Just had results of vitamins and wondering if anyone can help with brands of vitamins and starting doses in order to get these well within range?
Vit D 26.08 ng/ml range 30-70
B12 224.8 pg.ml range 197 -866
Folate 3.87 ng/ml " 3.10 - 17.5
Ferritin 19.65 ng.ml " 13 - 150
Last year I was taking Vit D given by the Doctor - 5 tablets a day for 10 weeks and then 1 daily - Make and dose - Desunin - 800 iu per tab. I took the whole course, ending early 2019.
B12 - in the past I have taken Jarrow 5000 mcg daily. and Solgar before that
Folate - advice please - dose etc
Ferritin - brand and starting dose
Any help would be great. I know that Ferritin has to be taken seperately from NDT should I be taking the other vitamins separately from NDT too?
Thyroid Results - dose NDT Thiroyd 2.5 grains.
Anti - TPO 25.4 0.00 - 40.0 IU/ml
TSH - 0.1 0.4 - 6.16 mIU/I
FT4 12.9 10.32 - 25.8 pmol/I
FT3 8.5 2.15 - 6.45 pmol/I
I figured that I should adjust my vitamins first as they could well have a bearing on my thyroid levels. Am I right in thinking this?
My T3 result is also a concern as it's high now. Could this level rise when I start on my course of Vitamins?
Given that my T4 is really low might it be better to go back on to levothyroxine eventually and T3 so I can adjust them independently?
Any thoughts would be most welcome.
Thank you
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princess20
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B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Ferritin...you can't assume iron is low, just because ferritin is low
Ask GP for full iron panel testing for Anaemia
Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption
Couldn't see that you have ever had both TPO and TG thyroid antibodies tested in past
If never had TG antibodies tested they need doing, but would have to be tested privately as NHS refuses to test TG antibodies if TPO antibodies are negative
Obviously your TPO are within range now.
Have they been high in past?
Do you have confirmed diagnosis of Hashimoto's as cause of being hypothyroid?
Have you ever tried strictly gluten free diet?
Can help with anxiety and generally improve symptoms, especially brain fog
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
Thank you so much I am in the process of digesting and reading it all. The Vit D measurement was taken here in Bulgaria. My TPO (Anti thyroid peroxidase) has always been mega high in the past so why do you think it's within range now?
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Last year I was taking Vit D given by the Doctor - 5 tablets a day for 10 weeks and then 1 daily - Make and dose - Desunin - 800 iu per tab. I took the whole course, ending early 2019.
Do you know, this really bugs me. They give loading doses for Vit D deficiency then go on to give a stupidly low maintenance dose - was your level checked after the loading doses? It's essential that it is so that you can then continue on an appropriate dose. And if you have Vit D deficiency then supplementation is generally for life. Bring the level up, stop the supplement, the level is bound to go down. I really don't understand why doctors don't get this, but then again, they're not taught about nutrients.
The Vit D Council recommends a level of 50ng/ml and the Vit D Society recommends a level of 40-60ng/ml and I would trust them to know a heck of a lot more about Vit D than any doctor.
To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 3,700iu D3 daily (nearest is 4,000iu)
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:
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).
Best absorption from an oral supplement that is swallowed is from a D3 softgel.
A very good supplement at a good price is Doctor's Best, they only contain D3 and extra virgin olive oil, and the cheapest place I've found is Dolphin Fitness. You could take 2 x 2000iu daily or 5000iu for 6 days per week
Some people prefer an oral spray (has too many extra unnecessary ingredients for my liking) or a sublingual liquid. These are recommended when Hashi's is present as they give better absorption as they bypass the gut.
B12 224.8 pg.ml range 197 -866
B12 - in the past I have taken Jarrow 5000 mcg daily. and Solgar before that
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."
Active B12 is a better test as it tests what is available to be taken up by the cells. Total B12 (your test) measures the total of bound and unbound (active) B12.
What were your results when supplementing? Why did you stop? I know testing when supplementing doesn't give you a baseline and you need to be off supplements for 4-5 months for that figure, but testing when taking supplements gives you an idea of whether you are taking enough to give you a good level.
Your current level is low enough to check for B12 deficiency - check for signs here
If you have any then list them and ask your GP to test for B12 deficiency/pernicious anaemia. Many people with a level in the 300s have needed to be started on B12 injections.
Folate 3.87 ng/ml " 3.10 - 17.5
This is very low and should be at least half way through range. You can eat folate rich foods and take a good B Complex such as Thorne Basic B or Igennus Super B. However, do not start taking B Complex until further tests for B12 deficiency have been carried out, it will mask signs of deficiency and skew results.
Ferritin 19.65 ng.ml " 13 - 150
This is too low for anyone here to recommend iron tablets. Low ferritin suggests iron deficiency anaemia and you should ask your GP to do a full blood count and an iron panel to check. If iron deficiency is present then your GP should prescribe appropriate treatment.
Anti - TPO 25.4 0.00 - 40.0 IU/ml
Although your antibodies are within range, they're not exactly right at the bottom end and I would be suspicious of autoimmune thyroid disease aka Hashimoto's. Your poor nutrient levels hint at this, Hashi's causes gut/absorption problems which can lead to poor nutrient levels or deficiencies.
Where Hashi's is present or suspected, some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
TSH - 0.1 0.4 - 6.16 mIU/I
FT4 12.9 10.32 - 25.8 pmol/I
FT3 8.5 2.15 - 6.45 pmol/I
Given that my T4 is really low might it be better to go back on to levothyroxine eventually and T3 so I can adjust them independently?
Taking NDT or T3 tends to lower FT4 so your level isn't surprising. However, we're all different where we need our hormone levels to be. Some people on NDT will be fine with your FT4 but personally I need both FT4 and FT3 at about 75% through range.
Not everyone gets on well with NDT because the ratio of T4:T3 is not right for them at approx 4:1. I take Levo plus T3 and the ratio that suits me is approx 6:1.
When I start on Vit D again should I take magnesium at the same time? What further tests need to be done in order to establish Vit B12 deficiency? It's difficult here as I cannot find an English speaking Dr at present and I'm having to rely on a local laboratory for my blood work. Should I get my Vit B12 deficiency/pernicious anemia test done first before anything else? If I don't have an order of priority I think i will get inundated with it all.
I had a full blood count done last year but I will get another done plus full iron panel work - can you tell me what the full iron panel tests are?. My current level of T4 might improve once I have a better level of vitamins - I am feeling very fatigued so any improvement has got to be good.
English speaking Dr at present and I'm having to rely on a local laboratory for my blood work. Should I get my Vit B12 deficiency/pernicious anemia test done first before anything else? If I don't have an order of priority I think i will get inundated with it all.
If you're going to the lab for blood work, why not get them to test for B12 deficiency, your full blood count and iron panel all at the same time - one blood draw (multiple tubes I expect).
An iron panel will probably consist of:
Ferritin
Serum iron
Total iron binding capacity (or transferrin)
Saturation %
Your very low ferritin could be the source of your fatigue.
Interesting article about low ferritin here, including a list of symptoms of low ferritin:
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Should I stop T4 and take T3 only medication?
Took Doctor a week to look at my vitamin results, should I supplement before seeing Doctor?
Blood results - should I still switch to Erfa? 
First NDT blood results - wow 😃
Hashimotos, in range. Should I take 25mcg Levoxyl?
