Supplement advice please

[Luv2018]

Please see previous thread.

healthunlocked.com/thyroidu...

Diagnosed iron deficient 2013, vitamin D deficient 2013, possible B12 deficiency 2017, folate deficient 2016. All results with dose changes and amounts below. Thank you

NOVEMBER 2011

*FERRITIN 22 (30 - 400)

*MCV 80.2 (83 - 98)

*MCHC 375 (310 - 350)

JANUARY 2012

FERRITIN 47 (30 - 400)

*MCV 78.9 (83 - 98)

*MCHC 362 (310 - 350)

AUGUST 2013 - started on ferrous fumarate 3x a day

*FERRITIN 15 (30 - 400)

OCTOBER 2013 - still taking ferrous fumarate 3x a day

*FERRITIN 21 (30 - 400)

DECEMBER 2013 - still taking ferrous fumarate 3x a day, prescribed vitamin D 800iu 1x a day

*FERRITIN 22 (30 - 400)

*FOLATE 3.8 (4.6 - 18.7)

VITAMIN B12 352 (190 - 900)

*VITAMIN D TOTAL 32.2 (25 - 50 DEFICIENT)

MAY 2014 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day from the 800iu vitamin D 800iu 1x a day

*FERRITIN 23 (30 - 400)

VITAMIN D TOTAL 59.6 (50 - 75 SUBOPTIMAL)

AUGUST 2014 - still taking ferrous fumarate 3x a day

*FERRITIN 15 (30 - 400)

NOVEMBER 2014 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day

*FERRITIN 27 (30 - 400)

VITAMIN D TOTAL 72 (50 - 75 SUBOPTIMAL)

JANUARY 2015 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day

*FERRITIN 19 (30 - 400)

FOLATE 5.9 (4.6 - 18.7)

VITAMIN B12 363 (190 - 900)

MARCH 2015 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day

FERRITIN 38 (15 - 150)

FOLATE 6.2 (4.6 - 18.7)

VITAMIN B12 384 (190 - 900)

VITAMIN D TOTAL 53.3 (50 - 75 SUBOPTIMAL)

SEPTEMBER 2015 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day

FERRITIN 17 (15 - 150)

FOLATE 10.1 (4.6 - 18.7)

VITAMIN B12 693 (190 - 900)

VITAMIN D TOTAL 71.1 (50 - 75 SUBOPTIMAL)

NOVEMBER 2015 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day

FERRITIN 18 (15 - 150)

FEBRUARY 2016 - still taking ferrous fumarate 3x a day, taking 3000iu oral spray (Better You) 1x a day, referred to haematology for iron infusion and heavy menstrual bleeding

FERRITIN 23 (15 - 150)

MAY 2016 - pre iron infusion, still taking Better You 3000iu oral spray vitamin D

*FERRITIN 189 (15 - 150)

FOLATE 5.1 (4.6 - 18.7)

VITAMIN B12 342 (190 - 900)

JULY 2016 - 6 week stage, haematology review, still taking 3000iu vitamin D (Better You) oral spray

FERRITIN 146 (15 - 150)

NOVEMBER 2016 - 6 week active monitoring for haematology, still taking 3000iu vitamin D (Better You) oral spray, prescribed folic acid 5mg once a day

FERRITIN 141 (15 - 150)

*FOLATE 2.1 (2.5 - 19.5)

JANUARY 2017 - 6 week active monitoring for haematology, still taking 3000iu vitamin D (Better You) oral spray and 5mg folic acid once a day, haematology recommended B12 injections for low B12 symptoms of neuropathy and neurological symptoms of B12 being low/deficient despite negative intrinsic factor antibodies. Microcytic anaemia confirmed from complete blood count., given 8 week trial of ferrous fumarate to take once a day

FERRITIN 110.3 (15 - 150)

*VITAMIN D TOTAL 38.8 (25 - 50 DEFICIENT)

*FOLATE >20 (2.5 - 19.5)

VITAMIN B12 285 (190 - 900)

JUNE 2017 - still taking 3000iu vitamin D (Better You) oral spray and 5mg folic acid once a day, no iron supplements

FERRITIN 98.5 (15 - 150)

*FOLATE 2.3 (2.5 - 19.5)

SEPTEMBER 2017 - still taking 3000iu vitamin D (Better You) oral spray and 5mg folic acid once a day, first B12 injection given, no iron supplements

FERRITIN 64 (15 - 150)

*FOLATE 2.2 (2.5 - 19.5)

JANUARY 2018 - still taking 3000iu vitamin D (Better You) oral spray with K2-MK7 and 5mg folic acid once a day, second B12 injection given, no iron supplements. No idea what my B12 level is, however neuropathic and neurological symptoms have reduced since the second injection.

FERRITIN 61 (15 - 150)

*FOLATE 1.9 (2.5 - 19.5)

VITAMIN D TOTAL 62.3 (50 - 75 SUBOPTIMAL. ADVISE ON SAFE SUN EXPOSURE AND DIET)

[Saggyuk]

Hi there

Just a quick few suggestions - you might want to get an iron panel and full blood count for a clearer picture of iron status as B12/folate deficiency can falsely raise ferritin (as can other illness and inflammation) so you still might be iron deficient/anaemic and it's clear supplementing hasn't done much for you in the past including folic acid - your levels are pretty bad.

