Taking 3000iu vitamin D for vitamin D deficiency diagnosed 2013. Taking ferrous fumarate 210mg once a day for iron anaemia diagnosed 2013. Taking 5mg folic acid for folate anaemia diagnosed 2016.
Symptoms - breathlessness when walking uphill, joint pain, headaches, tiredness, sweet cravings, dizziness, ears ringing, weight gain, flaky nails, eczema.
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Sam17b
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Serum ferritin 57 ug/L 30 - 400) - Taking ferrous fumarate 210mg once a day for iron anaemia diagnosed 2013
Is your iron deficiency anaemia being monitored? Has your MCV/MCHC you been tested lately?
The time has come to ask your doctor why, four years after being diagnosed with iron deficiency anaemia and supplementing, is your ferritin still so low in range.
The answer will be found within the guidelines for treating iron deficiency anaemia -
NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)
•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.
So you will see that if your results still show iron deficiency anaemia then you have been undertreated all this time. Point this out and ask to be treated appropriately (with an apology might be nice!!!)
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.
Point out to your GP that you are still folate deficient despite taking folic acid for a year, and ask him why. Is your folic acid daily or weekly?
Before you started taking the folic acid, were you checked for signs of B12 deficiency? Check now and think back because supplementing with folic acid can mask these signs b12deficiency.info/signs-an... If you have had or do have signs of B12 deficiency please post on the Pernicious Anaemia Society forum for further advice, your B12 is way too low healthunlocked.com/pasoc You need to quote your folate, B12 and ferritin results, mention your iron deficiency anaemia and any signs of B12 deficiency you are experiencing.
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."
**
Total vitamin D 63.5 nmol/L (50 - 75 suboptimal) - 3000iu vitamin D for vitamin D deficiency diagnosed 2013
Considering, again, how long you've been supplementing Vit D, your result is surprisingly low.
The recommended level is 100-150nmol/L according to the Vit D Council.
You could increase your dose up to 5000iu daily with no problem then retest in 3 months to see if you have improved.
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
One thing that springs to mind is that you have been taking all these supplements for such a long time with little to no improvement. This could very well be due to an absorption/gut problem which often goes hand in hand with Hashi's.
SlowDragon has information and links about this and I'm sure she'll join in when she's around.
Iro anaemia is monitored by GP and not haematology anymore, the haematologist wants my ferritin above 50. Any lower and I need another infusion. MCV is 78.2 (80 - 98) MCHC 379 (310 - 350) haemoglobin estimation 114 (115 - 150) iron 5.7 (6.0 - 26.0) transferrin saturation 12 (10 - 30)
Folic acid is daily and I was no checked for signs of B12 deficiency.
So your MCV is below range, MCHC above range, haemoglobin below range, iron below range. All point to continuing iron deficiency anaemia. You should be on the appropriate dose of FF as highlighted above. You should ask why you are not and how are you expected to overcome this if you're not given the correct treatment. Four years of treatment and still have iron deficiency anaemia - you have to wonder how they actually qualified in medicine!
I was no checked for signs of B12 deficiency.
Check now on the link given, and if you have any then post on the PA forum for further advice. Don't forget that taking folic acid could have masked the signs for the last 12 months.
I'd also suggest asking GP to investigate possible absorption problems seeing as you have problems with iron, folate and most likely B12.
potential problems: PA (see the links SeasideSusie has refered you to), Coeliacs, h pylori, SIBO, and drug interactions (including PPIs if you have any problems with stomach acidity)
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Vitamin/mineral levels
vitamin and mineral levels
Vitamin and mineral levels 
