Vitamins and minerals

[Ellenw]

Ferritin 61.1 (30 - 400)

Folate 2.6 (4.6 - 18.7)

Vitamin B12 323 (190 - 900)

Vitamin D 68.8 (50 - 75)

Taking 210mg ferrous fumarate once a day for anaemia, haematologist doesn't want ferritin below 50

Taking folic acid

Taking 3000iu vitamin D

Thanks

[SeasideSusie Remembering]

Ellenw

Ferritin 61.1 (30 - 400)

Taking 210mg ferrous fumarate once a day for anaemia, haematologist doesn't want ferritin below 50

Presumably you have a diagnosis of Iron Deficency Anaemia and your haematologist is monitoring you?

If so then you might want to ask why he's not following the treatment guidelines for iron deficiency anaemia

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.

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.

**

Folate 2.6 (4.6 - 18.7)

Taking folic acid

Vitamin B12 323 (190 - 900)

Is your folic acid 5mg daily or weekly? How long have you been taking it? Is this level from before you started supplementing or since you started?

Have you had, or currently have any signs of B12 deficiency b12deficiency.info/signs-an... If so you should post on the Pernicious Anaemia Society for further advice 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."

Sublingual methylcobalamin lozenges are what's needed to supplement B12 yourself along with a good B Complex to balance all the B vitamins.

**

Vitamin D 68.8 (50 - 75)

Taking 3000iu vitamin D

Your dose of D3 is fine as long as your level is rising, if not you could increase the dose. The Vit D Council recommends a level of 100-150nmol/L.

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.

[Ellenw in reply to SeasideSusie]

Haematologist no longer monitoring me and I have a diagnosis of iron deficiency

[SeasideSusie Remembering in reply to Ellenw]

So you need to discuss the treatment guidelines for iron deficiency with your GP and get the appropriate amount of ferrous fumarate.

[Ellenw in reply to SeasideSusie]

Taking folic acid for a year and it is daily. Level after supplementing

[SeasideSusie Remembering in reply to Ellenw]

As your GP why, after a year of supplementing, do you still have a folate deficiency.

[Ellenw in reply to SeasideSusie]

I have symptoms of B12 deficiency

[SeasideSusie Remembering in reply to Ellenw]

Post on the PA Forum as advised.

[Ellenw in reply to SeasideSusie]

Thanks could I increase vitamin D to 6000iu if 3000iu is not increasing it and take the prescribed 800iu in the winter?

[SeasideSusie Remembering in reply to Ellenw]

Yes, increasing to 6000iu now would be fine, test your level in November (privately if necessary).

Don't bother with 800iu as a maintenance dose, it's too low, especially for the winter. Come back with your level in November and if it's reached the recommended 100-150nmol/L you need to find your 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 (November and April are good times). You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

[SlowDragon Administrator]

Do you know if you have ever had your thyroid antibodies tested. If the result was ever above normal range this means the cause of being hypo is autoimmune thyroid disease also called Hashimoto's.

About 90% of hypothyroidism in UK is Hashimoto's

With Hashimoto's the gut is often affected, leading to low vitamins and also extremely common to get food intolerances- by far the most frequent is gluten

Changing to a strictly gluten free diet may help reduce symptoms and eventually start to lower antibodies. Very very many of us here find it really helps and is essential to be gluten free

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Great film definitely shows why just testing TSH is inadequate

drbradshook.com/understandi...

[Ellenw in reply to SlowDragon]

TPO antibodies 275 (<34)

TG antibodies 356.1 (<115)

I think that means Hashimotos.

[SlowDragon Administrator in reply to Ellenw]

Yes. Medics tend to ignore/not understand it.

Read as much as possible about everything to do with Hashimoto's

Need to get antibodies lower to feel better.