Ferritin etc

[me_shell]

FERRITIN 10 (30 - 400)

FOLATE 2.2 (4.6 - 18.7)

VITAMIN B12 144 (190 - 900)

VITAMIN D 13.6 (<24 SEVERE)

Thankyou

[SeasideSusie Remembering]

me_shell

What has your GP said about these results?

[me_shell in reply to SeasideSusie]

Hi nothing yet I am hoping to discuss these at appointment today

[ITYFIALMCTT in reply to me_shell]

Well, SeasideSusie is probably about to mention that those results are pretty woeful and give you some helpful discussion points with your GP.

[me_shell in reply to ITYFIALMCTT]

Oh sorry! I just thought doctor knows best

[SeasideSusie Remembering in reply to me_shell]

Oh sorry! I just thought doctor knows best

Rarely, where vitamins and minerals are concerned. They aren't taught nutrition and believe that once something is 'in range' then everything is hunky dory. Not so, us Hypos need optimal levels.

[SeasideSusie Remembering in reply to me_shell]

Oh well, depending on your relationship with your GP you could smile nicely and politely point out

FERRITIN 10 (30 - 400)

Below range ferritin and you need a full blood count and iron panel to see if you have iron deficiency anaemia.

For thyroid hormone to work (that's our own as well as replacement hormone) 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, it will raise your level within 24-48 hours. If offered iron tablets they will take months to raise your level so scream and shout for an infusion.

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...

If you are confirmed iron deficient anaemic then you will need iron tablets so 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 2.2 (4.6 - 18.7) VITAMIN B12 144 (190 - 900)

Folate and B12 deficient. Check for signs of B12 deficiency here b12deficiency.info/signs-an... then you absolutely must post on the Pernicious Anaemia Society forum for further advice, they are the experts and will guide you regarding testing for Pernicious Anaemia, you will probably need B12 injections. See what they say and discuss with your GP healthunlocked.com/pasoc Quote your Folate, B12, Ferritin results, and any signs of B12 deficiency you may be experiencing.

If your GP pescribes folic acid, don't start taking it until after other investigations have been completed.

**

VITAMIN D 13.6 (<24 SEVERE)

Severe Vit D deficiency and you need loading doses, accept nothing less. 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 maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU 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 regims 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. Do not accept 800iu, it must be the loading doses. Once these have been completed you will need a reduced amount (not a paltlry 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/

Your GP wont know, so no use discussing, 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.

**

Come back and let us know what your GP is going to do.

[me_shell in reply to SeasideSusie]

Thankyou complete blood count came back with MCV 75.3 (80 - 98) and MCHC 376 (310 - 350) iron panel was normal with iron 8.2 (6 - 26) transferrin 15 (12 - 45)

[SeasideSusie Remembering in reply to me_shell]

me_shell

Those results suggest iron deficiency anaemia, so that's something else you can point out to your GP, and this is the treatment - 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.

[SlowDragon Administrator]

As SeasideSusie says, and as we see on here day in day out, GP's do NOT understand the importance of good vitamins with thyroid disease

Or why the levels are so low.

You have Hashimoto's, and essential to start on Levothyroxine replacement Thyroid hormone ASAP

Your TSH is far to high - it's when OVER ten (not under 10)

GP should start you on 50mcgs or possibly because vitamin levels are so low, 25mcgs

Plus supplements for vitamin D, (loading dose) and ferritin and arrange full testing for Pernicious Anaemia before starting B12 and folate

Seriously consider gluten free diet, about 80% with Hashimoto's find it helps

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

amymyersmd.com/2017/02/3-im...

Read posts on here, and Thyroid Uk website to learn as much as possible about Hashimoto's

[Gambit62]

you are b12, folate and iron deficient - please, take a look at the PAS forum as suggested by SeasideSusie

healthunlocked.com/pasoc

multiple deficiencies suggests an absorption problem - so would be useful if your GP could investigate those (as well as treating you for the deficiencies above)

candidates as absorption problems: coeliacs, PA, low stomach acidity (could be result of PA), h pylori infection .... each has different consequences though ruling out some (eg PA) can be very difficult as the test is prone to false negatives - so negative is a long way from showing it couldn't be involved)

treatment for B12 should be started 24-48 hours before treatment for folate. B12 will be injections - make sure you have a list of symptoms - regardless of whether could also be thyroid - as there are different regimes for treating neurological symptoms.

pernicious-anaemia-society....

point out that macrocytosis (larger rounder red blood cells) isn't there in 25% of people with B12 deficiency ... and in your case may well be being masked by the microcytosis from the iron deficiency anyway.

[judburke]

You need to ask your Dr why your ferritin and vitamins are so low.

Coeliac is a common culprit for deficiencies. Some people are silent coeliacs ie they don’t have apparent gut problems or weight loss. Take a look at Coeliac UK for symptoms and getting tested