Other results

[Kes87]

Folate 2.2 (4.6 – 18.7)

Vitamin B12 217 (190 – 900)

Ferritin 18 (30 – 400)

Vitamin D 24.4 (<25 severe)

Iron deficient and vitamin D deficient confirmed by GP taking 800iu D3 and 1 ferrous fumarate a day

Thanks

[SeasideSusie Remembering]

Kes87 Can you please say what supplements you are taking and the dose.

[Kes87 in reply to SeasideSusie]

Done thanks

[SeasideSusie Remembering in reply to Kes87]

Kes - if these are being managed by your GP then he is as useless as your endo. But I am not surprised, we are seeing this in increasing numbers daily

If you want to go back and see this pathetic GP, I willl add some questions you might want to ask him. Personally, I'd see a different GP, get the appropriate treatment, then make a complaint for negligence about this one.

Folate 2.2 (4.6 – 18.7)

Vitamin B12 217 (190 – 900)

You are folate deficient with low B12. do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an... then go and post on the Pernicious Anaemia Society for further advice healthunlocked.com/pasoc Quote your folate, B12, ferritin, any results which confirmed iron deficiency anaemia, and any signs of B12 deficiency you may be experiencing.

You may need testing for Pernicious Anaemia, you may need B12 injections, you will need a supplement to raise your folate level (but don't start taking that until other investigations 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."

Question for your doctor:

*Please tell me why you ignored my folate deficiency, you can see it is a very long way under range?* (you could add - "surely that is negligence on your part?")

**

Ferritin 18 (30 – 400) -1 ferrous fumarate a day

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 infusion as your result is so far under range, an infusion will raise your level within 24-48 hours whereas tablets will take very many months. 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...

Iron deficient

As you have been diagnosed iron deficient, you are not being treated appropriately. 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.

So ask your doctor for the appropriate amount of iron tablets and ask the following question:

*Please tell me why you didn't give me the appropriatel treatment for my iron deficiency* (and you could add - "surely that is negligence on your part?")

**

Vitamin D 24.4 (<25 severe) - 800iu D3

And here again you've been failed. You are severely Vit D deficient and you need loading doses, you've been given a maintenance dose for someone with a reasonable level to start with (which actually isn't enough anywya!). 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. 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, maybe less, 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.

Question for your doctor:

*Please tell me why you have ignored my severe Vit D deficiency and only given me a maintenance dose when the guidelines stipulate loading doses?* (and you could add - "surely that is negligence on your part?")

**

Please let us know what happens.

[Kes87 in reply to SeasideSusie]

Thanks will do this

[Saggyuk in reply to Kes87]

Yes totally agree with SeasideSusie , I would definitely advise that you need to look for a new doc as he has completely missed the obvious and undermedicated the others so is useless and means you can't depend on doc for much help in other areas either.

If you can't get anywhere with the B12 testing, I would suggest you supplement anyway - especially before taking any folate as you can't normally overdose on this unlike vit d and iron.

Is there any particular obvious reason for these deficiencies - do you eat healthily enough or do you have any stomach/digestive issues?

[Kes87 in reply to Saggyuk]

Thanks I think have stomach issues. GP is testing me for coeliac disease.

[SlowDragon Administrator in reply to Kes87]

Hashimotos affects the gut.

When they reduced your dose to 50mcgs from 150mcgs gut function will have been trashed

About 5% with Hashimoto's are coeliac but over 80% are gluten intolerant

Only reliable test for coeliac is endoscopy. You need to eat high level of gluten for 4-6 weeks beforehand

Insist they give you a date for endoscopy if they want you to do this

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

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

chriskresser.com/the-gluten...

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

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Your vitamins are absolutely dire due to idiotic dose reduction by an endo who has no idea

[judburke in reply to Kes87]

That is good that you are getting tested for Coeliac. Did you get the results back yet?