Medical entitlement? Can you guide me? - Thyroid UK

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Medical entitlement? Can you guide me?


Slightly off topic but I have osteopoenia, likely to be a result of hypothyroid mis-management, and need vitamin D and Calcium which would normally be prescribed by a GP. Unfortunately as I am vegan the surgery has said "NHS rules locally state that a patient should purchase such medications over the counter" so I will have to pay for my own. One problem is that I cannot find a good-enough vegan supplement, the other is that I question the reasonableness of this and the fairness.

Can anyone tell me if they know better? Do any of you know of any vegans prescribed D and Calcium?

14 Replies


You should be able to check the local guidelines for your area and you may be able to find some information there. If you google "prescribing Vit D for vegans" and add UK or your area, you might be able to find something. One example from a quick google is here

which says on page 5-6

Colecalciferol (vitamin D3) is commercially synthesised from an animal source such as lanolin/wool fat from sheeps wool. If the animal is not harmed in the manufacture of the raw vitamin D3, the product could be considered suitable for vegetarians. It is advised that the source of vitamin D3 be discussed with vegans in order for them to make an informed choice as to whether this is acceptable to them or not.

Ergocalciferol (vitamin D2) is derived from a common plant steroid, and could be used at equivalent doses (in a gelatine free product) for vegans who do not find it acceptable to take colecalciferol containing products.

The choice of preparation should be discussed with patients who have various dietary requirements (e.g. halal, kosher, vegan or vegetarian, soya allergies), so that they can make an informed decision.

As there are now many licensed preparations of colecalciferol available for high dose (and maintenance vitamin D supplementation, if appropriate) which can be prescribed to meet the needs of various dietary requirements e.g. vegetarian, allergies (See Appendix 2 – Table 1). It is therefore, expected that prescribing of unlicensed preparations, will only be undertaken in exceptional circumstances to meet the

Prescribing of intramuscular vitamin D preparations should remain with the specialist, as this is usually reserved for those patients with compliance issues or malabsorption conditions.


specific needs of an individual. If in doubt on the suitability of a preparation, contact the Medicines Optimisation Team for further advice.

Licensed preparations should be prescribed by BRAND, where possible to avoid potential risk of unlicensed preparations or preparations that do not meet the dietary requirements of specific patients being dispensed.

thyr01d in reply to SeasideSusie

Thanks Seaside Susie, I will try this, and, the Medicines Optimisation Team looks promising, if it's national rather than local.

Reading the above website you will see that supporting the skeleton is about more than VitD and Calcium. Could you not ask the Vegan Society and seek their advice ? B12 is also involved in bone formation - could this be the cause ?

thyr01d in reply to Marz

Good idea Marz, I will try the Vegan Society. And, yes, I supplement B12 using Jarrows since seeing your advice some years ago but at my last endo appointment B12 was too high so I've reduced a little now.

Marz in reply to thyr01d

Once you are supplementing the results are skewed ! This is laid down in the Guidelines for the diagnosis and Treatment of Folate and Cobalamin Deficiency. See link below ... The test reveals what is circulating and not the amount reaching the cells - where it is needed ...

If your level is above the range then taking a GOOD B complex should maintain levels. The Serum test reveals both bound and unbound B12 and only 20% can reach the cells where it is needed :-(

thyr01d in reply to Marz

Phew Marz, I've just read not just the article you sent the link to on Dr Myhill's site but a lot more - all very interesting thank-you. I will keep referring back to it.

What played the biggest roles in helping you find your way back to good health, if you know?


Vitamin D mouth spray by Better You is made from lanolin from Australian sheep wool. So not a direct animal product

It also works well as avoids poor gut function

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

As Marz says, being vegan low B12 is likely

Presumably you supplement B12 and a good quality daily vitamin B complex

Using test of Homocysteine levels to check for low b12

Good explanation on homocysteine

Oral as good as injections

B12 generally

Thanks SlowDragon, I do take B12 and it's monitored by my endo. I take a balanced B complex (you may have noticed most are plentiful in the cheap Bs and low on the expensive ones which puts the B vitamins out of balance - this is not well known yet). I also take magnesium and vitamin K2 having read up on them as well as various other supplements for optimal thyroid function (selenium, zinc etc). It's the calcium and D I find difficult and, as there are now so many vegans and we are likely to be more at risk, I feel sure there must be a vegan calcium and vitamin D product available on the NHS.

SlowDragonAdministrator in reply to thyr01d

Is vitamin D processed of sheep's wool that has been shorn not acceptable?

thyr01d in reply to SlowDragon

Sadly SlowDragon no, because without the financial benefit of selling lanolin products sheep farming would be less viable, so in using lanolin I would be helping to support the suffering of animals.

According to my GP, my vit D was below acceptable but above critical (or words to that effect) and that, despite being on a very low income, the NHS decrees that I must purchase Vit D myself. He also told me to drink a pint of milk a day (!!), which I will not do. I only use skimmed cow's milk in tea and the smallest bottle lasts well over a week. Almond milk has much more calcium than cow's milk and tastes much better. Regarding a vegan Vit D, I am sure the Vegan Society could put you right there. Good luck!

thyr01d in reply to mademary

Thanks for your thoughts and good luck madeMary. I drink rice milk fortified with calcium, it's cheaper than almond milk, doesn't contain phytic acid (my ferritin is at bottom of range) and to me tastes better.

I think it is those of us with osteopoenia/porosis who are entitled to calcium and D on the NHS and you are better off not having them!

Hope no one talks you into Prolia shots for osteoporosis. It's a killer. HenronNS posted diet n supplements in her "my osteoporosis journey" article.

Thank-you Badsideeffects, I appreciate the warning and hope the effects on you have now worn off. Was HenronNS a vegan? Loads of people give me diet sheets but since soya is very bad for us and having Hashi's I avoid gluten and as my ferritin level is bottom of the range I have to be careful with phytic acid (nuts, seeds etc) it's difficult.

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