Help with supplements please

[Cheslie]

FERRITIN 34 (30 - 400)

MCV 80.2 (83 - 98)

MCHC 357 (310 - 350)

HAEMOGLOBIN ESTIMATION 118 (115 - 150)

RED BLOOD CELL COUNT 4.41 (3.80 - 5.80)

WHITE CELL COUNT 7.12 (4.00 - 11.00)

HAEMATOCRIT 0.40 (0.37 - 0.47)

PLATELETS 247 (140 - 400)

IRON 7 (6 - 26)

TRANSFERRIN SATURATION 13 (12 - 45)

TOTAL 25 OH VITAMIN D 40.8 (50 - 200)

FOLATE 2.6 (2.5 - 19.5)

VITAMIN B12 223 (190 - 900)

I take 800iu vitamin D tablets since 2014 and 5mg folic acid tablets since 2016 do I need anything else to take thankyou

[SeasideSusie Remembering]

Cheslie

FERRITIN 34 (30 - 400)

MCV 80.2 (83 - 98)

MCHC 357 (310 - 350)

Has your GP said nothing about these results? Low ferritin with below range MCV and over range MCHC indicate iron deficiency anaemia and you should be having treatment as per NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines):

cks.nice.org.uk/anaemia-iro...

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

You need an iron supplement and as your level is so low you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months. If you are given iron tablets then take each one with 1000mg Vit C to aid absorption and help prevent constipation. Take iron 4 hours away from thyroid meds and 2 hours away from any other medication and supplements as it affects their absorption.

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 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...

**

TOTAL 25 OH VITAMIN D 40.8 (50 - 200) 800iu vitamin D tablets since 2014

Was your level below 30 before starting the Vit D tablets? If so you should have been given loading doses.

Again, it beggars belief that you've been taking Vit D for 4 years and your level is still deficient yet your GP has done nothing about it. Time to take things into your own hands an buy your own supplement and I suggest, because you have Hashi's, that you use an oral spray for best absorption. BetterYou do one 3000iu dose. I would triple dose to start with and take 9000iu daily for 2 weeks, then 6000iu daily for 2 weeks, then 3000iu daily. Retest after 3 months, if your GP wont retest then you can do it with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

Once you've reached the level recommended by the Vit D Council - which is 100-150nmol/L - 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.

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.

BetterYou do a combined D3/K2-MK7 spray which saves the bother of a separate K2 supplement.

**

FOLATE 2.6 (2.5 - 19.5)

5mg folic acid tablets since 2016

Is your folic acid daily or weekly?

Again, how can your GP ignore the fact that 2 years supplementing and you're still just 0.1 inside the range.

Were you checked for B12 deficiency before starting the folic acid? Check now because

VITAMIN B12 223 (190 - 900)

This level is far too low. 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." Check here for signs and symptoms of B12 deficiency:

b12deficiency.info/signs-an...

If you have any then your GP should do further investigations and test for B12 deficiency/Pernicious Anaemia. However, you should be aware that taking folic acid can mask signs of deficiency (think back to before you started it), and all testing should be done before starting folic acid. Any further testing and it would be wise to stop the folic acid until completed.

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."

[Cheslie in reply to SeasideSusie]

Thankyou my vit D level was below 30 when diagnosed. Folic acid is daily and I haven't been checked for B12 deficiency even though I have many symptoms of it nothing done about iron or complete blood count either

[SeasideSusie Remembering in reply to Cheslie]

Cheslie

Oh dear

Well definitely see another doctor. Besides what's been discussed in your other thread, you now need to discuss

1) Iron deficiency anaemia, details in my post above.

2) List all your symptoms of B12 deficiency, ask for testing for this and Pernicious Anaemia. Remember to stop the folic acid or the results will be skewed.

3) Vit D - personally I wouldn't bother mentioning this. You may not get a higher prescription now that your level is 40.8 but you do need the oral spray form of D3 and that can't be prescribed.

**

Please read through SlowDragon 's reply near the bottom of this thread healthunlocked.com/thyroidu... where she gives information and links about gut and absorption problems and how to address them. You could ask your GP to do investigations for malabsorption. If testing for coeliac then you will have to delay starting a gluten free diet, but whether or not you are positive for coeliac (there are lots of false negative results) you will probably still benefit from being gluten free.

**

I don't think this doctor has been particularly helpful, it may be better to see a different doctor in the practice.

[Cheslie in reply to SeasideSusie]

Thankyou shall I post back about what the doctor I will see has said?

[SeasideSusie Remembering in reply to Cheslie]

Yes please Cheslie, it would be good to know

[Cheslie in reply to SeasideSusie]

I speak to a different doctor tonight about everything

[SeasideSusie Remembering in reply to Cheslie]

Excellent! Hopefully the new one is on the ball, if he gets everything organised with prescribing supplements, testing, etc, it might be an idea to discuss the fact that the other GP has been rather negligent.