Hi I am experiencing symptoms (constipation/fatigue/pins and needles/breathlessness/feeling cold/sweats/muscle spasms/muscle weakness) and I have ongoing iron deficiency and folate deficiency, also ongoing vitamin D deficiency which I am self treating with 3000iu vitamin D since the 800iu prescribed to me was not raising my level very much. Taking B12 injections for low B12 symptoms. Not taking anything for below range folate. Thanks for reading/advice.
FERRITIN 45 (30 - 400)
*MCV 75.2 (80 - 100)
*MCHC 388 (310 - 350)
HAEMOGLOBIN ESTIMATION 119 (115 - 150)
RED BLOOD COUNT 4.45 (3.80 - 5.80)
WHITE CELL COUNT 7.12 (4.00 - 11.00)
MCH 28.2 (28 - 32)
HAEMATOCRIT 0.41 (0.37 - 0.47)
IRON 7.4 (6.0 - 26.0)
TRANSFERRIN SATURATION 16 (12 - 45)
*FOLATE 2.3 (2.5 - 19.5)
VITAMIN B12 335 (190 - 900)
VITAMIN D TOTAL 56.1
(<25 SEVERE
25 - 50 DEFICIENT
50 - 75 SUBOPTIMAL
>75 ADEQUATE)
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Vkb6
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Vkb6 Why nothing for the below range folate? You should be prescribed folic acid.
Are you being treated for the iron deficiency?
Ferritin needs to be at least 70 for thyroid hormone to work, recommended is 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...
Vit D is recommended to be 100-150nmol/L according to the Vit D Council. You could continue with your 3000iu or even raise it to 5000iu for 3 months then retest.
Are you taking D3's important cofactors -
There are important cofactors needed when taking D3
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
Hi thanks, GP said folate only slightly below range and no supplement was needed. No longer treated for the iron deficiency. Not taking vitamin D co factors, I didn't know about them.
GP said folate only slightly below range and no supplement was needed
Jeez that sort of comment from doctors really pees me off. Ask why there are ranges if they're going to be ignored. If your GP refuses to give you anything then a good B Complex with 400mcg methylfolate will help raise it.
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No longer treated for the iron deficiency
Why not? It can't be ignored so discuss with your doctor.
**
Not taking vitamin D co factors, I didn't know about them.
Doctors aren't trained in nutrition so don't know anything about them, but they are important so you should also take them alongside your D3.
Wll that was last year and your ferritin is now down to 45. Some haematologists require their patients to go back for another infusion if ferritin falls below 50. Are you being monitored as per the guidelines for iron deficiency anaemia?
*MCV 75.2 (80 - 100)
*MCHC 388 (310 - 350)
These results show you are still iron deficient.
NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):
•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.
You should monitored at least twice a year. However in your case with out of range red blood cell parameters and a history of iron deficiency your GP should be at least phoning up haemotology for advice so they know what to do.
If you get too breathless particularly on physical exertion plus feel like you are going to collapse or actually do, then get someone to take you to A&E in their car or by taxi. Unfortunately some GPs only treat iron deficiency properly when the patient ends up in A&E.
D3 is one of the things that affect absorption of Levo - four hours for D3, iron, calcium, magnesium. Two hours for other supplements. Two hours for some medication, others as far away as possible.
Seaside suzie. I have looked but I cannot find anything on D3 affecting thyroid absorption levels.....only if its a combined tablet of D3 and calcium such as Adcal. As of course calcium does affect it.
I'm afraid I don't have time to look for scientific evidence to back up that statement, but everything I've read - on here in the four and a half years I've been a member, and elsewhere - says 4 hours eg reply by haug0099 here drugs.com/answers/synthroid... and because I've read it probably hundreds of times now then I'm happy that it is prudent to leave four hours rather than take it close together Levo is taken.
Hi Seaside Susie the link you sent me refers to a four hour gap if taking a combined tablet of vitamin D & Calcium. As I said this is because calcium is known for interferring with thyroid absorption. Vitamin D on its own wil not affect absorption.
I too have been a long term member....think since 2011...goodness how time flies!😊 🙃😊
Calcium can affect the way your medication is absorbed. There are 3 levels of warnings; Minor, Moderate and High. Vitamin D and thyroid medication is Moderate. In fact, the medical community recommends that you get you thyroid levels checked after taking Vitamin D to make sure your levels are still proper. Or space them 4 hours apart
I can't see where it is referring to a Calcium & Vit D combined tablet in that answer.
Is there a particular reason you are pursuing this? If you don't want to leave four hours, that's fine. After the hundreds of times I've read to leave four hours then I will go with that, and that's fine too.
It states it very clearly if you scroll down. I dont disagree that calcium affects absorption.
. Vitamin D is often bought on its own without the calcium. When taking pure vitamin D you do not need to worry about it affecting you thyroid uptake. I take mine without calcium added in. Hope that helps.
I can't see anywhere in either of the two answers following the one I quoted where it mentions a Calcium and Vit D combined tablet.
It would be a good idea if you started a thread about this, because others will then have an opportunity to give their opinions and some members might have relevant links.
I know that greygoose always advises 4 hours between Levo and Vit D but I can't think of any others off the top of my head.
Clutter always say to leave four hours between thyroid hormone and vit D. Remember, vit d is not just a vitamin, it is a prohormone. She also says to leave four hours between thyroid hormone and oestrogen. But, I don't have any scientific data, to back it up, either.
waveylines , not exactly scientific data, but a common opinion :
"Can we take levothyroxine and vitamin D side by side
In my opinion, each and every supplement should be separated by 4 hours with the thyroid medication to avoid decrease in absorption of levothyroxine systematically . If their is changes in absorption of levothyroxine in patients then dose adjustment is needed to maintain the same therapeutic effect required to provide the biological effect to avoid any side effects in the body system and lead the body functioning smoothly."
Thanks Greygoose. Hmm to be honest I dont leave it four hours but I do take my ndt seperately. I also take my vit D at night before sleep..... 😊
I think your right about the estrogen -Im on an estrogen blocker to zero estrogen in my body and since being on it I have had to lower my dose of ndt by half a grain.
This link says there are no interactions netween vit D & synthroid or levo so as you say its not exact and I guess its an individual decision. Unlike calcium which has a clear interaction.
Many of your symptoms could be caused by B12 and folate deficiency. Have you looked at the Perncious Anaemia/ B12 deficiency forum where you will find helpful information in the pinned posts?
You do need to supplement folate/folic acid as your B12 injections will be using up your folate. It may also be that you need more frequent B12 injections.
If your blood test results are after you started injecting B12 then your level is low indeed.
Blood results after B12 injection and because I tested negative for intrinsic factor antibodies pernicious anaemia and B12 deficiency were ruled out. Can go to other forum if they can still help me. Thanks
The intrinsic factor antibody test is unreliable and will only show positive in 40-60% of cases. If it’s positive you have PA, if it’s negative PA is still a possibility.
Worth looking at the PA/B12d forum and also the Pernicious Anaemia Society website for more information.
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Help with supplements please
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Help with supplements please
