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Thyroid UK
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Vitamin/mineral levels

Please see previous post


I take the following

Folic 5mg once a day - started Nov 2016

Hydroxocobalamin injections - started Mar 2016

210mg ferrous fumarate 3x a day - started Nov 2013

800iu D3 once a day - started Dec 2013

Results taken last month, advice welcome thank you

Ferritin 21 (15 - 150)

Folate 4.2 (4.6 - 18.7)

Vitamin B12 218 (190 - 900)

Vitamin D total 30.5 (25 - 50 deficient)

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So your Hashi's has really trashed your nutrient levels!

Ferritin 21 (15 - 150) - 210mg ferrous fumarate 3x a day - started Nov 2013

I expect you had a diagnosis of iron deficiency anaemia to be prescribed 3 x FF daily. Is this being monitored? Do you see a haematologist? Have you had an iron infusion? Was it stated that you should be referred for a repeat iron infusion if your ferritin fell below 50?

Do you take each iron tablet with 1000mg Vit C to aid absorption and help prevent constipation?

Do you take your iron tablets 4 hours away from thyroid meds and 2 hours away from other medication?

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 apjcn.nhri.org.tw/server/in... but I would say from all of these results you have an absorption problem which should be investigated by your GP.


Folate 4.2 (4.6 - 18.7)

Vitamin B12 218 (190 - 900)

Folic 5mg once a day - started Nov 2016 Hydroxocobalamin injections - started Mar 2016

Are you having your B12 injections every 3 months? Did you have loading doses to start with? Do you supplement or self inject between prescribed injections? Do you still have symptoms of B12 deficiency b12deficiency.info/signs-an...

Again, considering the length of time you have been supplementing, you are still folate deficiency and your B12 is still very low. Have you discussed this with your GP?


Vitamin D total 30.5 (25 - 50 deficient) 800iu D3 once a day - started Dec 2013

To still be this low after 4 years of supplementing is madness. Have you discussed this with your GP? What was your original level when originally prescribed and did you get loading doses or just 800iu D3?

Your current level is just 0.5 from the level where you should be given 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. If you were below 30 originally, speak to your GP and ask that as you are still only 0.5 above this level then he treats you according to the guidelines and prescribes the loading doses which you possibly should have had when originally prescribed if your level was below 30. 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 vitamindtest.org.uk/

When you buy your own D3, as you have Hashi's it's recommended to use an oral spray for best absorption, eg Better You.

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.


You need a serious discussion with your GP about these levels, the length of time you have been supplementing and the fact that they are still dire. You must ask him to investigate absorption problems.

You can help yourself where absorption is concerned, see SlowDragon's reply to this post for information and links healthunlocked.com/thyroidu... and she may be along later with further advice.


Please do not consider adding T3 to your Levo at the moment. You have to address the Hashi's and sort out the gut/absorption problems then aim for optimal levels of all nutrients before any thyroid hormone can work.

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Just replied on previous post πŸ˜€

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Thank you I have a diagnosis of iron deficiency anaemia which is no longer being monitored and I was discharged from haematology in Feb 2017 and I had an iron infusion in May 2016. My GP has been asked to refer me again for a repeat iron infusion if ferritin fell below 50 and I don't take vit C with the iron and I take iron in the evening and thyroid meds in the morning. B12 is taken every 6 months and I had no loading doses to start with and I don't supplement between injections or self inject. I do have B12 deficiency symptoms. Vit D at diagnosis was below 30.



So you need to chase up the repeat iron infusion urgently.

Has your MCV and MCHC been tested lately, do you still have iron deficiency anaemia? If so why aren't you still under haematologist?

You need to start taking Vit C with iron tablets as mentioned.

I would ask on the Pernicious Anaemia Society forum about your B12, my understanding is that injections are 3 monthly healthunlocked.com/pasoc and give them all the information about your B12 deficiency symptoms, your B12 and folate results, your ferritin results, iron deficiency information and any results appertaining to that, they will advise what you should do.

As your Vit D level was below 30 originally, discuss this with the GP, print off the information from the NICE summary I linked to and ask for the loading doses as suggested.


Thanks I still have iron deficiency anaemia and not under haematologist because he is more concerned about where the haemoglobin level is than where the ferritin and MCHC and MCV are


You are having the correct treatment for iron deficiency anaemia (3 x FF daily) but with all your dire levels despite the length of time supplementing, there is something seriously wrong which needs investigating, and you need to be chasing this up.


Please post on the PASoc forum


You have auto-immune gastritis as well as auto-immune thyoriditis.

This will affect your ability to absorb minerals and vitamins - and is particularly affecting your ability to absorb B12

serum B12 cannot be used to manage the frequency of B12 shots and 6 monthly is not adequate or you. After an injection your levels will be astronomic and off the scale and then they will gradually fall because your body is no longer able to use stores of B12 that enable most people to regulate their B12 levels. However, raising the B12 levels through an injection can kick of a second reaction that affects the efficiency with which the B12 passes from blood into the cells where it is used meaning that post injections many people actually need to maintain very high serum B12 levels to ensure enough B12 gets through to their cells.

Some people find that using very high dose tablets or sublinguals (>1000mcg) can keep their levels high but this doesn't work for everyone.


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