Thyroid UK
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Vitamins and minerals

Feeling unwell with cold intolerance, pins and needles, deep aching in bones, tiredness, memory loss, concentration, loss of outer third of eyebrows, puffy eyes. Am I likely under medicated? Diagnosed 2013 with iron deficiency and vitamin D deficiency and 2016 with folate deficiency. Thankyou

Sep 2017 (800iu vitamin D/1 ferrous fumarate/5mg folic acid)

Ferritin 53 (30 - 400)

Folate 2.3 (2.5 - 19.5)

Vitamin D 25.8 (25 - 50 deficient)

Vitamin B12 135 (180 - 900)

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Amberblue1

Ferritin 53 (30 - 400) 1 ferrous fumarate Diagnosed 2013 with iron deficiency

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. You can also 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...

As you have been diagnosed with iron deficiency, your treatment is wrong - assuming that you've been monitored and your results still show iron deficiency. Check out the following, discuss with your GP and ask for the appropriate treatment, also ask him why, considering you've been diagnosed with iron deficiency since 2013, has he done nothing about the fact that your ferritin (your iron store) is still so low in it's range and you're still showing iron deficiency (if you are).

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.

**

Folate 2.3 (2.5 - 19.5) Vitamin B12 135 (180 - 900) 5mg folic acid

What about your B12 deficiency? Did your GP check you for signs of it before starting the folic acid? He should have done. You can do that here b12deficiency.info/signs-an... Then you need to go and post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

With a B12 level that low you should be tested for Pernicious Anaemia and you probably need B12 injections. You should not have been started on folic acid until further investigations had been carried out.

See what the PA forum advises then discuss with your GP. He has been negligent in ignoring your B12 level.

**

Vitamin D 25.8 (25 - 50 deficient) 800iu vitamin D

You are 0.8 away from severe Vit D deficiency. 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level.

You need loading doses. Check out:

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 a paltry 800iu) 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.

Reply

Not monitored for iron deficiency, had MCV back at 78.2 (80 - 98) and MCHC 376 (310 - 350) Haemoglobin 121 (120 - 150) iron 7.4 (6.0 - 26.0) transferrin 15 (10 - 40) haven't been checked for B12 symptoms will go to pernicious anaemia forum

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MCV back at 78.2 (80 - 98)

This result suggests you still have iron deficiency. Speak to your GP about having the proper treatment, ie 3 x ferrous fumarate daily.

Your doctor has been extremely ignorant and negligent. I would see another GP and point out all that this GP has ignored.

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Hashimoto's very often affects the gut, leading to low stomach acid, low vitamin levels and leaky gut.

Your dire vitamin levels clearly demonstrates this.When vitamin D, folate, ferritin and B12 are too low they stop Thyroid hormones working.

It's essential to improve vitamins along side increasing dose back up and eventually adding T3 back in. Either with approval of another's endo or consider self medicating

But also as you have Hashimoto's then leaky gut leads to hidden food intolerances may be causing issues, most common by far is gluten. Changing to a strictly gluten free diet may help reduce symptoms. Very, very many of us here find it really helps and can slowly lower antibodies.

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/why-changi...

scdlifestyle.com/2014/08/th...

Vitamin D - personally I use this mouth spray (avoids poor gut function)

betteryou.com/vitamin-d-tes...

They also offer free spray with testing (you can order test or supplements individually)

Your going to need much higher dose than 800iu, more like 5000iu or 6000iu daily for 2-3 months and retest. NHS unlikely to offer regular testing.

We need to test twice a year until at least work out how much daily dose you need to keep at stable level of around 100nmol

Level may vary summer to winter. Try to also top up with proper sunshine (10-15mins without sunscreen and don't shower straight after)

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...

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Amberblue1

If you want to get well, you have to help yourself.

It's Your body suffering - Everything is low. 800 Vit D is pitiful - 5000iu daily may make a difference (iron & folate probably too). As others have said treat deficiencies first, eat well and regularly - any medication won't work otherwise.

If its Thyroid hormone you're 'undermedicated' on, you need to post your dose & blood results before anyone can offer help.

Best wishes J :D

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you have multiple vitamin deficiencies - on-going - which now seems to include B12 from the range above - sure SeasideSusie has given link to PAS forum which can give more advice specifically in relation to B12.

Your GP really needs to investigate potential absorption problems - which would include PA, coeliacs, crohn's, h pylori infection, SIBO .... and drug interactions such as PPIs

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