Vitamins and minerals

[Lily0405]

Ferritin 15 (30 - 400)

Folate 1.9 (2.5 - 19.5)

Vitamin B12 110 (180 - 900)

Vitamin D 25.6 (25 - 50 deficient)

Feedback welcome thanks

[SeasideSusie Remembering]

Lily0405 Oh good grief! Have these been ignored by your doctor or are you prescribed anything?

Have you had an iron panel and full blood count to see if you have iron deficiency anaemia?

Have you been tested for Pernicious Anaemia?

[Lily0405 in reply to SeasideSusie]

Been prescribed ferrous fumarate to take once a day and 800iu for vitamin D deficiency, complete blood count said my MCV is below range 78.2 (80 - 98) and MCHC 120 (115 - 150) iron 9.3 (6 - 26) transferrin 16 (10 - 30), haven't been checked for pernicious anaemia.

[SeasideSusie Remembering in reply to Lily0405]

Well, your GP needs sacking Lily!

Ferritin 15 (30 - 400)

For thyroid hormone to work (and that is our own thyroid hormone as well as replacement) ferritin needs to be at least 70, preferably half way through range. You need an iron supplement and as your ferritin is below range then ideally you need an iron infusion so ask for one. An infusion will raise your level in 24-48 hours. If you are prescribed tablets it will take months to raise your ferritin.

[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... ]

MCV is below range 78.2 (80 - 98) and MCHC 120 (115 - 150)

Low MCV suggests iron deficiency anaemia, also MCHC may be low when MCV is low and can also be seen in iron deficiency anaemia. Speak to your GP and point out that he is not treating you according to the guidelines by prescribing only 1 x ferrous fumarate daily - 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.

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 1.9 (2.5 - 19.5) Vitamin B12 110 (180 - 900)

Ask your GP why he has ignored your Folate Deficiency and your B12 deficiency.

Check for signs of B12 deficiency here b12deficiency.info/signs-an... then post these results on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc quoting also your ferritin/iron deficiency information and any signs of B12 deficiency you may be experiencing.

You will most likely need to be tested for Pernicious Anaemia and very likely to need B12 injections. If your GP prescribes folic acid don't start taking it until other investigations have been carried out.

Your B12 level can't be ignored, so please post on the PA forum.

**

Vitamin D 25.6 (25 - 50 deficient)

800iu D3

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 as you are just 0.6 away from severe deficiency. 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, 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.

**

Your GP is a waste of space. You would be well advised to see a different GP, sort out your treatment, and then make a complaint about this one due to his negligence.

[Lily0405 in reply to SeasideSusie]

Sorry MCHC is 379 (310 - 350) Haemoglobin is 120 (115 - 150)

[SeasideSusie Remembering in reply to Lily0405]

OK, so low MCV and high MCHC strongly suggest iron deficiency anaemia so information above is still correct.