As her guardian You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or correct antibodies tests
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
Private testing for suspected Graves - TSI or TRab antibodies
The Hairy Bikers Liver and Onions recipe is straightforward and super cheap and twice a week will help boost Ferritin. This is more effective than iron tablets for anyone who isn't vegetarian.
Vitamin D advice - your daughter's levels are pretty low there....
Make sure to take Vitamin K2 and Magnesium if you take larger doses of Vitamin D as these two cofactors will facilitate the uptake of Vitamin D and also improve Calcium levels in the bones.
The gp has now prescribed Vitamin D 10ug twice a day.
She has been prescribed a total of 800iu D3 daily and that is barely a maintenance dose for someone with a decent level already. She needs more than that.
The Vit D Council/Vit D Society/Grassroots Health all recommend a level of begtwee 100-150nmol/L. Unfortunately, the Vit D Council website is not available at the moment which is a shame because it has a lot of excellent information. However, the following guide shows what is needed, scroll down to "13 years and above" (ignore the fact that they sell the BetterYou oral spray, you can take whatever D3 supplement you wish, but softgels are better than capsules or tablets, and an oral spray is absorbed through the mucous membranes in the oral cavity)
You will see that for you daughter's current level of 42.1nmol/L they suggest 6,000iu daily for 1 month then 3,000iu daily as a maintenance dose. Retest after 3 months and if your GP wont do it (many wont) then she can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Once the recommended level is reached she'll need to find her 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.
Doctors don'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.
As SlowDragon has mentioned, this is far too low and will be causing symptoms, including fatigue. Low ferritin can suggest iron deficiency anaemia. Your daughter needs an iron panel and full blood count which. She should not supplement iron, nor eat liver or other iron rich foods, until further testing has been done. Iron testing should be done after a 12 hour fast (regardless of what you may be told at the GP surgery) so early morning is best so all she has to do is delay breakfast.
VITAMIN B12 302 ng/L (180 - 640)ng/L is the same as pg/nl
This is also 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."
Does she have any signs of B12 deficiency - check here:
If so then list them to discuss with the GP and ask for further testing for B12 deficiency and perncious anaemia.
If she doesn't have any signs she could supplement with a good B Complex containing methylcobalamin and methylfolate (Thorne Basic B or Igennus Super B are recommended here). She should not supplement if she does have signs as supplementing before further testing will skew results.
FOLATE 8.9 ug/L (3.0 - 20)
A little low, at least half way through range would be better. The B Complex will help this, as will lots of folate rich foods. Again, do not supplement before further testing for B12 deficiency/pernicious anaemia as it will mask signs of B12 deficiency. A B Complex should be started after B12 injections or B12 supplements have commenced.
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