Supplements advice please

I have Hashimotos and I have symptoms of going to the toilet more frequently (hard stool) heavy periods, tiredness, sweats, shaking, weak muscles, stretch marks on hips, hyperpigmentation on skin in creases, bone pain, headaches, weight gain, hair loss, puffy eyes and ankles.

Taking 6000iu vitamin D3 since March 2014, 5mg folic acid since October 2016, 210mg ferrous fumarate once a day for iron deficiency since January 2017. Results done in May 2017.

FERRITIN 57 (30 - 400)

FOLATE 2.35 (2.50 - 19.50)

VITAMIN B12 201 (190 - 900)

VITAMIN D TOTAL 66.2 (50 - 75 SUBOPTIMAL)

Thankyou

11 Replies

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  • Has the doctor prescibed the supplements? If so, have you asked him/her why your levels are still so low despite the supplements and what was their answer?

    Your B12 is terribly low and I don't see any supplement for it. Have you got symptoms of B12 deficiency? You're taking folic acid but with your B12 so low the folate supplementation could mask a B12 deficiency. B12 is best at top of range. Please post your B12 and folate results on the Healthunlocked Pernicious Anaemia forum for advice about these. I think your doctor needs to check for intrinsic factor antibodies to rule out pernicious anaemia but check with the experts.

    Look at SeasideSusie posts for correct supplementation of vitamins as I don't think you've been prescribed enough to get your levels up. You may also have some absorption issues which are common with thyroid conditions as you are taking a reasonable dose of vitamin D. Perhaps you need to consider a gluten free diet?

  • Sorry I lost my login. My GP prescribed the folic acid and ferrous fumarate and I had to buy the vitamin D 6000iu myself since the 800iu they prescribed to me did nothing. I have symptoms of B12 deficiency and I will consider going gluten free once I have done the gluten challenge and I know the results of this.

  • About 5% with Hashimotos are coeliac but about 88% are gluten intolerant or feel significantly better strictly gluten free. Antibodies often slowly drop too

    Do you have definite date for endoscopy

  • Thankyou no date for endoscopy yet. I will be speaking to my GP tomorrow about this at the appointment.

  • How can they ask you to do a gluten challenge and not have a date.

    Madness

  • Niki86

    FERRITIN 57 (30 - 400)

    210mg ferrous fumarate once a day for iron deficiency since January 2017

    If you actually have a diagnosis of 'iron deficiency' then your treatment is incorrect. See NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)

    cks.nice.org.uk/anaemia-iro...

    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.

    I would make an appointment with your GP and point this out, and ask to be given the appropriate 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.

    For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

    **

    FOLATE 2.35 (2.50 - 19.50)

    VITAMIN B12 201 (190 - 900)

    5mg folic acid since October 2016

    Well, you're getting the right treatment for folate deficiency. Is that 5mg daily or weekly?

    Before you started the folic acid, were you checked for signs of B12 deficiency? Taking folic acid can mask them. Check now, and think back to any that may have been present before starting the folic acid b12deficiency.info/signs-an...

    You would be better off posting on the Pernicious Anaemia Society forum for further advice, particularl as your B12 level is so very low, supplementing with OTC supplements doesn't really seem appropriate with that level. Quoe your folate and B12 results, your iron deficiency and any signs of B12 deficiency you have or still 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 TOTAL 66.2 (50 - 75 SUBOPTIMAL)

    Taking 6000iu vitamin D3 since March 2014

    Taking that amount of D3 for over 3 years, one would expect to see your level out of the sub-optimal category. I raised mine from severely deficiency at 15 to 200 in 2.5 months.

    You could raise your dose up to 10,000iu daily for 4-6 weeks then retest to see if it's made a difference

    vitamindtest.org.uk/

    If not then I imagine you might have an absorption problem which is very common with Hashi's. SlowDragon has lots of information about gut and absorption problems and I'm sure she'll be along soon with some links.

    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.

  • Sorry I lost my login. I take folic acid once a day.

  • Yes I had symptoms before starting the folic acid

  • It would be best to post on the PA forum then.

  • Hi - with those deficiency levels despite supplements, I would assume you have an absorption problem. Since you have hashis have you at least trialled a strict gluten free diet for at least 3 months? Do you have any stomach related symptoms that could suggest low stomach acid (easy to mistake for too much acid)? Have you taken any measures to heal leaky gut?

  • Sorry I lost my login I have not trialled a gluten free diet because GP wants me to do gluten challenge and I have stomach related problems as well such as loos stool but mainly constipation and some weight loss.

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