I have started levothyroxine today due to GP accepting private bloods, he transferred them from the printout onto my medical record. He has said I am to start iron 3 times a day and folate once a day and vitamin D 800iu once a day. I told him I have cramps and spasms in muscles and he says could be low magnesium. My serum magnesium is normal but low but he did say magnesium blood test is not reliable so wondering if taking some magnesium would help?
Thankyou
Ferritin 15 (30 - 400)
Vitamin D total 28.8 (25 - 50 deficient)
Folate 2.0 (2.5 - 19.5)
Vitamin B12 203 (190 - 900)
Calcium 2.25 (2.20 - 2.60)
Calcium corrected 2.25 (2.20 - 2.60)
Magnesium 0.81 (0.70 - 1.00)
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Elena116
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Your B12 is also extremely low although in range and you need to check with the Pernicious anaemia forum on Healthunlocked because I believe that if you have unaddressed vitamin B deficiency then talking folic acid can mask a B12 deficiency and cause serious problems, 'subacute combined degeneration of the spinal cord'. B12 needs to be top of range to feel well anyway. Your doctor won't offer you supplements because you are within NHS range and so the NHS deems it not necessary to treat (saves money) but you should check it out with the experts so you don't run into problems.
800iu vitamin D is unlikely to be sufficient. Your doctor needs to give you loading doses I think. This is where SeasideSusie expertise comes in. Please check out her posts to other people for NICE guidelines and check out your CCG local area guidelines too.
As for magnesium, just supplement a reasonable amount, I take magnesium malate but I think magnesium citrate is fine. Your body doesn't store it so you need a little every day. It will tell you on the bottle how much you can take. It's one of the co-factors for vitamin D in addition to K2.
Your prescription for iron tablets 3 times a day is good! Did you have an iron panel and full blood count, was iron deficiency diagnosed? Ferrous Fumarate three times a day is the treatment for iron deficiency.
Ideally, with ferritin that low, you should have had an iron infusion which would have raised your level within 24-48 hours, tablets will take months. It might be worth asking him for this.
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.
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...
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Vitamin D total 28.8 (25 - 50 deficient) 800iu once a day
No, you need far, far more. Here are the NICE ~Clinical Knowledge Summary guidelines
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 ask 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 (not the 800iu you will be prescribed) 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/
If your GP wont give you the loading doses, come back and we can suggest a supplement and dose for you.
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
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."
As Nanaedake has said, your B12 is so low that it must be brought up much higher in range. I agree with her suggestion to pop over to the Pernicious Anaemia Society forum for further advice. Don't start your folate supplement yet as this can mask signs of B12 deficiency. You may need testing for Pernicious Anaemia, you may need B12 injections. Post on the PA forum, quote your Folate, B12 and Ferritin results, mention your iron deficiency (if that has been diagnosed) and any signs of B12 deficiency you may be experiencing healthunlocked.com/pasoc/posts
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Magnesium 0.81 (0.70 - 1.00)
Most of us test low in magnesium. The magnesium you take as a cofactor of D3 will take care of this.
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Calcium 2.25 (2.20 - 2.60)
Calcium corrected 2.25 (2.20 - 2.60)
These look fine.
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Don't start all supplements at once. Start with one, give it a week or two, if no reaction add in the next one, give it another week or two, if no reaction add the next one, and so on. This way if there are any problems you will know what caused it.
Well, it's at the low end of the range, but the range isn't very wide anyway. Vit D enhances absorption of calcium so that might raise it a bit. You need the K2 to direct the calcium away from arteries and soft tissues and to bones and teeth, very important
Although having calcium below or above range is obviously to be avoided, it is quite possible that all the supplements and the thyroid treatment you are getting will help your body to absorb more nutrients from your food. A suitable level of vitamin D supplementation will help a lot, as SeasideSusie said.
Calcium supplements should be avoided unless levels are deficient (not just low in range). If the body gets more calcium than it can cope with or use it starts getting deposited in the arteries and organs, which is where you definitely don't want it.
The fact that you have severe autoimmune hypothyroidism as well as very low nutrient levels suggests that you are one of the majority of sufferers of hypothyroidism - your gut doesn't work very well, and you almost certainly have very low stomach acid. To help yourself to get better you can't ignore your gut health.
Low stomach acid reduces absorption of Levo or other thyroid hormones, reduces your body's ability to extract nutrients from food, causes inflammation, increases the risk of parasites and infections getting a hold. You could also have Helicobacter Pylori. You probably have leaky gut (a condition that many doctors don't believe in - but the treatment for it is good for the gut anyway, so it doesn't really matter whether doctors "believe" or not).
1) You could ask your doctor for a Helicobacter Pylori (H. Pylori) test if you think it is appropriate for you. Do some research.
2) Search the forum for posts about stomach acid and how to deal with it when its low.
3) Go gluten-free - 100% ruthlessly and religiously. It doesn't matter whether you've been tested and found negative for coeliac, it is worth trying anyway. The testing is unreliable.
4) I strongly recommend you join this community and read lots of posts :
healthunlocked.com/glutenfr...
5) Do searches on the forum and on google for leaky gut, dysbiosis, sibo, Betaine HCL with Pepsin, apple cider vinegar, Chris Kresser, scdlifestyle.
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