Advice needed please, taking 1 ferrous fumarate tablet since Feb 2017, folic acid since 2016, vitamin D 800iu since 2013, B12 injections once every 3 months since Feb 2017. Results taken 3 weeks ago. Thank you
Ferritin 21 (15 - 150)
Folate 2.0 (2.5 - 19.5)
Vitamin B12 229 (180 - 900)
Vitamin D total 31.1 (25 - 50 deficient, supplementation is indicated)
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SJS60
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All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results
Your GP should increase dose of Levo by 25mcg and retest again in further 6-8 weeks. Repeating until TSH is around one and FT4 towards top of range and FT3 at least half way in range
Your vitamin levels are all much too low
Has GP tested you for coeliac disease? If not suggest he does.
How low was vitamin D, before started supplements? You are on far too small a dose. Should have had loading dose to start with
Ferritin dose is too low. You really need iron infusion
See SeasideSusie many detailed replies on vitamin supplements eg
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels stop Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Did your GP do an iron panel and complete blood count to rule out iron deficiency anaemia?
Folic acid is deficient. Are you taking 5mg folic acid daily?
B12 is very low. Looks like your injection is due shortly?
800iu is a maintenance dose to be prescribed once vitD deficiency is corrected and vitD is replete >75. Your GP should refer to local guidelines or the cks.nice.org.uk/vitamin-d-d... 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.
I think transferrin, MCV and haemoglobin indicate iron deficiency anaemia. Usual treatment is 3 x 210mg Ferrous Fumarate. If you take each tablet with 1,000mg vitamin C it will aid absorption and minimise constipation. iron should be taken 4 hours away from Levothyroxine.
I think you should discuss an increase in folic acid with your GP and arrange a B12 injection very soon. Were you tested for pernicious anaemia? If PA is confirmed you should be having 3 monthly injections.
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