Vitamin and mineral results

[Jj86]

Vitamin D 28.2 nmol/L (25 - 50 vitamin D deficiency. Supplementation is indicated)

Vitamin B12 247 pg/L (190 - 900)

Folate 2.2 ng/L (4.6 - 18.7)

Ferritin 28 ng/L (30 - 400)

800iu D3/folic acid 5mg/1 ferrous fumarate

Thanks

healthunlocked.com/thyroidu...

[SeasideSusie Remembering]

Jj86

Vitamin D 28.2 nmol/L (25 - 50 vitamin D deficiency. Supplementation is indicated) 800iu D3

Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level. You should be on loading doses - 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 so post your new result as the time for members to suggest a dose) 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 you have Hashi's, once you start buying your own D3 supplement you would benefit from an oral spray which will give better absorption as it bypasses the stomach, eg BetterYou

**

Vitamin B12 247 pg/L (190 - 900)

Folate 2.2 ng/L (4.6 - 18.7) folic acid 5mg

Is the folic acid daily? How long have you been taking it?

Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an... If so you should go and post on the Pernicious Anaemia Society forum for further advice.

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 28 ng/L (30 - 400) 1 ferrous fumarate

Below range ferritin can suggest iron deficiency anaemia. Have you had an iron panel and full blood count? If not then ask your GP to do them.

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. Ideally you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours. If given iron tablets then take each one 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.

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...

[Jj86 in reply to SeasideSusie]

Thanks complete blood count only showed MCV 77.1 fL (80 - 98) but everything else in range. Iron was 9.6 umol/L (6 - 26) and transferrin saturation 15% (12 - 45) folic acid is daily and have been taking it for 5 months

[SeasideSusie Remembering in reply to Jj86]

Jj86

Low MCV suggests iron deficiency anaemia, so as you also have low ferritin you should discuss this with your GP.

One would expect your folate to have come back into range after 5 months of 5mg folic acid daily. Point this out to your GP, maybe you need investigation into absorption problems.

What about any signs of B12 Deficiency?

[SlowDragon Administrator]

Not surprised at these, having replied to your other posts.

Going to need to get these very much better, following SeasideSusie detailed advice, plus highly likely you will find gluten free diet helps reduce Hashimoto's changes and heal gut

Dose of Levo high enough to lower TSH to around one (or lower) and FT4 towards top of range and FT3 at least half way in range

Dose should only ever be increased or decreased by 25mcg max at any one time. Retesting after 6 weeks.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

If you want a new endo.

Email Louise at a Thyroid UK for list of recommended thyroid specialists [e-mail]