Hi I am having worsened symptoms of feeling cold, decreased sweating, weight gain, pins and needles, tinnitus, fatigue, dry skin, hair loss, constipation, heavy periods. Haematologist stopped iron in 2016 due to increased ferritin levels post iron infusion. Been taking vitamin D 800iu since 2014 and folic acid since 2016. Advice welcome thankyou
VITAMIN B12 156 (180 - 900)
FOLATE 2.36 (4.60 - 18.70)
FERRITIN 14 (15 - 150)
VITAMIN D TOTAL 29.3
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Laura_C1990
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Laura_C1990 Has your doctor said or done anything about these? If not he should have done.
You say in your other thread that you are 'taking supplements'. Are you taking anything other than the 800iu D3?
FERRITIN 14 (15 - 150) Haematologist stopped iron in 2016 due to increased ferritin levels post iron infusion
Have you been monitored at all? Normally a haematologist will say that if ferritin falls below 50 then to re-refer and another iron infusion will be given.
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 desperately need an iron supplement and as your level is so low you should ask for another iron infusion which will raise your level within 24-48 hours, tablets will take many months. Once your level is raised you should be monitored and maybe on a maintenance dose of iron to keep you at a good level.
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...
Have you had an iron panel and full blood count done to see if you have iron deficiency anaemia? If not then ask. If you have diagnosed iron deficiency anaemia then you should be on 2 or 3 ferrous fumarate daily and should be taking 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.
You should now post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc
Post these results, your ferritin results, any iron deficiency anaemia information you have, plus any signs of B12 deficiency.
You will most likely need intrinsic factor antibodies testing to see if you have Pernicious Anaemia. You most likely need B12 injections. You will need folic acid prescribing for the folate deficiency. Do not start folic acid until other investigations have been completed, and B12 should be started before the folic acid.
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VITAMIN D TOTAL 29.3 Vitamin D 800iu since 2014
You should ask your GP the following question:
Considering I have been taking 800iu Vit D for 3 years, why is my level still in the deficiency category?
The answer is because you should have been given loading doses originally, but your GP wont admit that. Do you remember your original level in 2014? 800iu daily will never, in the reign of pig's pudding, raise your level. See NICE treatment summary for Vit D deficiency:
"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
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
Those results point to iron deficiency anaemia, go and see your GP and ask that he treats it or refers you back to the haematologist urgently - see 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.
Mention this in your post on the Pernicious Anaemia Society forum.
Your GP is dangerous. See another one, get treatment sorted then give serious consideration to making a formal complaint for negligence against this one.
So you were in the Severely Deficient category back then and there is absolutely no doubt that you should have been started on loading doses as per the link I gave. Ask for them now and complain very loudly that this doctor has been keeping you very, very ill. You can see how 3 years of supplementing with 800iu daily has made very little difference in your level.
Were you checked for Pernicious Anaemia? You should not be on folic acid until other investigations have been carried out and B12 started. Please don't waste time in asking for advice on the PA forum, giving all the details mentioned in this thread.
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