Hi had another phone call from the doctors to say that I need to take over the counter vitamin D by the doctor I had a full blood test - they are not prescribing it
Please could you help with the best type to get I was told I need to take 400 a day. I no longer have any confidence in the surgery as they have merged with 3 others and it seems to be a complete mess now.
If that is 400iu then that's not going to help raise your level.
Can you please post your result along with it's unit of measurement, i.e. nmol/L or ng/ml, and I will point you in the right direction of how much to take and information about the important cofactors necessary when taking D3.
Also, say if you have Hashi's as that can make a difference about what type of supplement to buy.
I twice asked the surgery today all they said was 400 vitamin d I have just had an increase to 200microgrammes of levothyroxine at weekends and 175 during the rest of the week.
Serum TSH level 4.00 mu/L [0.35 - 3.5]
Above high reference limit
Specimen Type: SST Serum
Specimen Reference#: 2
Collected: 30 Sep 2019
Received: 30 Sep 2019
Provider Sample ID: 1961430109_SST
Pathology Investigations
Vitamin D
Serum total 25-hydroxy vitamin D level 38 nmol/L [50.0 - 120.0]
Below low reference limit
Comment Vitamin D insufficiency ( 25 OH Vitamin D 30 to <50
nmol/L )
Please note: the assay was performed by immunoassay
N.B. Adequate vitamin D status 50 - 120 nmol/L
Serum folate level
Serum vitamin B12 level 304 ng/L [130.0 - 1100.0]
Serum folate level 4.0 ug/L [2.7 - 15.0]
B12 interpretation
Less Than 100ng/L Low B12
100-129 ng/L Borderline B12, may be due to causes other th
an B12
deficiency
Greater Than 130 ng/L Normal
Pathology Investigations
Tumour Marker
Serum CA 125 (cancer antigen 125) level 37.5 ku/L [0.0 - 35.0]
Above high reference limit
Pre-labelled sample
NICE guidance states that any undiagnosed patient with a CA125 of >35
kU/L should
be referred for pelvic ultrasound (nice.org.uk/CG122)
General Information
Service Type: New
Status: Unspecified
Provider Report ID: 1961430109 RM100 D259848
Report Date: 30 Sep 2019
So, have you been referred for a pelvic ultrasound? Check with reception that you've been referred. It should be a speedy referral.
gojo1
So I think it just goes to show how ignorant the medical profession is about vitamins. Vit D comes in International Units (iu) and Micrograms (mcg). If it was 400mcg that would be a very large amount, 400mcg = 16,000iu and that would be too much for a daily dose.
total 25-hydroxy vitamin D level 38 nmol/L
We can see from the notes included with your results that a result below 50nmol/L is in the Insufficiency category. The NICE Clinical Knowledge Summary suggests GPs can prescribe D3 when the following applies
"Treat for vitamin D insufficiency if serum 25(OH)D levels are in the range of 25–50 nmol/L and the person:
Has a fragility fracture, documented osteoporosis, or high fracture risk.
Is being treated with an antiresorptive drug for bone disease.
Has symptoms suggestive of vitamin D deficiency.
Is at increased risk of developing vitamin D deficiency in the future, for example because of reduced sunlight exposure.
Has raised parathyroid hormone levels.
Is taking an antiepileptic drug or an oral corticosteroid, or is on long-term treatment with other drugs known to cause vitamin D deficiency, such as colestyramine.
Has a malabsorption disorder (for example Crohn's disease) or other condition known to cause vitamin D deficiency, such as chronic kidney disease."
So we'll assume none of that applies so you have to buy your own D3.
You haven't said that you have Hashi's so for best absorption an oil based softgel is recommended, these give much better absorption than tablets and capsules.
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 38nmol/L (15.2ng/ml) the Vit D Council suggests taking 4,900iu D3 (nearest is 5,000iu)
vitamindcouncil.org/i-teste...
Retest after 3 months.
A good D3 softgel is Doctor's Best and the cheapest place to buy it is here:
dolphinfitness.co.uk/en/doc...
and they have different size bottles.
