Hello. I have had tests for Vit B12, Folate, Vit D and Ferritin (done by the NHS) and need some advice as to whether the levels are OK or not.
Serum Vitamin B12 438 ng/ml (187 - 883)
Serum Folate 5.2 ng/ml (3.1 - 20.5)
Serum Ferritin 136 ng/ml (20 - 204)
Serum Vitamin D 27 nmol/l (80 - 150)
I have been put onto a Vitamin D3 supplement - 800 IU (20 ug) per day
I would appreciate your opinions if these levels are sufficient or not and any advice you can offer.
I have been feeling weak, tired and grumpy with cold hands and feet for two years and at times down right ill. I have Hashimotos and am on 75 micrograms of levothyroxine per day and am wondering if I am undermedicated. Unfortunately I am also on Bisoprolol for PAF and this rather muddies the waters as it can produce the same symptoms. I may have to get a test for TSH, T4 and T3 done privately.
On the advice given on this group's posts, I am on a gluten-free diet as I had symptoms of an irritable bowl. I am feeling much better as a result of this diet. I am also trying to eat a variety of vegetables and protein sources to get more minerals and vitamins into my diet but I am not sure I eat enough to fulfil the daily requirements of all of them. Anyway I would appreciate your comments. Many thanks.
UPDATE: Thank everyone for their advise. As advised, I went back to the GP and asked him if I should be given a loaded dose of Vitamin D. He agreed and prescribed a dose of 50000 IU weekly for 6 weeks. I thought this was a large dose and, after reading articles sourced on this site, discovered that the dose should be worked out according to a formula based on weight. The 50000 IU weekly is for a person of 100kg. I only weigh 60kg so I decided to take 25000 IU for 8 weeks. I feel so much better. All the muscle weakness and nausea have disappeared and I can walk the distances I used to and enjoy it again. My appetite has returned. I have also been supplementing with a good Vitamin B complex and magnesium glycinate. I advise people to get their Vitamin D checked. A deficiency can make you feel awful. After finishing the loaded dose, I shall go on to a maintenance dose of Vitamin D.
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Happywalker
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B12 is usually measured as pg/ml or ng/L or pmol/L. pg/ml and ng/L are the same.
1ng/ml is the same as 1000pg/ml
According to 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."
Serum Folate 5.2 ng/ml (3.1 - 20.5)
Folate should be at least half way through range - 12+ with that range.
Serum Ferritin 136 ng/ml (20 - 204)
This is fine, recommended is half way through range. If you are supplementing, I'd drop back a bit.
Serum Vitamin D 27 nmol/l (80 - 150) - I have been put onto a Vitamin D3 supplement - 800 IU (20 ug) per day
Your GP should have put you on loading doses because your level is below 30, according to NICE treatment summary for Vit D deficiency:
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 125nmol/L - and 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/
If your GP wont increase your dose, come back and I can tell you how much you should be supplementing with.
Your doctor wont know, because they are not taught nutrition, but 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 such as hardening of the arteries, kidney stones, etc.
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. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium 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
** If you are on Warfarin or other blood thinning medication, you should look into whether you should be supplementing with Vit K2. Vit K1 is the blood clotting vitamin which should be avoided when taking blood thinning medication, but some articles tell you that Vit K2 should be avoided as well. It's up to you to make enquiries and decide whether you take K2-MK7. It can be found in certain foods so you could check that out as well.
am on 75 micrograms of levothyroxine per day and am wondering if I am undermedicated.
We can't help you with that unless you post your thyroid test results with reference ranges:
TSH
FT4
FT3
As for your Hashi's, as well as your gluten free diet, supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Thank you so much for all the information you have given me. I would have had no idea if I had not joined this group.
You are right. The Vitamin B12 is 438 pg/ml. Sorry for my error.
I am seeing my GP in a week's time so will bring all this to his attention. At least I am seeing the one Dr in the practice who does seem to listen to his patients.
Hello Happywalker you don't sound too happy for a start ! Most drugs have side effects go back to a normal diet how old are you? Daily exercise gentle exercise bike stepper light weights fast reps after build up. Try floor abs work bit of flexi exercises should make you more relaxed and supple. A bit of fun would be a good idea couple of drinks meal with friends or better still friend and some hot stuff! My attitude is trust your Dr don't get too technical unless you are a Dr you'll just give yourself a headache to go with all the other stuff. slozem is a good replacement for amlodipine and bisoprolol but irritates the skin or it does mine. Overall 20mg omeprazole 240 mg slozem 100micros thyroxine clopigerel and rivaroxaban it's a party 72 having fun still here magic most of all keep laughing!
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