Supplementation advice please

[Abbi9]

Vitamin D total 50.3 (50 - 75 suboptimal) taking 800iu D3

Ferritin 43 (30 - 400) taking ferrous fumarate

MCV 76.1 (80 - 100)

MCHC 384 (310 - 350)

MCH 28.2 (27 - 32)

Haemoglobin estimation 115 (115 - 150)

Platelets 253 (150 - 400)

Iron 10.2 (6.0 - 26.0)

Transferrin saturation 17 (10 - 30)

Folate 2.1 (2.5 - 19.5)

Vitamin B12 202 (190 - 900)

Thanks

[SeasideSusie Remembering]

Abbi9

Vitamin D total 50.3 (50 - 75 suboptimal) taking 800iu D3

800iu is going to take forever to raise your level. You need to buy your own and I suggest bodykind.com/product/2463-b... and take 5000iu daily for 8 weeks then reduce to 5000iu alternate days. Retest 3 months after starting with them. Once you've reached the level recommended by the Vit D Council - which is 100-150nmol/L 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.

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Ferritin 43 (30 - 400) taking ferrous fumarate

How much ferrous fumarate?

For thyroid hormone to work ferritin needs to be at least 70, preferably half way through range. 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 76.1 (80 - 100)

MCHC 384 (310 - 350)

MCH 28.2 (27 - 32)

Haemoglobin estimation 115 (115 - 150)

These results suggest iron deficiency anaemia. If you are taking 2 or 3 x ferrous fumarate daily then that is the correct treatment according to 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 your GP is not following these guidelines then you should ask him to treat you appropriately.

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.

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Folate 2.1 (2.5 - 19.5)

Vitamin B12 202 (190 - 900)

You are folate deficient with very low B12. Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an... then post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc quoting these results, your ferritin and iron deficiency results, and any signs of B12 deficiency you may be experiencing.

You probably need testing for Pernicious Anaemia, you may need B12 injections, you should have folic acid prescribed but don't start folic acid until any other tests have been carried out.

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."

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Considering what a hash your current GP and endo have made of dosing of thyroid meds and ignorance of your Hashi's, you might want to consider changing both because your folate/B12 results should have been acted upon and your iron deficiency anaemia if you've not been given the correct treatment already.

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Just thought would add my two pence worth in, high mchc can be down to b12/folate deficiency but also is a sign of hemolytic anemia which I'm told is quite common in autoimmune diseases. Basically means your blood cells are being destroyed prematurely. My son has had 6 blood tests with high mchc and has been under the care of a haematologist due to it. I'd mention it to the doctor just to rule it out.