What's the plan on your B12 shots, how many injections, how frequently etc?

Has the doctor not investigated why you don't appear to be absorbing any nutrients (unless not eating anything) - has he ruled out coeliacs or other stomach issues or referred you to Gastroenterologist? If you're not absorbing these, you're likely not absorbing all the other stuff not generally tested as well - all of which are important.

Do you have any digestive issues?

[Luv2018 in reply to Saggyuk]

Thanks. B12 deficiency and folate deficiency confirmed with complete blood count. Iron deficiency confirmed with iron panel. I have digestive issues. I have B12 shots every 3 months

[Saggyuk in reply to Luv2018]

Okey well you should keep testing the folate, b12, ferritin plus iron panel and blood count and treating until all normalised and optimal. They can mask each other and doc should be keeping close eye on everything. You should test your B12 just before the next shot you are due to see what your level is then. B12 is very dangerous to become deficient in. You also need to start working out why constant supplementation isn't working and you're not able to keep our levels up. I would agree with others below and try a gluten free diet but must be 100% gluten free including cross contamination and for at least three to six months to know for sure if you will get any improvements. If this doesn't work then you really need to be referred to a gastro to investigate. I couldn't absorb zilch for decades until I went gluten free.

I

Hope you feel better soon

[SeasideSusie Remembering]

Diagnosed iron deficient 2013

You should actually have been diagnosed iron deficient in 2011. below range Ferritin/MCV and above range MCHC confirmed it back then. Are you still being actively monitored.

I see you are no longer taking iron tablets and your ferritin is falling. You should point this out to your GP/haematologist. You don't want to end up back where you started.

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 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... Not only does liver help raise ferritin, it is a superfood and contains lots of other important vitamins and minerals chriskresser.com/natures-mo... so including some in our diet on a fairly regular basis is a good idea.

If you are prescribed iron tablets again at any time, take each one with 1000mg Vit C to aid absorption and help prevent constipation, and take iron 4 hours away from thyroid meds and 2 hours away from any other medication and supplements as it affects their absorption.

**

folate deficient 2016

You should have been diagnosed folatle deficient in December 2013. Your level has been and down considerably despite taking folic acid daily. Your current level of 1.9 (2.5 - 19.5) is dire and you need to speak to whoever is dealing with this (GP?). Folate should be at least half way through it's range.

B12

Presumably you are getting 3 monthly injections. If you are getting benefit from them then make sure you get them on time, many members are going way past their 3 months, one recently was 7 months and that's just not on when you need them regularly.

**

Vit D

You were correct to take more D3 than the prescribed 800iu and your 3000iu has been effective in raising your dose; however it has been up and down. Your current level is too low, the Vit D Council recommends 100-150nmol/L and you could increase your dose during the winter and maybe take 2 sprays and retest around April time. Because we can't make Vit D naturally from the sun during the winter we use up our store so we often need to increase our dose during the winter months. When supplementing it's recommended to retest once or twice a year to keep within the recommended range. Your GP may not be willing to do this so 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

vitamindcouncil.org/about-v...

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

naturalnews.com/046401_magn...

Check out the other cofactors too.

**

SlowDragon has given you information and links about gut/absorption problems in her reply to your other thread. I think this is why your nutrient levels are so awful and why they aren't showing a steady and stable improvement. You need to address these problems as per SlowDragon's advice so you can optimise your vitamins and minerals and only then can thyroid hormone work properly.

[Luv2018 in reply to SeasideSusie]

Thanks. New GP not actively monitoring me. Folate is being dealt with by GP. Vitamin D tested every 6 months and I get B12 injections on time

[SlowDragon Administrator in reply to Luv2018]

Make an appointment and request a blood test for coeliac disease

Then, regardless of the results try strictly gluten free diet for at least 6 months

Getting gut healed is key to this disease

Follow SeasideSusie advice on supplements.

You need at least 6000iu vitamin D at moment. Likely to be able to reduce once back on T3.

Magnesium and vitamin K2 Mk7 are both important too

Magnesium helps vitamin D

hypothyroidmom.com/two-vita...

magnesiumeducation.com/how-...

naturopathconnect.com/artic...

articles.mercola.com/vitami...

Folate is terrible. You need a good vitamin B complex that includes folate in it (not folic acid)

Igennus Super B complex is good one

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...

Strictly gluten free diet and vitamin levels at optimal will help

Getting right dose and brand Levothyroxine so that TSH is around one and FT4 towards top of range

If FT3 remains low then, like many of us with Hashimoto's you are likely to need a small dose of T3 adding

Read as much as possible about Hashimoto's and gut connection

Dr Rangan Chatergee is good - has website, book and podcasts

Dr Michael Moseley - Clever Guts diet

Plus all the USA based links I gave you on other post