Vitamins and minerals advice please

GP is not helping me with them thank you

Folate 2.1 (4.6 - 18.7) not taking anything

Vitamin B12 184 (180 - 900) not taking anything

Ferritin 49 (15 - 150) diagnosed iron deficient, taking 1 iron tablet a day

Vitamin D 25.8

(<25 severe vitamin D deficiency

25 - 50 vitamin D deficiency

50 - 75 vitamin D suboptimal

>75 adequate) taking 800iu vitamin D3

8 Replies

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  • Your GP needs a severe telling off. Amongst other things your Vitamin D is very very low... And at 800iu you will never reach optimal levels. You need to take at least 3000iu daily if not more. The experts on here will help you with the other issues but your GP is ridiculous.

  • Thanks. My GP and endo has been messing about with my thyroid medication dose constantly. I feel like I have hit a brick wall and with no explanation about why they are doing what they're doing I just feel like giving up.

  • My GP knew nothing either... I learned LOADS from this site and from similar ones, talking to people in the same situation really helps. I had a total thyroidectomy due to cancer 2 weeks ago and slowly recovering but its a long haul x

  • So sorry to hear you had cancer. I was suspected of having cancer but only had an ultrasound and no biopsy. Glad you're recovering. x

  • It took some finding... 2 biopsies were inconclusive, to be honest it was only confirmed when I went private - I was getting fobbed off by NHS - so bit the bullet and paid out a LOT of money. Worth every penny though! Do Not Give Up. Its your body and your health. If you feel fobbed off or pushed aside, keep fighting x

  • To state the obvious, your folate is low and below the reference range and your B12 just about faints across the bottom of the reference range. Given this, you need a chat with your GP about these results because it starts to be complex to disentangle folate and B12 deficiencies and you need to explore the B12 angle before supplementing folic acid/folate because that is known to confound the results. SeasideSusie has excellent advice on this topic (as so many others) and if she doesn't see this, I'll dig up some of her previous replies on the topic that might be relevant to you.

    Ferritin is in range but not at the higher level that is typically recommended here for people to use their thyroid hormones efficiently (both their own hormones and any supplemented ones). However, it's not impressive given that you've been supplementing so I don't know if humanbean has anything to suggest for you.

    As has already been stated, your vitamin D level is 0.8 out of the category of severe deficiency and just made it into the bottom of the deficiency range. You need a decisive intervention from your GP as 800IU is plainly not doing the job.

  • See this response from SS about ferritin etc (scroll down): healthunlocked.com/thyroidu...

    SS on vitamin D, B12 etc. to someone with similar results: healthunlocked.com/thyroidu...

    This from SS about B12: healthunlocked.com/thyroidu...

  • Bluepixiediamond

    GP is not helping me with them

    Your jerk of a GP isn't helping you with anything, I think he would be better in another job, preferably one that doesn't have anything to do with people's health.

    **

    Folate 2.1 (4.6 - 18.7) not taking anything

    Vitamin B12 184 (180 - 900) not taking anything

    Most people ignore this next piece of advice, I implore you not to.

    You are folate deficient with extremely low B12. Do you have any signs of B12 deficiency b12deficiency.info/signs-an...

    Please post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

    Quote your Folate, B12, Ferritin results, iron deficiency information, and any signs of B12 deficiency you may be experiencing. Mention that you appear to have absorption problems because your levels have not improved.Then you need to discuss their advice with a GP, preferably a different one to the one who has ignored these results.

    You most likely need testing for penicious anaemia, you may very well need B12 injections. You certainly need folic acid prescribing but don't start that until other investigations have been done.

    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."

    **

    Ferritin 49 (15 - 150) diagnosed iron deficient, taking 1 iron tablet 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 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...

    As you have a diagnosis of iron deficiency anaemia, then you have been given the wrong treatment - 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.

    Point this out to the GP and ask for appropriate 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.

    **

    Vitamin D 25.8

    (<25 severe vitamin D deficiency

    25 - 50 vitamin D deficiency

    taking 800iu vitamin D3

    Again you are on the wrong amount of D3, you need loading doses. 800iu will never in the reign of pig's pudding raise your level, it is barely a maintenance dose for someone with a decent level to start with. You are just 0.8 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 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 (more than 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 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.

    **

    As mentioned in your other thread, it is vital that you get these nutrients up to the optimal levels. Doctors aren't taught nutrition so as long as a result is even 1 point within the range then they are satisfied that everything is fine - not so. They know nothing about cofactors either so you wont get those prescribed, you will have to buy your own.

    **

    Please let us know what the GP is going to do about these levels and what is being prescribed. You will be better off seeing a different GP, sort out the treatment then seriously think about reporting this one for negligence.

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