemia Society forum for further advice. Quote your Folate, B12 and ferritin/iron results, plus any signs of B12 deficiency you are experiencing 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."

**

Vitamin D 20.6 (<25 severe)

As you can see you are severely deficient.

NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...

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. Go and see your GP and demand that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and 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

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.

[Katalina2 in reply to SeasideSusie]

I have been prescribed 210mg ferrous fumarate to take 3 times a day because complete blood count showed MCV 78.2 (80 - 98) MCHC 375 (310 - 350) and Haemoglobin 126 (120 - 150)

Iron panel was in range 9.3 (6.0 - 26.0) transferrin saturation 15 (10 - 30)

Loading dose of vitamin D given of 300,000 for 6 weeks and then maintenance dose of 800iu. Folic acid given, 5mg once a day. Waiting on intrinsic factor results.

[SeasideSusie Remembering in reply to Katalina2]

Katalina2

You are on the correct dose of ferrous fumarate, hopefully you are being monitored in accordance with the guidelines.

Your maintenance dose of 800iu D3 is likely to be totally inadequate as mentioned above. Have you been retested following your loading dose and what was it?

[Katalina2 in reply to SeasideSusie]

Hi I was put on loading dose of 300,000 vitamin D following the above results, I don't know what my results are now.

[SeasideSusie Remembering in reply to Katalina2]

You really need to know. He has given you the correct loading doses but 800iu wont raise your level if it's still below the Vit D Council recommended level of 100-150nmol/L. 800iu is barely a maintenance dose for someone with a decent level. I need 2000iu daily all year round to keep mine between 100-150. Often you can't get a retest on the NHS because they say it's expensive. To prevent you staying in the deficient or insufficient category, I strongly recommend you test yourself with City Assays as mentioned above, find out your level, post on the forum and we can advise a sensible dose.

Don't forget the very important cofactors needed when taking D3.

[SlowDragon Administrator]

These vitamins are absolutely dire due to reduction in dose you last endo advised. How long has dose been reduced? Did it go straight from 175mcg T4 and 10mcg T3 down to 100mcg T4 only?

Do you have test results from when on higher dose?

Your going to need to improve these terrible vitamin levels, probably need to supplement permanently at some maintenance level

Highly likely you will find strictly gluten free diet helps, as per my reply on your other post

But you need also to put dose Levo back up. Probably in 25mcg steps while vitamins are improving. Once more stable on higher dose of Levo look at adding T3 back in too

If your GP has not reacted to these results you need to see a different one.

[Katalina2 in reply to SlowDragon]

Dose reduced 2 weeks ago straight from 175mcg and 10mcg to 100mcg levo only, results on higher dose

TSH <0.02 (0.2 - 4.2)

Free T4 20.6 (12 - 22)

Free T3 5.3 (3.1 - 6.8)

[SeasideSusie Remembering in reply to Katalina2]

Kataline - there was absolutely nothing wrong with those results and a reduction in dose was not warranted in the slightest. The suppressed TSH panicked your doctor but both free Ts were in range.

See Dr Toft's article in Pulse magazine (he is past president of the British Thyroid Association and leading endocrinologist) thyroiduk.org.uk/tuk/about_... > Treatment Options - which says

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

That applies to someone on Levo only. Once you add T3 into the mix, TSH is generally very low or suppressed and FT4 can lower, but as long as FT3 is within range there is no problem, the patient is not overmedicated. If you were feeling well with those results you should have been kept on the same doses, if you were feeling a little over medicated then a small decrease in Levo would have been enough. With your current results in your other thread, it's already been said that you need your dose increased, preferably back to what you were on or maybe 150mcg Levo and 10mcg T3 and see how you feel.

[Katalina2 in reply to SeasideSusie]

Hi no I was feeling under medicated and not over medicated at all. Thanks

[SeasideSusie Remembering in reply to Katalina2]

You now need to fight to get your dose put back up.

[SlowDragon Administrator in reply to Katalina2]

So when were vitamins tested? Since dose decrease ?

Or when on 175mcg and 10mcg T3