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Thyroid UK
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Why aren't vitamin and mineral level improving?

I have constipation, swollen ankles which has only just come on, sudden weight gain, have suddenly gone from 56.1kg to 56.9kg within a day, loss of appetite, tiredness, pale skin, bruising on legs, flaky nails, aches and pains. My thyroid gland has grown in size but goes down on its own. The last time this happened was 4 years ago. Ultrasound scan in 2015 showed thyroid gland enlarged but if thyroid gland did not make my neck swell up back then I really don't know what to think or if I should see a different endo. Endo says he does not understand my results going up and down. Am I right to worry about his way of thinking if he doesn't know what is happening to my levels. Iron being dealt with by haematology as MCV below range. Thankyou

Ferritin 31 (30 - 400)

Folate 2.0 (2.5 - 19.5)

B12 198 (190 - 900)

Vit D 50.1 (50 - 75 suboptimal)


800iu D3 since Dec 2013

8 Replies

You have Hashi's, that's why your levels go up and down. And an endo ought to know that!

Last time you gave your thyroid levels, you were under-medicated. Have you had an increase in dose since then?

Your nutrients are dire. Are you only supplementing vit D? With that low level of ferritin, you doctor ought to be doing other tests to find out why.


Thanks no I haven't had increase and I supplement 800iu D3 only and I have complete blood count results


Make an appointment with GP and ask for 25mcg dose increase in Levothyroxine

Can you add the results of the full iron panel and then, assuming that confirms Anaemia you need ferrous fumerate or an iron infusion

SeasideSusie can comment on iron panel results

800iu is only a maintenance dose of vitamin D for a well person. Anyone with Hashimoto's has poor absorption and likely to need at least 3000iu daily (or higher) Aiming to improve to around 100nmol.

Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you try 3000iu for 2-3 months and retest. It's trial and error what dose each person needs. Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Also look at magnesium and vitamin K2 Mk7 when on high dose vitamin D



Both folate and B12 are too low and you will likely need B12.injections. But must be tested fully for Pernicious Anaemia first. Folic acid supplements should not be started until 48 hours after first B12 injection

Post about Loading doses of B12


All this is direct result of being under medicated for Hashimoto's.



As mentioned in your other thread, they're probably not improving due to gut/absorption problems caused by your Hashi's. SlowDragon has given you lots of links and information.

It's also been explained that your endo is probably a diabetes specialist and doesn't know enough about thyroid disease which is why he doesn't understand why your results are going up and down. To be honest, you'd be better off ditching this endo, he wont help you. Either find a proper thyroid specialist or don't bother with an endo at all. You can send for the list of thyroid friendly endos from Thyroid UK. Email Dionne


Then you can ask for feedback from members on any that you can travel to.

As for your results

Ferritin 31 (30 - 400)

It seems as though you have a diagnosis of iron deficiency anaemia.

Have you been prescribed 3 x ferrous fumarate daily? You should take each tablet with 1000mg Vit C, and take iron 4 hours away from thyroid meds and 2 hours away from any other supplements and medication as it will affect 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...

Folate 2.0 (2.5 - 19.5) B12 198 (190 - 900)

Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an...

If so then list them and discuss with your GP. Your level B12 level is low enough to warrant testing for B12 deficiency/pernicious anaemia, plenty of people with higher levels than yours need B12 injections.

Folate is deficient and you need folic acid prescribing. Don't start taking it until further investigation into your B12 has been carried out as folic acid can mask signs of B12 deficiency.

Vit D 50.1 (50 - 75 suboptimal) Taking 800iu D3 since Dec 2013

Do you remember what your Vit D level was in Dec 2013? If it was below 30nmol/L you should have been given loading doses totalling 300,000iu over a number of weeks followed by a maintenance dose.

The Vit D Council recommends a level of 100-150nmol/L and 800iu D3 daily wont raise your level to any great extent, it's barely a maintenance dose for someone who already has a decent level.

You really should be taking around 5000iu daily for a few weeks. As you have Hashi's you should use an oral spray for best absorption and BetterYou do one which comes in 3000iu dose. I would take 6000iu daily for 6 weeks, followed by 3000iu daily for 6 weeks then retest. When you've reached the recommended 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/

There are important cofactors needed when taking D3 as recommended by the Vit D Council -


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


Check out the other cofactors too.

But as mentioned, you need to address the gut/absorption problem for the supplements to work

1 like

Thanks my vitamin D level back in 2013 was 29.3 (25 - 50 deficient) and no ferrous fumarate given. I have signs of B12 deficiency



Iron being dealt with by haematology as MCV below range.

How is it being dealt with if no ferrous fumarate has been prescribed.

Vit D

The NICE Clinical Knowledge Summary shows that <30 then loading doses should be given so your GP was wrong to give you just 800iu


However, too late now and you now know what dose you should be supplementing with and how to go forward.


As you have signs of B12 deficiency then discuss with your GP and ask for further testing as mentioned above.


Thanks I am having iron infusion next week to treat anaemia


GP prescribed me loading doses of vit D too


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