Help with supplements please

[Khora]

Ferritin 23 (30 - 400) in August 2017, was 95.5 in January 2017. Confirmed as anaemic

Folate 2.24 (2.5 - 19.5) in August 2017, was >20 in January 2017. Confirmed folic deficient

Vitamin B12 169 (180 - 900) in August 2017, was 643 in January 2017. No B12 given.

Vitamin D total 38.8 (25 - 50 deficient) in June 2017, was 72 (50 - 75 suboptimal) in January 2016. Confirmed vitamin D deficient.

Feedback welcome

[SeasideSusie Remembering]

What are you supplementing for any of the above?

[Khora in reply to SeasideSusie]

Thanks only 3000iu vit D3, oral spray

[SeasideSusie Remembering in reply to Khora]

Previous post for further information healthunlocked.com/thyroidu...

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Khora

Your GP has obviously seen these results so must have realised how they have deteriorated over the last few months, so why hasn't s/he done anything about it?

Ferritin 23 (30 - 400) in August 2017, was 95.5 in January 2017. Confirmed as anaemic

As you have confirmed anaemia, ask for the appropriate treatment. For Iron Deficiency Anaemia (assuming that is the diagnosis) 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.

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.

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.

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...

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Folate 2.24 (2.5 - 19.5) in August 2017, was >20 in January 2017. Confirmed folic deficient

Vitamin B12 169 (180 - 900) in August 2017, was 643 in January 2017. No B12 given.

Confirmed folate deficient and nothing given? Below range B12 and nothing given? Why? What has your GP said about these?

You need intrinsic factor antibodies testing, you very likely have Pernicious Anaemia and you very likely need B12 injections.

Do you have any signs of B12 deficiency (I'd be very surprised if you don't) - check here b12deficiency.info/signs-an... then you can post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc quoting your folate/B12/ferritin results, iron deficiency information, and mention any signs of B12 deficiency you may be experiencing from the list linked to.

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."

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Vitamin D total 38.8 (25 - 50 deficient) in June 2017, was 72 (50 - 75 suboptimal) in January 2016. Confirmed vitamin D deficient. 3000iu vit D3, oral spray

You should be taking a lot more D3 than 3000iu daily. If your level was below 30 you would be prescribed loading doses totalling 280,000 - 300,000iu over a few weeks. My suggestion would be to triple your daily dose to 9000iu for 4 weeks then reduce to 6000iu daily and retest in March. When you have reached the level recommended by the Vit D Council - which is 100-150nmol/L - 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.

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As you have Hashi's, there's obviously an absorption problem and this needs to be addressed. For thyroid hormone to work properly nutrient levels must be optimal, so you need to sort out the absorption problem. Check out SlowDragon 's reply to this post which contains links and information to help healthunlocked.com/thyroidu...

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If your GP has ignored these dire results then it's time to see a different GP in the practice, sort out treatment then consider making a complaint for negligence about this one. If it's your endo who has ignored them then ditch the endo, it's obvious from your other thread that he hasn't a clue about treating hypothyroidism anyway!