Vitamin and mineral levels

[Nishac]

Hi I have adrenal insufficiency and told I have Hashimotos could I have advice on vitamin and mineral levels please

FOLATE 2.1 (2.5 - 19.5)

FERRITIN 16 (30 - 400)

VITAMIN D 54.4 (50 - 75 SUBOPTIMAL)

VITAMIN B12 201 (190 - 900)

Thank you

[Nanaedake]

All your vitamin levels are much too low, no wonder adrenals aren't working properly! Have you been prescribed any supplements?

Ferritin needs to be 70 or mid-range for thyroid hormone to work properly. Have you got any symptoms of vitamin B12 deficiency? b12deficiency.info/signs-an...

If so then post your B12 and folate result with a bit of background information on the HealthUnlocked Pernicious anaemia website for their expert patient advice.

You need supplements for vitamin D deficiency too. Check out SeasideSusie s advice on vitamins,, you'll see her replies on other people's posts re. vitamin levels.

[Nishac in reply to Nanaedake]

Thanks nothing prescribed and I have symptoms of B12 deficiency

[Nanaedake in reply to Nishac]

Did you have these done at your GP's and are you in the UK? Has your GP contacted you about these results and how long ago were they taken?

Make sure you post on the Pernicious Anaemia Healthunlocked forum too as you need their advice.

[Nishac in reply to Nanaedake]

Done by GP and in UK. GP didn't contact me and they were done 3 months ago

[Nanaedake in reply to Nishac]

Well, that's very distressing as these results are dire and given your symptoms you must be feeling awful. Your GP is neglectful if he/she has not contacted you about these.

Make an appointment immediately to see a different GP in the practice and point out your deficiencies and that no one has contacted you. Ask for the correct treatment and make sure you print off SeasideSusie's advice before you visit the GP so you can check you are being given the correct treatment.

Your GP may only offer you 800iu of vitamin D supplement but it will not be enough so you may need to add some of your own supplement. The NHS advice is for doctors to give loading doses of vitamin D if results are below 30. However, 800iu is only a maintenance dose for the general healthy population and isn't likely to be sufficient for you.

Do not take folate supplements until you have your B12 levels investigated as folate can mask B12 deficiency and you need to start B12 supplements before folate but get advice on it from the other forum.

Have you had a full iron panel done because if not, your GP should do that considering your dire ferritin level. On your other post your thyroid medication is insufficient as your TSH is raised. This is probably causing poor vitamin absorption and hence your deficiencies but your doctor needs to rule out pernicious anaemia due to your low B12 level and your symptoms. Take a list of your symptoms to your GP.

[Nishac in reply to Nanaedake]

Iron panel and complete blood count came back with GP saying not clinically significant

MCV 76.2 (80 - 98)

MCHC 377 (310 - 350)

Haemoglobin 110 (115 - 150)

Iron 6.4 (6 - 26)

Transferrin saturation 13 (12 - 45)

Thanks

[SeasideSusie Remembering in reply to Nishac]

Nishac

Your GP is utterly stupid and negligent. Those rsults clearly say iron deficiency anaemia. Ask for the appropriate 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.

I would see a different GP, sort out the appropriate treatment, then make a formal complaint against this idiot for negligence.

[Nanaedake in reply to Nishac]

Well, what do the NHS have ranges for if GP's are going to ignore them? MCV is clearly below range.

It's definitely NOT ok for your GP to leave you, a thyroid patient with antibodies, with low iron and ferritin levels because:

- it will make you feel ill.

- your thyroid hormone won't work properly until the deficiency is corrected.

[SeasideSusie Remembering]

Nishac

Make an appointment with your GP (or another one), point out these dire results and the fact that you weren't contacted about them and now you want the proper treatment for them considering they've been ignored for 3 months.

FOLATE 2.1 (2.5 - 19.5)

VITAMIN B12 201 (190 - 900)

Folate deficiency. Check for signs of B12 deficiency here b12deficiency.info/signs-an... then go and post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc Quote your folate and B12 results, your ferritin result (and iron deficiency anaemia information if you already have that) and list your symptoms of B12 deficiency. You may need testing for Pernicious Anaemia, you may need B12 injections, you certainly need folic acid prescribing for your folate deficiency. Don't start folic acid until other investigations have been carried out, and B12 must be started before folic acid.

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."

Folate should be at least half way through it's range.

As your GP why these results have been ignored.

**

FERRITIN 16 (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 are way below range and need an iron supplement and as your level is so low you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months.

You can also 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...

You need an iron panel and full blood count to see if you have iron deficiency anaemia, and if this is confirmed then the treatment is 2 or 3 ferrous fumarate tablets daily. 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.

As your GP why this result has been ignored.

**

VITAMIN D 54.4 (50 - 75 SUBOPTIMAL)

This is not low enough for yourGP to prescribe anything; however, the Vit D Council recommends a level of 100-150nmol/L.

I suggest you take about 5000iu D3 daily for 3 months then retest.

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 are Hashi's, for best absorption use an oral spray such as BetterYou. They do a 3000iu dose so take 6000iu for 3 months. They do a D3/K2-MK7 spray to save you buying separate supplements.