Hi I have been taking 800iu vitamin D since 2013 for vit D deficiency and ferrous fumarate since 2014 for iron deficiency caused by heavy periods does anything need correcting thank you
Total 25 OH vitamin D 27.2 (25 - 50 deficiency)
Ferritin 19 (30 - 400)
Folate 2.1 (2.5 - 19.5)
Vitamin B12 196 (180 - 900)
Summer89 I think you need to ask your GP a few questions!
Total 25 OH vitamin D 27.2 (25 - 50 deficiency)
800iu vitamin D since 2013
Your dose of D3 is totally inadequate, 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 and you should have had them in 2013 as I assume your level was the same or even lower. You have been given the maintenance dose they they prescribe when your level is higher than yours.
You are 2.2 away from severe Vit D deficiency and you need to ask your GP why he has ignored this and for him to treat you appropriately. 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 paltlry 800iu daily) 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/
Your GP will be unaware, because they're not taught nutrition, but 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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Ferritin 19 (30 - 400) ferrous fumarate since 2014 for iron deficiency
How much ferrous fumarate? I'm guessing 1 x daily considering you've been supplementing for 3 years and your ferritin is still under range. See 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.
If you have been having only 1 x FF then point this out to your GP and ask why he hasn't followed the guidelines. Also point out that it says you should be monitored to ensure adequate response. Ask him how can you be classed as having adequate response if your ferritin is still below range after 3 years.
For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. You need an iron supplement.
Ideally you need an iron infusion so ask for one, but you may only be allowed to have the 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.
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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Folate 2.1 (2.5 - 19.5)
Vitamin B12 196 (180 - 900)
Nothing said about these by your GP? You need to ask him why he has ignored your folate deficiency. You also have very low B12 - do you have any signs of B12 deficiency b12deficiency.info/signs-an... You should pop over to the Pernicious Anaemia Society forum for further advice then discuss it with your GP. You may need testing for Pernicious Anaemia, you may need B12 injections. Don't start taking folic acid which may be prescribed until after other investigations have been done.
When did GP see these? What have they advised/prescribed instead (if anything)
Your vitamins are extremely low, due to Hashimoto's only just been diagnosed. You have obviously had this some time, at least as long as 2013/14 when vitamin supplements were started.
But the current supplements are to little. You need much higher doses
I will add SeasideSusie in - she is the vitamin expert. (I see she's already on the case)
Vitamin D, because our gut function is badly affected with Hashimoto's, supplementing vitamin D mouth spray by "Better You" will probably work better. It comes in various strengths. Best start with either 5000iu daily or 2 x 3000iu daily. Available from most health shops or online
Unless GO does prescribe loading dose
When taking high dose vitamin D, it's recommended to also take magnesium and vitamin K2 (SeasideSusie will explain why)
Retest after 2-3 months. You will almost certainly need to take a maintenance dose daily once you get level up to around 100nmol. Have to experiment with how much, 2000-3000 may be enough, might need more - may vary summer to winter. Test twice year - Feb and sept roughly
Vitamindtest.org.uk - £28 postal kit
Its a lot to get your head around especially as you probably are feeling pretty rough. Stick with this fantastic support group.
Ask as many questions as you like
Medics won't tell you but ........ but as you have Hashimoto's then 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...
Gluten free is actually easier than you might think, especially these days. Eating out is getting easier all the time.
Thanks GP did these 2 months ago and I am only taking 800iu and 1 ferrous fumarate
2 months ago and GP did nothing, that is really outrageous
Is there another GP in the practice you can see? Or if not perhaps consider transfer to different practice.
Doses of supplements advice needed please
Ferritin folate vitamin D and vitamin B12
Vitamin and mineral results
