i am feeling gradually worse each day. hands very cold, undereyes dark, sore and dry, hard stool, aching in joints, gaining more weight, feeling more tired, heavier periods, losing hair, sweating with exertion. i was diagnosed in 2012. results taken december 2017. many thanks for any advice.
ferritin 64 (30 - 400)
folate 2.3 (2.5 - 19.5)
vitamin b12 200 (190 - 900)
vitamin d total 25.5 (25 - 50 deficient)
taking 800iu d3 since 2013, folic acid 5mg since 2016, iron since 2012
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Zarabr
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so vitamin D was always much too low - though not quite as low as now
It should be at least 80nmol. Most with thyroid issues find just above 100nmol best
Suggest you get Better You vitamin D mouth spray - 3000iu or 5000iu. Take 5000iu or 6000iu (2 x 3000iu) daily for 2-3 months - retest via Vitamindtest.org.uk £28
Read up about why to also take magnesium and vitamin K2Mk7 as well when on high dose vitamin D
Folate fallen from 10 to 2.3 and now deficient
Vitamin B fallen from 693 to 200 - now also deficient
Ferritin - fallen from 64 to 33 - just one ferrous fumerate per day was not enough before, you probably needed 2 per day. Now you need 3 per day (plus 1000mcg vitamin C with each to aid absorption)
You need to get ferritin up to at least 70 for thyroid hormone to work. I've seen it said that 100-130 is best for females.
Continue with your iron tablets, taking each one with 1000mg Vit C to aid absorption and help prevent constipation, and take iron 4 hours away from thyroid meds and at least 2 hours away from other medication and supplements as it affects their absorption.
You can also 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...
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folate 2.3 (2.5 - 19.5)
vitamin b12 200 (190 - 900)
folic acid 5mg since 2016
Whoah!!! What about your B12? Anything been done about that? Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so you should post on the Pernicious Anaemia Society forum for advice healthunlocked.com/pasoc
You really should have intrinsic factor antibodies tested to see if you have Pernicious Anaemia, you may need B12 injections. You should not be taking folic acid until further investigations have taken place 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."
For you still to be folate deficient despite taking folic acid since 2016, then obviously there is a problem that your GP should be looking into.
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vitamin d total 25.5 (25 - 50 deficient)
taking 800iu d3 since 2013
This is another problem that your GP should be looking into. 4 years supplementing with D3 and still deficient!
What was your level before starting supplements?
You should have been started on loading doses according to 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 vitamindtest.org.uk/
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
You need to take note of what I said about B12 then. You need further testing, most likely B12 injections. Post on the PA forum then go and see your GP and get things organised.
As for Vit D you can go ahead and discuss with your GP about increasing your D3 to loading doses, which you are entitled to with your level. Or treat yourself. You need 300,000iu over several weeks so if you get the Better You 3000iu spray my suggestion would be that you could take 3 doses - 9000iu daily for 4 weeks, drop down to 6000iu daily for 4 weeks then retest. Once you've reached 100-150nmol/L find your maintenance dose, it will be for life, you may need more in winter than summer. Remember the important cofactors.
Suggest you the list of recommended thyroid specialists from Thyroid UK - see if anyone NHS in Bristol area on it - request referral as your "NHS 2nd opinion" in the light of terrible reaction and drop in vitamins after having T3 removed (against your wishes)
Read up about candidia too - can also be due to drop in stomach acid
Your GP should refer to local guidelines or the cks.nice.org.uk/vitamin-d-d... 800iu is an inadequate dose to correct deficiency. It is a maintenance dose prescribed after vitD is replete >75. 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.
Take 1,000mg vitamin C with each iron tablet to aid absorption and minimise constipation. It might help to take an extra iron tablet once or twice a week.
I have the same kind of problems and found out that VitaminD should be supplemented at 5000/day for people like us if you want any effect. All results for all vitamins should be over the maximum as a proof of good health as the ranges are based on sick people not healthy ones. Underlying is a problem of lucky guts and most certainly candida in the intestines which means that you have to stop eating gluten, lactose and sugar ie transform your diet. Sugar is a big one as it is everywhere especially in the UK. Good luck and get knowledgeable if you want to take your health in your hands and stop suffering.
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