Abigail1989 Your GP appears to have been as negligent with these results as he has been about your thyroid results and dose of Levo.
Vitamin B12 198 (190 - 900)
Folate 2.0 (2.5 - 19.5)
You are folate deficient with very low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... You need to post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your Folate, B12, ferritin and iron deficiency anaemia information, together with any signs of B12 deficiency you might be experiencing. Whatever they advise discuss with your GP. You definitely need folic acid but you should be tested for Pernicious Anaemia before starting it, and you may need B12 injections. Make sure you ask your GP why your folate deficiency has been ignored and point out that your very low B12 should have been investigated too.
Ferritin 22 (30 - 400) Haemoglobin estimation 115 (115 - 150) Mean corpuscular volume 78.1 (80 - 100) Mean corpuscular haemoglobin conc. 383 (310 - 350) Mean corpuscular haemoglobin 28.2 (28 - 32) Iron 8.4
Your ferritin is below range and the other results suggest iron deficiency anaemia.
For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range so you need iron supplements. Ideally you need an iron infusion so ask for one, but you may only be prescribed 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...
As for the iron deficiency anaemia, see NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)
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.
Again, ask your GP why all this has been ignored.
Vitamin D 48.8 (25 - 50 deficient) 800iu vitamin D since 2013 with a level of 43.6
Well, you can see that taking 800iu for 4 years has done very little to raise your level.
The recommended level, according to the Vit D Council, is 100-150nmol/L.
Your GP is actually prescribing according to the guidelines, so the best thing you can do now is to help yourself. I suggest you buy some D3 softgels like these bodykind.com/product/2463-b... and take 5000iu daily for 8-10 weeks, then drop down to 5000iu alternate days. Retest 3 months after starting. Once you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily (or you could stick to 5000iu alternate days), 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
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
Check out the other cofactors too.
There's no way thyroid hormone can work unless nutrient levels are optimal. Hashi's can trash nutrient levels due to affecting absorption, and I can see that SlowDragon has addressed that in your other thread.
Adopting a gluten free diet, as SlowDragon has mentioned, can help reduce the antibodies, as can supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.