Vitamin and mineral levels

[jennij]

In Dec 2017 -

Ferritin 62 (15 - 150)

Folate 2.1 (2.5 - 19.5)

Vitamin B12 302 (190 - 900)

Vitamin D total 32.1 (25 - 50)

I have autoimmune thyroid disease confirmed on this site and suspected coeliac disease

I have iron anaemia and iron stopped in May 2016

1st B12 injection done Jan 2018, dizziness instantly disappeared after receiving it, taking 800iu D3 for 5 yrs, prescribed folic acid once a day for 4 yrs

Thankyou

[Saggyuk]

Obviously the stomach issues aren't going to help as will stop you absorbing the vits as well. The doc should have increased your Vit D as the 800iu is just a maintenance dose and you're still far too low. You can show him the NICE guidelines which I will find later as just no where near enough.

Folic acid needs to be increased too until you've got your stomach resolved as just not appearing to be doing anything - and you should continue with the B12 shots and iron also as will only drop again. Can you eat some liver once a week?

[jennij in reply to Saggyuk]

Thankyou I don't like the taste of liver so have been trying to increase ferritin by eating spinach for 4 months and ferritin only rose 3 points in that time, is there any way I can put liver in something I won't taste it? My periods are also very heavy

[Saggyuk in reply to jennij]

You can put chicken liver pate into spaghetti bolognese - hides it quite well lol.

Your docs basically just not doing enough so doc needs a kick up the bum.

Go to him and get it sorted and push to get the coeliac tests asap

[jennij in reply to Saggyuk]

Thankyou will give doctor a kick up the bum tomorrow as seeing her about other stuff

[Saggyuk in reply to jennij]

Good! so you need:

An increase in your thyroid meds to be retested in six weeks

An increase in your Vit d in line with guidelines (i will get later)

An increase in the folic acid as clearly still under range

Back on B12 shots at least until your stomach gets sorted

Coeliac blood test with referral for biopsy

I would ask for an iron panel and full blood count too as suspect you are still very iron deficient. Ferritin can be misleading when you have low B12 or other inflammatory issues. Ferritin is just storage iron - it doesn't indicate the amount in your blood for actual use which an iron panel does.

If she doesn't do these, get another doctor

xx

[jennij in reply to Saggyuk]

Thankyou I have no inflammatory markers and complete blood count showed MCHC above range that was it

[Saggyuk in reply to jennij]

B12 deficiency and iron deficiency have the opposite effect on your blood cells so one makes them small and the other large for example so both deficiencies can mask each other. However, B12or Folate deficiency can sometimes completely mask iron deficiency even in an iron panel so whatever happens, make sure you get your iron retested after B12 and folate is higher and stomach issues resolved, I still think you're likely to be iron deficient

[Clutter]

Jennij,

How much folic acid are you prescribed?

800iu is wholly insufficient to treat deficiency. It is a maintenance dose to be prescribed after 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.

Alternatively, vitamin D3 is inexpensive and doesn't require a prescription. You could buy your own. I suggest 10,000iu D3 daily for 6 weeks then reduce to 5,000iu and retest late April. Vitamin D should be taken 4 hours away from Levothyroxine.

Ferritin is optimal halfway through range. You can raise ferritin by eating more iron rich food.

If you buy on Amazon please use the affiliate link healthunlocked.com/thyroidu...

[jennij in reply to Clutter]

5mg folic acid once a day I have been raising ferritin with spinach for 4 months and it only rose my ferritin by 3 points and I have heavy periods thankyou

[Clutter in reply to jennij]

Jennij,

Low iron can cause heavy periods. Ideally your GP will do an iron panel and full blood count to check whether you are still iron deficient. If you are you will need to resume taking iron.

Ask your GP whether folic acid dose can be increased. It's ridiculous that folate has been deficient for 4 years and folate needs to be good for the B12 injections to work. Eating leafy green veg raises folate but if you are already eating spinach regularly you're obviously not absorbing nutrients.

Has your GP tested tissue transglutaminase to rule out Coeliac disease causing malabsorption?

[jennij in reply to Clutter]

Thankyou I have only had MCHC come back out of range and doctor checking me for coeliac due to mouth ulcers and diarrhoea and eczema

[Clutter in reply to jennij]

Jennij,

If FBC is good then you are no longer iron deficient. You may need to supplement iron to maintain levels though. Perhaps 1 x 210mg Ferrous Fumarate alternate days will be sufficient. Take each tablet with 1,000mg vitamin C to aid absorption and minimise constipation and take iron 4 hours away from Levothyroxine.

[jennij in reply to Clutter]

Thankyou complete blood count was abnormal and iron panel abnormal as well

[Clutter in reply to jennij]

Jennij,

If you know that the abnormal results mean you are iron deficient then you need to supplement iron. 3 x 210mg Ferrous Fumarate is the usual treatment for iron deficiency anaemia.

[Saggyuk in reply to jennij]

DO you have blood count results to post?

[jennij in reply to Saggyuk]

Yes

MCHC 355 (310 - 350)

MCV 80.1 (80 - 98)

MCH 28.1 (28 - 32)

Haemoglobin 116 (115 - 150)

RBC count 4.41 (3.80 - 5.80)

WBC count 4.60 (4.00 - 11.00)

Platelets 241 (140 - 400)

Iron 5.8 (6 - 26)

Transferrin saturation 12 (12 - 45)

[Saggyuk in reply to jennij]

Yes this clearly shows you are still iron deficient in my opinion and will only drop further while you don't seem to be absorbing anything so again, a kick up the bum

[SlowDragon Administrator]

In part your vitamin levels don't improve because of gluten but you are also under medicated for Hashimoto's

Heavy periods are classic sign of being hypothyroid

List of hypothyroid symptoms

thyroiduk.org/tuk/about_the...

You must improve vitamin levels

See Box 1. Towards end of article

Some possible causes of persistent symptoms in euthyroid patients on L-T4

You will see low vitamin D, folate, ferritin and B12 listed

onlinelibrary.wiley.com/doi...

Vitamin D supplements, many of us find Better You vitamin D mouth spray good as avoids poor gut function. Suggest getting 3000iu (perhaps twice daily for 6-8 weeks, then once daily) or 5000iu strength and retest after 2-3 months

Vitamindtest.org.uk £28

Aiming for level around 100nmol

Test twice yearly, trial and error what dose each person needs as maintenance dose.

B12 - you should be having injections every 3 months minimum. But if you were having symptoms of low B12 you should have several injections close together

You can ask on PAS healthunlocked

healthunlocked.com/pasoc

Adding a good vitamin B complex is recommended too as with Hashimoto's we often have low levels of other B vitamins (thiamine and B5 for example)

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Read as much as possible about Hashimoto's. It's as much gut related as the thyroid

Improving gut biome essential.