Thyroid UK
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Vitamin and mineral levels

Could I have advice on supplements please.

Diagnosed iron deficient May 2013, ferrous fumarate restarted March 2017 but only taking 1 a day and not 3

Diagnosed folate deficient November 2016, taking folic acid once a week, shouldn't it be once a day?

B12 injections started June 2017 due to possible B12 deficiency, only had 1 injection

Diagnosed vitamin D deficient November 2012, taking 800iu D3 prescribed and have stopped and started it

Also had magnesium and selenium and zinc checked, do they look low?

Thanks

Nov 2016

Folate 2.3 (2.5 - 19.5)

Vitamin B12 335 (190 - 900)

Sep 2017

Ferritin 46 (30 - 400)

Vitamin D 61.3 (50 - 75 suboptimal)

Selenium 0.93 (0.89 - 1.65)

Magnesium 0.84 (0.70 - 1.00)

Zinc 14 (11 - 23)

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Hollie2016

Ferritin 46 (30 - 400)

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 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...

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Diagnosed iron deficient May 2013, ferrous fumarate restarted March 2017 but only taking 1 a day and not 3

I think you should discuss the following with your GP and ask for the appropriate 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.

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 2.4 (2.5 - 19.5) - Diagnosed folate deficient November 2016, taking folic acid once a week, shouldn't it be once a day?

It's normal for folic acid to be daily unless there is a particular reason for it to be weekly. As this result is from September 2017 you should ask your GP why, after taking folic acid for almost a year, are you still deficient, and what is he going to do about it.

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Vitamin B12 335 (190 - 900) - B12 injections started June 2017 due to possible B12 deficiency, only had 1 injection

Are any more injections planned? It's normal for them to be 3 monthly where there is Pernicious Anaemia I believe.

Ask if you are going to have regular injections, if not then come back and we can suggest a suitable supplement to raise your level.

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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Vitamin D 61.3 (50 - 75 suboptimal) Diagnosed vitamin D deficient November 2012, taking 800iu D3 prescribed and have stopped and started it

Stopping and starting isn't a good idea. The Vit D Council recommends a level of 100-150nmol/L and once you reach this level then you don't stop, you find a maintenance dose. 800iu is pretty useless as a maintenance dose, you'd be better off buying your own at a higher dose. As you have Hashi's you will probably be better off with a D3 spray, I would suggest taking 3000iu daily for now, retest after 3 months, then when you've reached the recommended level you can lower the dose to find your maintenance dose. It's trial and error, it might be 2000iu, it might be less.

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 helps D3 to work and 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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Selenium 0.93 (0.89 - 1.65)

It is quite low in range. If you take the amount recommended for Hashi's in my reply on your other thread that should be fine.

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Magnesium 0.84 (0.70 - 1.00)

Most of us Hypos are low in magnesium. If you take some as a cofactor of D3 as mentioned above, this should be fine.

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Zinc 14 (11 - 23)

Zinc should be half way through it's range. Before supplementing, you might want to get copper tested. Apparently, when zinc is low copper can sometimes be high, and there's a balance. A lot of zinc supplements contain copper, so you should check this.

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Thanks no I haven't been booked in for another B12 injection and they are once every 3 months. Folate result from November 2016, it hasn't been rechecked since

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Suggest you outline this situation on PAS Unlocked, they are the B12 experts

You may need more frequent injections to start and/or folate supplements

healthunlocked.com/pasoc

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The fact you have been on supplements so long it's likely you have had Hashimoto's at least that long

See SeasideSusie detailed replies on vitamin supplements

Gluten free diet helps many/most of us with Hashimoto's and can help keep vitamin levels higher

Once you get on correct dose of thyroid hormones this will also help

Gluten intolerance also linked to PCOS

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