Amber86 You need to make an appointment with your GP as soon as possible and ask the following questions.
*FOLATE 1.7 (2.5 - 19.5)
VITAMIN B12 203 (190 - 900)
Question - Why, when I am clearly folate deficient, have you done nothing about it?
Besides folate deficiency, your B12 is extremely low. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so then post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your folate, B12, ferritin (and all the other results). You may need further investigation to see if you have Pernicious Anaemia, you may need B12 injections. See what they say and then discuss that with your GP too.
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."
Do not start taking folic acid until any further investigations have been carried out.
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FERRITIN 58 (30 - 400) ferrous fumarate once a day on prescription since 2013
*MCV 78.2 (80 - 98)
*MCHC 385 (310 - 350)
Ferritin needs to be at least 70 for thyroid hormone to work, recommended is half way through it's range. I see that you are prescribed 1 x ferrous fumarate daily, so you need to ask
Question 1 - why, when my MCV and MCHC results suggest iron deficiency anaemia, have you not treated me appropriately?
Question 2 - why, when I have been taking ferrous fumarate for 4 years, is my ferritin still so low in range and I appear to have 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.
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 49.3 (25 - 50 deficient) - 800iu daily since 2013
Question - why, considering I have been supplementing Vit D for 4 years, is my level still within the Deficiency category?
The recommended level, according to the Vit D Council, is 100-150nmol/L.
800iu D3 isn't going to raise your level. It is hardly a maintenance dose for someone with a reasonable level.
However, your GP probably has his hands tied by the guidelines and is only allowed to prescribe 800iu. What you need is to buy some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 8 weeks then retest, privately if necessary. Once you've reached the recommended level you'll need a maintenance dose which may be 2000iu daily (or you could use 5000iu alternate days), 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
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
Brilliant advice from SeasideSusie but itsacontibual trend that I seen to be saying why don't doctors look at your results and advise you what to do. If things are out of range then it needs addressing. Complete waste of money if nothing is done about it and doesn't help the patient either!
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