Vitamin and mineral levels: Thanks Ferritin 1... - Thyroid UK

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Vitamin and mineral levels

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Ferritin 11 (30 - 400)

Folate 3.1 (4.6 - 18.7)

Vitamin B12 177 (180 - 900)

Vitamin D total 26.6 (25 - 50 deficient

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I am assuming that your GP has also said that nothing needs to be done about these results too.

Your levels are dire and you are deficient in all of them, they need urgent attention. If your GP has ignored these, then throw the book at him.

Ferritin 11 (30 - 400)

Low ferritin often suggests iron deficiency anaemia. If you have had a full blood count and iron panel please post the results.

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 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 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

If you are prescribed iron tablets, then take each one 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 3.1 (4.6 - 18.7) Vitamin B12 177 (180 - 900)

You are both folate and B12 deficient. Check for signs of B12 deficiency here then go and post on the Pernicious Anaemia Society forum for further advice (click FOLLOW then you can make your post). Quote your folate/B12/ferritin and iron deficiency anaemia information if you already have that. Also quote any signs of B12 deficiency you may be experiencing from that list.

You probably need intrinsic factor antibodies testing, you may have Pernicious Anaemia and you may need B12 injections. You definitely need folic acid prescribing but you should not start that 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."


Vitamin D total 26.6 (25 - 50 deficient)

You are 1.6 away from severe deficiency. You need loading doses - 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 at 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

Your doctor wont know, because they are not taught nutrition, but 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

Check out the other cofactors too.

As you have Hashi's, when you buy your own supplement then for better absorption an oral spray is best as it bypasses the stomach. BetterYou do an oral spray which is readily available.



As you are Hashi's and this has played a big part in trashing your nutrient levels, you need to address the gut/absorption problems. Please check out SlowDragon's reply to this thread for information and links to help

Thyroid hormone can't work until nutrient levels are optimal, and you wont be able to get nutrients absorbed until the gut and absorption problems have been addressed as well as the Hashi's.


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