Vitamin levels query

[rachjo27]

Hi everyone

I've been reading posts on here for a while now and found them very useful. After a bit of guidance please.

I had thyroid cancer just under 3 years ago and over the last year I've been struggling with fatigue, heat intolerance, weight issues the list goes on....

Over the last two months I've had the following results that have shown issues

Vitamin D - 52 (50-150)

Ferratin - 16 (12-300)

However my Gp has just told me to buy over the counter vitamins does this sound right or should I keep pushing for higher doses.

Thank you

[bluebug]

You are not severely deficient so it is up to you to buy supplements not the NHS.

(I have to run)

[humanbean in reply to bluebug]

I would describe a ferritin level only 1.4% of the way through the reference range as being severely deficient. It only has to drop by 5 to be under an extremely wide range.

With the reference range given I would want to get my ferritin level up to about 140 - 150 (roughly mid-range). But having said that, I wouldn't suggest supplementing until a full iron panel was done.

I would also suggest supplementing with more than one iron tablet a day if the iron panel suggests supplementation is a good idea. I took 1 tablet, 3 times a day, of ferrous fumarate 210mg, for nearly 2 years to get my levels as close to optimal as I could.

[rachjo27 in reply to humanbean]

Thank you for the detailed reply I have bought some ferrous sulphate and will take that for now I am seeing an endocrinologist in March so hopefully will get some more information. I too was a little worried and the Gp has said he wants it above 70 I just didn't know whether over the counter supplements would provide the increase.

[humanbean in reply to rachjo27]

The important thing with any iron supplement is how much pure iron each dose contains.

A healthy person requires about 15mg of pure iron a day in their diet to cater for what they use up or lose. It won't raise levels. At best it maintains them.

But the people who use this forum are not healthy, and many of us do not absorb iron well, and we may lose more than we should.

Every iron supplement you can buy should tell you how much iron it contains. I don't recall how much iron there is in ferrous sulfate, you'd have to look at the Patient Information Leaflet. However, each tablet of ferrous fumarate 210mg contains 69mg of pure iron. The maximum dose is one tablet, three times a day, making a total of 207mg pure iron per day. I would consider that to be the maximum amount of pure iron for anyone taking any iron supplement.

Ferrous fumarate 210mg comes in boxes of 84 and must be bought from a pharmacy - you have to ask for it, it is not on display - and the pharmacist can refuse, but that rarely happens. If you are refused just go to a different pharmacy. I used Lloyds and Tesco. It can also be bought from online pharmacies, although I've never used these myself.

Many people tolerate ferrous fumarate 210mg better than ferrous sulfate. There are some who are the other way around.

There are other iron supplements, with less iron in them. Strangely enough, the less iron there is in a supplement the more expensive it tends to be.

A useful link for you :

dropbox.com/sh/3waycnbzhywi...

For people who eat meat, some people manage to raise their iron/ferritin levels well by eating liver once or twice a week.

[SeasideSusie Remembering]

You won't get Vit D prescribed with your level, you don't need loading doses as it doesn't come into the Deficiency category. My suggestion would be to buy some D3 softgels 5000iu and take one daily for 3 months then retest. The Vit D Council recommends a level of 100-150nmol/ so when you reach that level you will need to find your maintenance dose by trial and error, it may be 2000iu daily, maybe more or less.

Look at Doctor's Best or Now Foods D3 softgels, good brands with no unnecessary ingredients.

There are important cofactors needed when taking D3 - K2-MK7 and magnesium so make sure you introduce those too vitamindcouncil.org/about-v...

For you low level of ferritin it could suggest iron deficiency anaemia so you should ask your GP to do a full blood count and iron panel. Start eating liver regularly, maximum 200g a week, to help raise ferritin, get the other tests done first though.

Ferritin meds to be at least 70 for thyroid hormone to work (our own or replacement hormone), preferably half way through it's range.

[rachjo27 in reply to SeasideSusie]

Hi thank you for the detailed response. Unfortunately I don't have any thyroid left and am on Levothyroxine. I have bought some vitamin D and ferrous sulphate hopefully that will help. My full blood count came back as normal but Ferratin was low he wants it above 70.

[bluebug]

For iron take one ferrous sulphate/fumerate per day with vitamin C. 4 hours away from thyroid meds and 2 hours away from other food drink and supplements.

Tell a pharmacist in a pharmacy you don't normally use that you have low iron and have been told to buy it. A packet/jar of 84 should cost less than £5.

You need to be retested in 6 months as ferritin rises slowly but the NHS is unlikely to test you.

[rachjo27 in reply to bluebug]

Thank you I have bought some and hopefully can get the timings right to take them

[SlowDragon Administrator]

What are your thyroid results like?

Presumably after cancer endocrinologist is keeping TSH suppressed

Have you got TSH, FT3 and FT4 results and ranges

You may need small dose of T3 adding if FT3 is too low

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

[e-mail]

Also request list of recommended thyroid specialists, some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many, especially note husband comments on current inadequate treatment following RAI or thyroidectomy

rcpe.ac.uk/sites/default/fi...

The fact your vitamin D and ferritin are low suggests you may be under medicated

Have you had B12 and folate tested? If not, request they are