Help with supplements please

[Hollie118]

Please could I have advice about my supplement doses? I also have iron deficiency. Thanks

July 2017

Ferritin 51 (30 - 400) down from 98.5 in May (30 - 400) taking 1 iron tablet a day

Folate 2.2 (2.5 - 19.5) not on anything for folate

Vitamin D total 65.5 (50 - 75 suboptimal) up from 38.4 (25 - 50 deficient) in January 2017 taking 6000iu vitamin D, GP monitors vitamin D every 6 months

Vitamin B12 326 (190 - 900) down from 548.3 (190 - 900) in January, not on anything for B12

[SeasideSusie Remembering]

Hollie118

Ferritin 51 (30 - 400) down from 98.5 in May (30 - 400) taking 1 iron tablet a day I also have iron deficiency.

Oh dear! With iron deficiency 1 x ferrous fumarate a day is the wrong treatment. 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.

You need to speak to your doctor and ask for the correct amount of ferrous fumarate. 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.

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. Hopefully it will improve with the extra ferrous fumarate, but 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...

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Folate 2.2 (2.5 - 19.5) not on anything for folate

Vitamin B12 326 (190 - 900) down from 548.3 (190 - 900) in January, not on anything for B12

You need to speak to your GP about your folate, your result shows folate deficiency. But first check for signs of B12 deficiency b12deficiency.info/signs-an... and then it would be a good idea to post on the Pernicious Anaemia Society for further advice. Quote your folate, B12, ferritin and iron deficiency information plus any signs of B12 deficiency you may be experiencing.

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."

Sublingual methylcobalamin lozenges are what's needed if you self supplement, along with a good quality B Complex to balance all the B vitamins.

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Vitamin D total 65.5 (50 - 75 suboptimal) up from 38.4 (25 - 50 deficient) in January 2017 taking 6000iu vitamin D, GP monitors vitamin D every 6 months

That's all good so far but it does seem to be taking it's time to improve. I raised mine from severely deficient at 15 to 200 in 2.5 months then reduced to my dose to achieve the level recommended by the Vit D Council which is 100-150nmol/L and that's where I now maintain it.

I wonder why yours is taking so long. Are you taking your D3 with the fattiest meal of the day? D3 is fat soluble so needs to be taken with dietary fat.

Your GP wont know, 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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It's very likely that your Hashi's is causing gut/absorption problems as they do tend to go hand in hand. SlowDragon has some very good information about that which I'm sure she will post soon.

[Hollie118 in reply to SeasideSusie]

Thanks not taking vitamin D with fattiest meal of the day. I don't eat much fat at all.

[SeasideSusie Remembering in reply to Hollie118]

D3 must have some dietary fat for absorption. If you use softgels rather than tablets you can get something like these

bodykind.com/product/2463-b...

and they contain olive oil so you could take them with something like a full fat yogurt or cracker and butter.

We all need some fat (good fats), a low fat diet isn't good for us. I think it's greygoose who has good information about that, much better than I can explain (sorry GG if I've remembered wrongly and it's not you)

[greygoose in reply to SeasideSusie]

Well, I am anti-low-fat diets. The body needs fat, and it's low fat diets that are leading to obesity and depression.

Why aren't you eating much fat, Hollie118 ? Question of taste or do you think it's bad for you?

[Hollie118 in reply to greygoose]

Thanks I am going to sound fussy but I just don't eat a lot of fat. Never have done.

[greygoose in reply to Hollie118]

Well, you couldn't be fussier than I! But, I do love my butter!!!

[Hollie118 in reply to greygoose]

Sorry I thought I was being told off for not eating a lot of fat.

[greygoose in reply to Hollie118]

Ummm... well... you should probably eat more. There are some vitamins that you can't absorb without fat.

[Hollie118 in reply to greygoose]

I didn't realise that. But I am happy to include more fats into my diet now that I know.

[greygoose in reply to Hollie118]

That's good.

There's quite a choice of good fats - there's butter, of course, olives and olive oil, nuts and nut oils (walnut oil and hazelnut oil are the tops for salads!) avocado and avocado oil, coconut and coconut oil... Just avoid seed oils, which are highly processed.

[Hollie118 in reply to greygoose]

Thanks for the info, this has helped lots. I love salads

[greygoose in reply to Hollie118]

You're welcome.

[Lucieb01 in reply to greygoose]

no messing with the goose lol