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[AbbieC]

FERRITIN 22 (30 - 400)

FOLATE 2.0 (2.5 - 19.5)

VITAMIN B12 193 (190 - 900)

VITAMIN D TOTAL 25.6 (25 - 50 deficiency)

Hi new member been told my thyroid levels are normal so here are vitamin and mineral levels thanks

[Nanaedake]

Hello AbbieC and welcome. It would be good if you posted your Thyroid results and include the laboratory ranges too. Often we are told by our GP that our thyroid results are fine but what the doctor thinks is fine might not be optimal or make us feel well. People with experience on here will be able to help.

Your vitamin levels are deficient. What is your doctor doing about them? You need to ask for a full iron panel but in the meantime you need supplements. Has your doctor contacted you? If not make an urgent appointment to get the help you need.

SeasideSusie gives excellent supplements advice. You can check out her post to another forum member here.

healthunlocked.com/thyroidu...

Scroll down the post to find her reply.

[AbbieC in reply to Nanaedake]

Hi I have been prescribed 800iu for vitamin D and 210mg ferrous fumarate to take once a day and given 5mg folic acid . Was told B12 is still in range.

[Nanaedake in reply to AbbieC]

You've not been prescribed enough iron yet. Check out the information in the post by SeasideSusie. You need ferrous fumarate 3 times a day with an iron level that low so make sure your return to your GP to discuss. When is your next appointment? B12 is hardly in range and it's best at the top of the range. If you supplement with folic acid and have a B12 deficiency you may mask the B12 deficiency and this can have consequences. I'm not an expert so you need to get advice from Healthunlocked Pernicious Anaemia forum and take the information to your GP. Post your B12 and folate results on the Pernicious Anaemia forum to get advice

800iu is not enough for vitamin D deficiency. You need loading doses and 800iu is hardly a maintenance dose. Your GP should follow NICE guidelines which will be similar to local area guidelines. Go back to your GP and ask to be treated as per the NICE and local area guidelines. You can read more on the weblink I gave in previous msg.

[SeasideSusie Remembering in reply to AbbieC]

AbbieC

FERRITIN 22 (30 - 400) 210mg ferrous fumarate to take once a day

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

Ideally you need an iron infusion so ask for one, but you may only be prescribed the tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.

I don't think 1 x FF daily is enough considering your ferritin is below range. 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...

Did you have an iron panel and full blood count to see if you have iron deficiency anaemia. As your ferritin is below range this really should be done and the treatment is 3 x ferrous fumarate daily.

**

FOLATE 2.0 (2.5 - 19.5) VITAMIN B12 193 (190 - 900) 5mg folic acid

"Was told B12 is still in range." - yes it is, but look how close to the bottom it is, and where the top of the range is. Your GP should have checked to see if you have signs of B12 deficiency - check that now b12deficiency.info/signs-an... then pop over to the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc/posts quoting your Folate, B12, Ferritin results, any iron deficiency information, and say you're taking folic acid, also mention any signs of B12 deficiency that you may be experiencing. Bear in mind that taking folic acid can mask signs of B12 deficiency so think back to before you were taking it. You may need testing for Pernicious Anaemia, you may need B12 injections. Whatever they advise, discuss with your GP.

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."

Folate should be at least half way through it's range.

**

VITAMIN D TOTAL 25.6 (25 - 50 deficiency) 800iu for vitamin D

You are just 0.6 away from severe deficiency and 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. 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 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.

**

Vitamins and minerals all need to be optimal for thyroid hormone to work. I have my doubts that your thyroid levels are 'normal' considering these deficiencies. It will be interesting to see what they are and how much Levo you are taking.

**

Edited to add:

Yes, iron deficiency anaemia. Discuss with your doctor the 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.

[AbbieC in reply to Nanaedake]

Also MCV 78.3 (80 - 100)

MCHC 379 (310 - 350)

MCH 28.1 (28 - 32)

Haemoglobin estimation 116 (115 - 150)

Iron 7.2 (6.0 - 26.0)

Transferrin 15 (10 - 30)

[Nanaedake in reply to AbbieC]

Ok so your iron panel confirms deficiency. MCV is below range and MCH only just within but nowhere near mid-range. Iron is only just in range but far too low.

[Clutter]

Welcome to the forum, AbbieC.

Normal simply means results are within range. Hypothyroidism isn't diagnosed until TSH is over range or FT4 below range. If you are already diagnosed and taking Levothyroxine you should be looking for optimal results not normal results.

VitD 25.6 is deficient. Has your GP prescribed D3 and, if so, what dose?

B12 193 could be deficient even though it is just within range. If you have symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice.

Folate is deficient and your GP should prescribe 5mg folic acid for 2-3 months but you shouldn't take folic acid until 48 hours after B12 deficiency is treated with injection or B12 deficiency is ruled out.

Ferritin is deficient and can indicate iron deficiency anaemia. Your GP should order an iron panel and full blood count to check.

[AbbieC in reply to Clutter]

Also MCV 78.3 (80 - 100)

MCHC 379 (310 - 350)

MCH 28.1 (28 - 32)

Haemoglobin estimation 116 (115 - 150)

Iron 7.2 (6.0 - 26.0)

Transferrin 15 (10 - 30)

Taking 800iu vitamin D3 thanks

[Clutter in reply to AbbieC]

AbbieC,

MCV below range and low ferritin and iron indicates iron deficiency. The usual dose for deficiency is 2 or 3 x 210mg Ferrous Fumarate. Take each dose with 1,000mg vitamin C to aid absorption and minimise constipation. If you are taking Levothyroxine it should be taken 4 hours away from Ferrous Fumarate.

I suggest you ask PAS forum for advice about B12 and folate as I advised earlier.

Vitamin D is deficient and 800iu is totally insufficient to treat deficiency. Your GP should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults cks.nice.org.uk/vitamin-d-d... Alternatively you can buy vitamin D3 without prescription and I suggest 10,000iu for 6 weeks and then reduce to 5,000iu and retest in 4-6 months. Vitamin D should be taken 4 hours away from Levothyroxine and T3.

If you buy on Amazon please use the affiliate link healthunlocked.com/thyroidu...