Taking vitamin D 800iu and ferrous fumarate since 2013 when should levels be rising on this? Thank you
June 2017
Ferritin 22 (30 - 400)
Folate 3.1 (4.6 - 18.7)
Vitamin D 25.5 (25 - 50 deficiency)
B12 203 (190 - 900)
Fultium 800iu vitamin D once a day
210mg ferrous fumarate once a day
No B12
No folate
Something is not right Khlo!
All your levels are exceptionally low and are indicative of serious deficiencies.
Vitamin D 800 iu is very low and will not boost your levels.
Could you please provide a list of the supplements/brands/strengths/frequencies of what you have been taking.
Done thanks
Thanks.
Vitamin D
Better to switch from Fultium as you'll need 5000 iu for three - 6 months. Vitamin D is fat soluble; so, to be taken with your main meal. Morning or night, it doesn't matter, as long as you have fat ie cheese, oil, meat, fish, butter, etc.
Iron: You can triple the dose for three months; then, reduce to double.
210 mg of ferrous fumarate three times a day for three months; then, twice a day for another three months and test.
All iron supplements to be taken away from calcium, tea, coffee, and best to be taken with vitamin C. So to add, Vitamin C to your daily routine with a minimum of 500 mg x 2 a day.
B12: 5000 mcg of methylcobalamin for three months; then reduce to 1000 mcg daily + whatever dose is in the B-Complex, as below.
You need to add to this a good b-complex to balance the B vitamins and to get the folate. All B-complex will have 400 mcg of folate safer to start with this dose as we don't know the condition of the methylation in your body and its pathway. If they are congested, too much folate will upset your system.
Avoid 'Folic acid' as it is the synthetic form and will not be properly absorbed; hence, the recommendation for folate.
Lots of brands are out there for the Vitamin D, b-complex, and the same for methylcobalamin which comes as pills and as lozenges. All depends on your personal preferences. I take pills as I am not very fond of the lozenges.
Please have a look at Amazon, iHerb, and decide which ones you'd prefer.
Test in 6 months; so, to establish the new levels.
I hope all goes well this time.
Khlo3 There are far too many dire results here to just increase the supplements yourself. You need to discuss some of this with your GP.
Ferritin 22 (30 - 400)
210mg ferrous fumarate once a day
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...
BUT you really need an iron infusion for a level as low as this so ask for one, but you may only be allowed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.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.
ALSO did you have a full blood count and iron panel done to see if you have iron deficiency anaemia. A ferritin level as low as yours can indicate this so if not done ask for them to be carried out. Treatment for iron deficiency anaemia is 3 x ferrous fumarate daily and you need monitoring either by a haemotologist or your GP.
You need to ask your GP why, after 4 years of supplementing with ferrous fumarate, is your ferritin level still below range. This needs investigating, you may have absorption problems.
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Folate 3.1 (4.6 - 18.7)
B12 203 (190 - 900)
You need to ask your GP why these results have been ignored.
You are folate deficient with extremely low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... You should post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc and you should quote your folate, B12, ferritin results, any iron deficiency information, any signs of B12 deficiency you may be experiencing. You may need testing for Pernicious Anaemia and you may need B12 injections.
You should discuss the PA forum's advice with your GP. If you are prescribed folic acid DO NOT start taking it until any further investigations regarding your B12 have been done.
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."
I think a B12 level is too low to start self supplementing.
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Vitamin D 25.5 (25 - 50 deficiency) Fultium 800iu vitamin D once a day
Again, you need to ask your GP why, after 4 years of supplementing, are you 0.5 away from severe Vit D deficiency. You need far, far more than 800iu daily, that isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.
You need loading doses - see
NICE treatment summary for Vit D deficiency:
cks.nice.org.uk/vitamin-d-d...
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 (not the paltry 800iu prescribed) 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 maintenance dose which may be 2000iu daily (not 800iu), 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
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.
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You have Hashi's so very likely you have gut/absorption problems as SlowDragon has mentioned in your other thread. That needs addressing before vitamins and minerals can be absorbed properly.
**
I find it quite shocking that your GP can see, and has ignored, that 4 years supplementing has done nothing to improve your levels. I really do think you need to ask him why he has ignored this.
Hi GP said complete blood count and iron panel results don't suggest anaemia and that's why I only take 1 iron tablet a day.
RBC count 4.46 (3.80 - 5.80)
WBC count 6.15 (4.00 - 11.00)
MCHC 375 (310 - 350)
MCH 27.8 (27 - 32)
MCV 78.4 (80 - 98)
Haemoglobin 120 (115 - 150)
Iron 7.8 (6.0 - 26.0)
Transferrin saturation 15 (10 - 30)
MCV 78.4 (80 - 98)
This suggests iron deficiency anaemia.
From labtestsonline.org.uk/under...
When the MCV is decreased, your RBCs are smaller than normal (microcytic), which may indicate iron deficiency anaemia, inflammation or occasionally thalassaemias.
From drkaslow.com/html/blood_cel...
The MCV is decreased in:
......
Iron deficiency (blood loss, parasites, poor intake, low stomach acid, etc)
.....
From healthline.com/health/rbc-i...
Low MCV
The MCV will be lower than normal when red blood cells are too small. This condition is called microcytic anemia.
Microcytic anemia may be caused by:
•iron deficiency, which can be caused by poor dietary intake of iron, menstrual bleeding, or gastrointestinal bleeding
........
You might want to ask your GP exactly what these out of range results do mean
MCHC 375 (310 - 350)
MCH 27.8 (27 - 32)
MCV 78.4 (80 - 98)
A key criterion of treating anemia is the full profile as you have said. However, you have been taking one ferrous fumarate since 2013, a long period, and your results continue to be way too low, as per your original post.
The levels of ferritin are strikingly low and so are your B12 and ought to be addressed very soon. Your transferrin saturation, again very low, came to confirm it. Please check with a different GP. Most surgeries have now more than one.
Have they checked you for celiac?
I wish you'll soon get on the right track!
Take care
Hi haven't been checked for coeliac, what does that involve? Thanks
Coeliac is an auto-immune condition whereby the villis, hair-like sensors designed to facilitate absorption, within the small intestine, which is about 20 ft long, are wiped out/destroyed. As result, you are not absorbing iron, folate, and B12. All of these are usually absorbed in the upper two parts of the intestine. This condition has a strong connection with gluten.
Several tests can be done for diagnosis such endoscopies (to examine the condition of the intestine followed by biopsies (taken from different parts of the small intestine to assess the quality of the villi), and blood tests. Endoscopy is done via an endoscope which is a tube with a camera at its end going down your throat into the stomach and then to the small intestine). A day procedure that can be done with a sedation.
One of the most common sign of celiac disease in adults is iron-deficiency anemia that is unresponsive to iron therapy. In your case, the iron supplementation dose was too weak to make a difference; however, due to the low B12 and folate, your GP might support you with a referral to have the celiac blood test and an endoscopy. Once the diagnosis is done, the main recommendation is to give up gluten ( a protein found in wheat and other grains).
I hope this helps for now.
If you need any other information, please let me know.
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