Thyroid UK
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Vitamins and minerals

Hi all, I have things like constipation, heavy periods and eczema. I have just started taking the 50mcg Levo but am suffering with tiredness, feeling unsteady and dealing with random aches in my wrists, hands, fingers, knees and hips. Do I need to supplement anything? Thanks for reading and replies.

Ferritin 15 (15 - 150)

Folate 2.33 (2.50 - 19.50)

Vitamin D total 32.1 (25 - 50 deficiency. Supplementation is indicated)

Vitamin B12 202 (190 - 900)

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Michr89

Yes you do need to supplement, all of them are dire. But first, what has your GP said about these results?

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Thanks my GP said my ferritin is in range and complete blood count showed the only the things out of range were haemoglobin estimation 114 (115 - 150) MCV 80.5 (83 - 98) MCHC 377 (310 - 350). GP said not clinically significant. Iron was low in range and transferrin saturation low in range, again GP said acceptable.

Folate was thought by GP to be just out of range (acceptable) and nothing said about B12 or vitamin D.

Thanks

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Michr89

OK, well I can't think of a polite way to say this but your GP is a jerk.

Ferritin 15 (15 - 150)

GP said my ferritin is in range

Yes, but at the very bottom of the range. What would he have said if it was 14.9? Low ferritin can suggest iron deficiency anaemia and guess what ........

haemoglobin estimation 114 (115 - 150) MCV 80.5 (83 - 98) MCHC 377 (310 - 350). GP said not clinically significant.

Like I said, GP is a jerk, these confirm iron deficiency anaemia.

Take a look at this PDF, the chart at the bottom on the right hand side irondisorders.org/Websites/... and you will see that

Serum Iron, Serum Ferritin, Transferrin Iron Saturation Percentage, and Haemoglobin all low confirm Iron Deficiency Anaemia

I think you should point this out to your GP. In fact, I would ditch this GP and see another one.

**

Folate 2.33 (2.50 - 19.50)

Folate was thought by GP to be just out of range (acceptable)

Nope, not acceptable. Ranges are for a reason, and out of range is out of range.

Vitamin B12 202 (190 - 900) nothing said about B12

Well, it's in range but far too low. B12 and folate work together. You should check for signs of B12 deficiency here b12deficiency.info/signs-an... then post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc You may need testing for pernicious anaemia, you may need B12 injections, you certainly need something for your folate deficiency and if you are prescribed folic acid then it shouldn't be started until further investigations that may be necessary regarding your low B12 have been carried out, and B12 should 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."

**

Vitamin D total 32.1 (25 - 50 deficiency. Supplementation is indicated)

nothing said about vitamin D.

Did your GP miss the bit that says "Supplementation is indicated"?

You are 2.1 away from the level where you would be given loading doses of D3 - 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)."

Your GP may offer you 800iu D3 if pushed, but it's not going to help. You need the loading doses so if your GP wont do those you can do it yourself.

The Vit D council recommends a level of 100-150nmol/L.

To self supplement you can buy some D3 softgels like these bodykind.com/product/2463-b... and take 10,000iu daily for 4 weeks (280,000iu, same as loading dose), then reduce to 5000iu daily. Retest 3 months after starting, privately if necessary with City Assays home fingerprick blood spot test vitamindtest.org.uk/

When you've reached the recommended level 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.

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.

**

Personally, I would see a different GP and get this sorted, your current GP is going to keep you ill.

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Dear seasidesusie

Thank you so much for this. I am currenty D deficient (44.8 - normal range is 50-125)

I can only find max 1000iu here in my country (malaysia) and importing online means more weeks + customs problems. So i will need take a lot of caps to make it to 10000iu per day but im willing to anything. The capsule is small anyway

But for vit A, magnesium and calcium how much do i need to take to balance out the 10000iu vit D3 / aid absorption?

Ive used google but couldnt get the numbers right :( the closest i can come to understand is yours so THANK YOU so much again for this post.

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But for vit A, magnesium and calcium how much do i need to take to balance out the 10000iu vit D3 / aid absorption?

Magnesium is easy, just take what the recommended dose is on the pack.

Calcium we don't supplement unless tested and found to be deficient. We should be able to get what we need from our diet.

Vit A again can come from food. I used to take a combined D3/Vit A/K2 supplement but no-one has it here in the UK at the moment (It's a US supplement).

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Thank you ☺️

the only K2 supplement i can find readily here is a combined pill of D3+cal+K2.

Per tablet the D3 is only 400iu while the calcium is 600mg and the k2 is 45g and dosage is twice per day

Is it safe to take 1200mg of calcium per day for 4 weeks (in additional to separate dosage d3 of 9000iu to treat my D deficiency)

Im on a gluten free dairy free diet so is it ok for that 1200mg per day dosage?

I only want the K2 but couldnt find any single form in this entire country :(

Thanks in advance for your advice

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The more members we have, the more we read the same old stories, i.e. you are in normal range. We are not supposed to be at the bottom of normal but nearer the top of the range. They fail to understand this fact and as SeasideSusie states she could add a few descriptive names about them. The fact, too, is that our suffering is completely able to resolve if they used their brain and the information on this forum. Maybe it should be recommended reading for prospective doctors/endocrinologists.

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