My daughter (21) has put on a lot of weight over the last year and is complaining of fatigue, joint pain and sore throats. I have had Hashis from age 33 by the way, and was diagnosed with PCOS at 26. She has had some blood results which the GP says are normal (aside from suggesting she gets some vitamin D supplements), but I am not so sure. Am I just being anxious Mum? Any advice appreciated! I am posting some of the results, with her permission, below:
TSH 2.37 mu/L [0.27-4.2]
Free T4 14.8 pmol/L [12.0-22.0]
Ferritin 17.7ug/L [13.0-150]
B12. 458ng/L [197-771]
Folate. 11.3ug/L [1.9-25.0]
CRP. 2mg/L [0.0-5.0]
Vitamin D 250H total serum 48mmol/L [50- 120]
Thank you
Written by
Clover29
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Important to realise that when a doctor says 'normal', all he means is 'in range'. He has no idea if it's actually 'normal' - meaning what most people have. He doesn't think out of the box.
Your daughter's FT4 is only 14.8% through the range. It would be more like 50% if she were euthyroid - that is to say 'normal'. But, her TSH is not as high as one would expect with such a low FT4. So, whilst she isn't exactly hypo at the moment, this needs keeping an eye on.
But her ferritin is much, much too low. Her doctor really ought to be doing an iron panel to find out why. Her B12 should be at least 550, so that needs keeping an eye on, too. What has he given her for the vit D? And how much?
Thank you for your response Grey Goose. She has not been prescribed vit D: she was just told it was 'a bit low' and that she could buy some supplements. I thought the ferritin looked low too but the GP did not comment on that.
Don't suppose he knows. They don't know much about nutrients, but her vit d is under-range so he was duty-bound to mention it. Perhaps SeasideSusie will be along soon to advise you how much she should take.
But, she does need to get back to him about that ferritin.
I shall be bossy Mum and tell her so! She has always been so active and an athlete at one time, it's heart-breaking to see her struggling like this. Thank you for your help Grey Goose.
As she is below 50 she is not in the "Sufficiency" category and some GPs do prescribe D3 at 800iu for this level. However, that is not enough and it's better to source your own.
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. To reach the recommended level from your daughter's current level, based on the Vit D Council's suggestions she could supplement with 5,000iu D3 daily
Retest after 3 months.
Once she's reached the recommended level then she'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. She can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
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 Vit 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.
This is very low and low ferritin can suggest iron deficiency anaemia. She needs an iron panel and a full blood count. At this level it's not something to self supplement, further tests need to be done but she should be prepared for her GP to say that it's fine because it's within range but she should push for further testing.
Check out this article about low ferritin, and there is a list of symptoms which your daughter can use as a checklist:
Those are all in range so don't suggest iron deficiency anaemia.
However, it's possibly to have iron deficiency without anaemia and an iron panel can throw up different possibilities, so I think that's the next step.
Can you track back when it started? What changed in your daughter’s life before it started?
Autoimmune is the result of ongoing chronic inflammation , and you and your daughter can “guess” and analyse together what changes in her lifestyle possibly caused that.
Did she move to study? Changed her diet drastically? Had a course of antibiotics? And so on...
Hi Clover29, I don’t think there is any cause for concern with regards to your daughters thyroid test from my unqualified opinion however i wouldn’t under estimate the low vitamin D so really get those levels up with a good quality supplement. Also has she been tested for Glandular Fever? Worth a check given her symptoms and age. PS not qualified, just done ALOT of research for own health issues. All the best.
Thank you Morning_gl0ry, that is a thought. I had glandular fever at her age, then pre-eclampsia with my second pregnancy, then thyroiditis. I don't know how much genetics have to do with any of this...
It is considered a hereditary condition however i have hypothyroid but no else appears to have it in my family. I have read that raised oestrogen levels interfere with thyroid function so for example the pill, also long term stress interferes with t4 converting to t3. Perhaps relating to cortisol levels being high? My advice to your daughter would be to eat well and listen to your body, when it says its tired, rest! That is something we sometimes feel guilty for but i have learnt it is essential, as the Mars bar advert used to say Work, Rest and Play! all three are important for good health, never feel you are lazy for having a rest in the daytime, if anyone asks it’s your lunch break!
Sounds familiar! My daughter’s at uni too and does everything for herself when she’s there and very much nothing when she’s home! Hope your daughter feels better soon.
HI, I've previously suffered from Graves disease (hyperthyroid - now in remission), however, my thyroid has been damaged and tends to head towards under active. I feel my best when my TSH is around 1.5 - in Germany for instance they treat Thyroid for TSH levels over 2, However, it seems a lot is going on at once, very similar to myself. My ferritin levels were at 11 earlier this year and my GP said she wouldn't be happy unless it was at 33. Vit D on low side also. When this happens I feel tired and have really bad joint and muscle aches. Really bad pain in feet and arms get pain just from carrying in the shopping. It all however eases off when I am supplemented with Iron and Levothyroxine and I take a daily low dose of Vitamin D as advised by my GP. I think it's fair to ask the GP for iron supplements to get levels back up to a higher range and see if this eases her pain and fatigue? I feel dreadful with low ferritin and know many people the same. I suffered for years where the doctors wouldn't treat it, wasted. I'm so much better on the supplements - really is worth a go. Good luck to her!
Clover - SeasideSusie is correct that your daughter needs a full iron panel before starting iron supplementation. I would really follow up on her suggestions for that and vitamin D and K2.
Hi Clover 29 my friends daughter had similar thing maybe worth checking on vitamin 12 b levels? she now has vitamin injections and is so much better worth a try good luck
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