Your GP probably will have no further interest in your Vit D level now that you've been told to buy your own supplements, so if your GP wont retest (very common) then please do so yourself (details below).
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
vitamindcouncil.org/about-v...
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.
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
Check out the other cofactors too (some of which can be obtained from food).
Serum TSH level 4.00 mu/L [0.35 - 3.5]
Is this the only thyroid test done? Although it indicates that you need a dose increase, it's important to know your actual thyroid hormone levels - FT4 and FT3. TSH is not a thyroid hormone, it's a signal from the pituitary to tell the thyroid to make hormone. However, you were on a pretty decent dose of Levo already that it's surprising your TSH came back so high, and one wonders why your GP isn't curious as to why.
It was mentioned 4 months ago in this post:
healthunlocked.com/thyroidu...
that you had a full thyroid and vitamin panel. Although you've had your vitamins done with the GP, it still leaves the very important FT4, FT3, thyroid antibodies and ferritin. I would seriously consider doing one of the tests linked to in that previous post and you might get to the bottom of your problem.
Serum vitamin B12 level 304 ng/L [130.0 - 1100.0] - ng/ml is the same as pg/ml
This is low. 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 a B12 level in the 300s have been found to need B12 injections.
Do you have any signs of B12 deficiency - check here:
b12deficiency.info/signs-an...
If you have any you should list them to discuss with your GP and ask for further testing for B12 deficiency/pernicious anaemia.
Serum folate level 4.0 ug/L [2.7 - 15.0]
Although in range, this is very low. It's recommended that folate is at least half way through range.
If you don't have any signs of B12 deficiency listed in the link given, then you could supplement with a good B Complex containing methylfolate and methylcobalamin, which would raise both B12 and folate levels. Good brands recommended here are Thorne Basic B or Igennus Super B.
Do not supplement if you do have signs listed in that link as it will mask signs of B12 deficiency and skew results.
Because your Vit D, B12 and Folate are low, I'm wondering if you do have Hashi's (autoimmune thyroid disease) which is confirmed by raised thyroid antibodies. Hashi's tends to cause gut/absorption problems which can lead to low nutrient levels. I also think you may have an absorption problem because of your quite high dose of Levo yet your TSH remains high. So testing thyroid antibodies and ferritin now becomes important.
Thank you so much,I now realise how limited doctors are - I dont have much faith in the doctor who checked my results. The surgery used to be reasonable but they had a bad inspection and now have merged with 3 other surgeries. It`s thanks to you and this site that I have got some answers. They also just said keep taking the vitamin D
So your results
vitamin D level 38 nmol/L [50.0 - 120.0]
Guidelines say you will need minimum of 1600iu daily for 6 months
Local CCG guidelines
clinox.info/clinical-suppor...
GP will only prescribe to bring vitamin D up to 50nmol.
Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Retesting twice yearly via vitamindtest.org.uk
Vitamin D mouth spray by Better You is good as avoids poor gut function.
It's trial and error what dose each person needs.
Frequently with thyroid disease, especially with Hashimoto's we need higher dose than average
Government recommends everyone supplement October to April
gov.uk/government/news/phe-...
If vitamin D is low, B vitamins may be too. As explained by Dr Gominack
healthunlocked.com/thyroidu...
B12 & Folate and both on low side.....Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.
chriskresser.com/folate-vs-...
B vitamins best taken in the morning after breakfast
Igennus Super B complex are nice small tablets. 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 Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules
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
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
Do you have any Low B12 symptoms ?
b12deficiency.info/signs-an...
You need ferritin tested
See GP about pelvic ultrasound scan
Thanks so much -everyone is so knowledegable and helpful.
Update really pelvic scan ok. Decided to send me to see endo finally took bloods at hospital then obviously everything cancelled. Still taking vit d and 200 levothyroxine only.
Nothing else changed. I am taking various other vitamin tablets. Apart from everything going on moved house and divorcing and trying to help 3 sons look after my ex who has cancer of esophagus due to drinking mostly. Amazingly he started chemo a couple of weeks ago. Also looking after my 73 year old mother and have part time job in shop.
Was hoping for some weight loss with 200 but not so far. I suppose my diet needs to change more.
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