Thyroid UK
90,643 members105,014 posts

Daughters bloods for vitamin levels

She does not take anything thank you

FERRITIN 11 (30 - 400)

FOLATE 1.4 (4.6 - 18.7)


VITAMIN B12 144 (190 - 900)

6 Replies

Pebble66 Has your daughter seen her GP and has s/he said anything about these levels?

FERRITIN 11 (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.

She needa an iron supplement and as her level is so low she should ask for an iron infusion which will raise her level within 24-48 hours, tablets will take many months.

She 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

Low ferritin can suggest iron deficiency anaemia so she should ask for an Iron Panel and Full Blood Count to be done. If iron deficiency anaemia is confirmed then the treatment is 2 or 3 x ferrous fumarate daily. She should 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.


FOLATE 1.4 (4.6 - 18.7)

VITAMIN B12 144 (190 - 900)

She is folate and B12 deficient.

Does she have signs of B12 deficiency

You need to go straight over to the Pernicious Anaemia Society forum for further advice. Post these results, ferritin result, iron deficiency anaemia information if she has that already and mention any signs of B12 deficiency she may be experiencing.

She needs testing for intrinsic factor antibodies, she may have Pernicious Anaemia, she may need B12 injections, she certain needs folic acid prescribing for the folate deficiency, which she shouldn't start until further investigations have been carried out and B12 started.

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."



She has severe Vit D deficiency and needs loading doses, she must not accept a prescription for 800iu which is a mainenance dose for someone with a decent level already. 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. She should go and see her GP and ask that he treats her according to the guidelines and prescribes the loading doses. Once these have been completed she will need a reduced amount (more than 800iu so post herr new result as the time for members to suggest a dose) to bring herr level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then she'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. She can do this with a private fingerprick blood spot test with City Assays

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 her best and as it's calming it's best taken in the evening, four hours away from thyroid meds

Check out the other cofactors too.

As she has high antibodies which confirm Hashimoto's, when she starts buying her own maintnance dose she should get an oral spray for better absorption, eg BetterYou.


Thanks for your reply, nothing has been given for these and she has given up going to the GP to get these sorted because she is told her symptoms are in her head. Complete blood count showed some abnormalities but when she got the printout the comments against the abnormalities say not clinically significant.

MCV 82.3 (83 - 98)

MCHC 385 (310 - 350)

Iron came back in range and was 6.5 (6 - 26)

Transferrin saturation 12 (12 - 45)


Her MCV is only just below range, nevertheless it is out of range, and coupled with high MCHC plus very low in range iron and bottom of range transferrin saturation, then they suggest iron deficiency anaemia.

If the GP says her symptoms are in her head then he is suggesting she has a mental illness of some description. She should ask for a referral to a psychiatrist or psychologist for confirmation of this - she wont get it!

Make no mistake, her deficiencies are serious. She ignores them at her own risk. If she has given up with this GP then she has two choices - continue to suffer or find another GP. Sorry to sound harsh, but you've had all the evidence pointed out and now the ball is in her court. She is the only one who can push this forward. If she isn't assertive enough then she could take someone to her appointments with her who can speak on her behalf if necessary.


Thanks she is not at all confident or assertive


So could you go with her, or someone who knows her well enough to be able to help her out at the appointment.



I'm not surprised your daughter is so unwell. She is severely deficient. If a GP has seen these results and marked them no action required your daughter should make a very strong complaint to the practice manager.

Vitamin D is severely deficient. GP should refer to local guidelines or the NICE CKS recommendations for treating vitamin D deficient adults She should not accept a prescription for 800iu as this will not be sufficient to correct deficiency. My GP prescribed 40,000iu daily x 14 followed by 2,000iu daily x 8 weeks which raised vitD from <10 to 107. Vitamin D should be taken 4 hours away from Levothyroxine.

Ferritin is deficient and this may indicate iron deficiency anaemia. Her GP should do an iron panel and full blood count to check. If she is prescribed iron it should be taken 4 hours away from Levothyroxine.

B12 and Folate are deficient. GP should investigate whether pernicious anaemia is causing B12 and folate deficiency. B12 injection should be initiated 48 hours prior to starting folic acid to correct folate. are the experts on PA, B12 and folate deficiency.

1 like

You may also like...