Thyroid UK
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Do I need to supplement ?

Hi,

I have just had bloods done & am vitamin D deficient. GP has prescribed Vit D Colecalciferol 3,200 IU to take daily for 4 months.My question is - should I be concerned about VIT B12, Folate & ferritin levels too?..they are in range but bit low I think?... My test results are below ,with the range of limits in brackets for reference:

Vitamin D2 & D3 combined- 33.5 nmol/ L ( 50- 220)

Vit B12- 333 ng/L ( 187- 883)

Serum Ferritin- 32 ug/ L ( 10- 300)

Serum folate- 8.4 ug/ L ( 3.1- 20)

Haemocrit- 0.41 L/L ( 0.3- 0.5)

Many thanks in advance for acvice X

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Dibble

Your GP obviously hasn't done anything about your other results because they are within range. However, they're not optimal.

Vit B12- 333 ng/L ( 187- 883)

Check for signs of B12 deficiency here b12deficiency.info/signs-an... and if you have any then list them and see your GP about further testing for B12 deficiency/Pernicious Anaemia.

If you have no signs of deficiency then an extract from the book, "Could it be B12?" by Sally M. Pacholok states:

"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."

In your position I would be supplementing with sublingual methylcobalamin lozenges and I would use 1 bottle of 5000mcg strength then change to 1000mcg strength. Solgar and Jarrows do 5000mcg (check prices, Solgar did go stupidly expensive at one point) and personally I use Cytoplan for 1000mcg strength.

When supplementing with B12 we also need a good B Complex to balance all the B vitamins. Look for one with methylfolate and a couple of brands recommende here are Thorne Basic B and Igennus Super B.

**

Serum folate- 8.4 ug/ L ( 3.1- 20)

Folate should be at least half way through range, so 11.5+ with that range. The B Complex will take care of that.

**

Serum Ferritin- 32 ug/ L ( 10- 300)

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 would probably need to push for iron tablets from your GP with that level and he may not be willing to prescribe. However, the easiest way to raise ferritin (if no iron anaemia is present, you could ask for an iron panel and full blood count to check that) is 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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Vitamin D2 & D3 combined- 33.5 nmol/ L ( 50- 220)

Your GP has given you a decent amount of D3, almost the normal loading dose for deficiency, but he has spread it over a long time and you could have had a higher amount to raise your level in less time.

The Vit D Council recommends a level of 100-150nmol/L so once you reach this level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, 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

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.

If your prescribed D3 is a tablet, then make sure you do take it with a good amount of dietary fat. If it's a softgel containing some kind of oil (maybe olive oil or sunflower oil) then there is already some fat there to aid absorption so just a full fat yogurt or toast and butter would be enough.

If you have autoimmune thyroid disease aka Hashimoto's (as confirmed by raised antibodies) then an oral spray D3 gives best absorption as it bypasses the stomach. You wouldn't get that on prescription though.

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Hi Seaside Susie, Thank you so much for replying to my question & thank you so much for the knowledgable indepth info & advice you have provided me with- I'm going to follow it! X

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Hi Dibble. I raised my ferritin from 48 (tested early January 2018) to 102 ( retested early April). The only change I made was eating 8 oz beef liver religiously every Monday. Prior to this I haven't eaten liver since I was 6 years old and tasted it. (now 74). I really dislike it. But for other reasons didn't want to start iron supplements right now. Iwant it higher so will continue the liver. I treat it like a particularly nasty medicine. My plan is when ferritin becomes optimal for me I will cut to every 2 weeks. One thing that has already greatly improved are mt RLS (restless leg). Grateful for this and liver is a small price to pay. Hope this helps. (I DROWN the liver in onions and garlic!😊 irina

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Hi Irina, thank you for posting in answer to my question- I can relate to the dislike of liver- I haven't eaten it since childhood either! ...Think I might just have to 'bite the bullet' though and chomp some down- with the onions & gravy of course! It sounds like doing so has worked very well for you and fantastic that the RLS has improved. X

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