I have been having various blood tests after not getting a regular cycle back after stopping the pill.
I had bloods done in March and recently repeated.
Main worry is my TSH has gone up. But still 'in range'. Should I be pushing for a full thyroid panel? Or maybe I should just do a postal test.
In March I had low folate and ferritin, for which I have been taking Folic Acid and Ferrous Sulphate, and these are much improved as is my haemoglbin. Doctor said I could stop taking these now but may be a good idea, as a pescatarian, to take for one month out of every 4 or so. Seems like a sensible approach, I have also not ruled out eating some liver!
I asked for vitamin D test too this time, remembering the advice of this group. Doctor said it would not harm to supplement given my result. I've since compared to my 2015 result for vitamin D and seems very low in comparison. Any advice on what dose to try for this?
I understand SeasideSusie usie is the queen of vitamin info, I would really appreciate your views 😊
TSH
March - 2.19 (0.35-5.5)
July - 2.74 (0.35-5.5)
Free T4
March - 12.5 (10-19.8) (not restested)
Ferritin
March - 7.2 (10-291)
July - 28.3 (10-291)
Folate
March - 4.69 (>5.38)
July - >24 mU/L (>5.38)
B12
March - 306 (211- 911) (not retested)
Haemoglobin
March - 125 (120-156)
July- 139 (120-156)
Vitamin D
July - 34.8 nmol/L. Below 30 deficient, 30-50 - may be inadequate in some people, 50+ sufficient for almost whole population.
July 2015 - fingertip postal test- 125.4 nmol/L where more than 50 = adequate.
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In March I had low folate and ferritin, for which I have been taking Folic Acid and Ferrous Sulphate, and these are much improved as is my haemoglbin. Doctor said I could stop taking these now but may be a good idea, as a pescatarian, to take for one month out of every 4 or so. Seems like a sensible approach, I have also not ruled out eating some liver!
What! You've gone from ferritin below range to 6.5% through range and he thinks you can stop, or just take iron supplements one month out of four. He's an idiot. Ferritin is recommended to be half way through range although I have seen it said that 100-130 is a good level for females. It's said it needs to be 70 for thyroid hormone to work.
With a below range ferritin, it's essential to do a full blood count and iron panel as low ferritin suggests iron deficiency anaemia. Were these tests carried out?
With such a low ferritin an iron ifusion would have been the smartest thing to do, it improves levels within 24-48 hours whereas tablets can take many months.
Folate
March - 4.69 (>5.38)
July - >24 mU/L (>5.38)
This is now a good result.
B12
March - 306 (211- 911) (not retested)
Have you been supplementing for this?
Is it ng/L or pg/ml or pmol/L.
Whichever, it is low. If you confirm the unit of measurement I can give more information.
Vitamin D
July - 34.8 nmol/L. Below 30 deficient, 30-50 - may be inadequate in some people, 50+ sufficient for almost whole population.
July 2015 - fingertip postal test- 125.4 nmol/L where more than 50 = adequate.
I wonder what happened to make your level plummet like that?
Have you had thyroid antibodies tested? Hashi's can cause nutrient deficiencies and you certainly come into that category. Thyroid Peroxidase and Thyroglobulin antibodies need testing.
The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml).
To reach the recommended level from your current level of 34.8nmol/L (13.9ng/ml), based on the Vit D Council's suggestions you could supplement with approx 5,000iu D3 daily
When Hashi's is present then for best absorption an oral spray is recommended (eg Better You) or sublingual drops (eg Vitabay Organics). When Hashi's isn't present best absorption is obtained from D3 softgels with olive oil (eg Doctor's Best).
When you've reached the recommended level then you'll need a maintenance dose to keep it there, 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 an NHS lab which offers this test to the general public:
Your GP won't know, because they're not taught much about nutrients, 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 if taking tablets/capsules/softgels, no necessity if using an oral spray
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 taking tablets/capsules, no necessity if using topical forms of magnesium.
Check out the other cofactors too (some of which can be obtained from food).
As for your thyroid results, they are classed as euthyroid (normal) because they are in range. However, you can't discount Hashi's which gradually destroys the thyroid.
Do you do your thyroid tests no later than 9am, after an overnight fast from evening meal/supper the night before, drinking water only? That gives the highest possible TSH which is needed when looking for a diagnosis.
So low ferritin could still be the cause of the TSH getting worse I guess? As I am much lower than 70.
I think I will carry on with the Ferrous Sulphate in that case. How about the Folic Acid, maybe I can stop that one?
B12 - 306 ng/L. No supplementation taken for this.
I have been taking magnesium and zinc for last 3 ish months, same sort of timescale as the ferrous sulphate and folic acid.
Will look into the Vitamin D you suggest.
Yes full blood counts were taken. Only things of note were low mean cell volume, low mean cell haemoglobin level, and high red blood cell distribution width, which were all back to within range this time round.
Only other oddity is my CRP (inflammation) - was 4 in Sept 2018, 11 in Jan 2019, 13 in March 2019, and 11 in July 2019.
Thinking what has changed since 2015....I broke a bone in my back in 2016, had surgery and have metal 'scaffolding' internally. I had to retire my horse last year and no longer have a horse to look after so may have been outside somewhat less. Also am a 9-5 office based worker but that has been the case for 20 years! I am very pale and do have to cover up and use sunscreen often.
Health wise, things have been very haywire since coming off combined contraceptive pill April 2018, and a few months on mini pill April-Sept 18. Been off hormonal contraception since end September 2018. Acne, rapid weight gain, fatigue, low mood and amenorrhea were my main symptoms. Things are improving albeit slowly.
B12 - 306 ng/L. No supplementation taken for this.
ng/L is the same as pg/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."
Many people with serum B12 in the 300s have needed to start B12 injections.
and if you have any then list them to discuss with your GP and ask for testing for B12 deficiency/pernicious anaemia.
If you don't have any of those symptoms you could supplement to improve your level. If that was my result and I had no symptoms of B12 deficiency then I would take sublingual methylcobalamin 1000mg, along with a good B Complex to balance all the B vitamins. Then after the bottle is finished I would continue with just the B Complex.
Good B Complex supplements contain methylfolate (not folic acid) and methylcobalamin not cyanocobalamin.
I would stop the folic acid now and just take a B Complex.
Yes full blood counts were taken. Only things of note were low mean cell volume, low mean cell haemoglobin level, and high red blood cell distribution width,
That would have suggested iron deficiency anaemia. It can also suggest microcytic anemia which is usually caused by a deficiency of iron.
Only other oddity is my CRP (inflammation) - was 4 in Sept 2018, 11 in Jan 2019, 13 in March 2019, and 11 in July 2019.
This can be raised by inflammation or infection. I doubt if it's infection because your ferritin would probably be raised as well. Hashi's causes inflammation of the thyroid and it could possibly be this, you really should get thyroid antibodies tested.
Thank you so much. Feel like sacking my doctor! Will get ordering some B vitamins!
Going to have a think about whether to ask GP (maybe a different one!) to follow up re: thyroid, or just to get the thyroid panel done through postal test in the first instance.
The CRP could have been an infected root canal tooth actually, though that was removed 3 weeks before most recent test so maybe not. Have read research to say CRP can be raised with obesity also. I'm in obese BMI now, usually sit in overweight before the rapid weight gain last year.
Sorry not sure about folic acid I was on them for awhile I saw no difference with them my Doctor took me off of them in the end...I do not think folic acid is good long term so I have heard...They help some, others they do not. I would try to get it if possible in food consumption
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