Hi guys. Hope all are staying safe as you can and sending hugs to all during this very difficult time.
I'm taking 30mg hc and 50 mg t3. Folate below ref range and b12 dropped more as well. D3 also needs supplementing can anyone just advise on when to dose? I take fist dose of hc at 6am and t3 at 7am then hc again about 5 hours later and so on. 4 doses of both hc and t3 throughout the day.
Any advice appreciated. Thanks x
Jan61
Doses of supplements are based on what your current results are. Can you please post them, with reference ranges, so that suggestions can be made.
I think you'll find you are taking 50micrograms (mcg) T3, not milligrams (mg) there is a massive difference 
Lol Susie yes there is massive difference!
Folate 3(3.7-18.7)
B12 400 (197-771)
Ferritin 47 (13-150) ( this one was tested in December but they didn't test this time)
D3 27 can't find ref range. X
jan61
Folate 3(3.7-18.7)
This is below range and may or may not be considered to be folate deficiency - see
cks.nice.org.uk/anaemia-b12...
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
You should discuss this with your GP, he may be willing to consider it folate deficiency and prescribe folic acid.
Folate is recommended to be at least half way through range (your GP will be happy with it just achieving "in range").
**
B12 400 (197-771)
This is low in range but your GP wont be concerned, anything with the range is fine as far as doctors are concerned. However, 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."
pg/ml is the same as ng/L. Is the unit of measurement for your test either of these? Or is it pmol/L? If it's pmol/L that's equal to 542pg/ml so still on the lowish side.
In either case a supplement to raise your level is suggested. However, do not supplement for this until you know what your GP is going to do about your folate level. I expect a good, bioavailable B Complex (eg Thorne Basic B or Igennus Super B) will be enough to raise both B12 and folate but come back when you've spoken to your GP to let us know what he's doing.
**
Ferritin 47 (13-150) ( this one was tested in December but they didn't test this time)
There's no saying what your level is now. No-one should supplement with iron tablets unless they know they need them, and to know you'd need an iron panel and full blood count to see if you have iron deficiency or iron deficiency anaemia. When neither of these are present then you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
apjcn.nhri.org.tw/server/in...
Ferritin is recommended to be half way through range, so about 82 with that range.
**
D3 27 can't find ref range
Is the unit of measurement nmol/L or ng/ml?
In the UK it's usually nmol/L in which case you are just 2 points above Vit D deficiency but doctors wont treat until it's below 25.
You can address this yourself and follow the NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...
(click on Management > Scenario:Management)
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
So the easiest way is to take 5,000iu D3 for 2 months then retest to check your level. Come back with your new level for suggestions on how to proceed from that point.
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.
Once 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:
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 D3 as 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 magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
Thank you Susie
Doc wanted to supplement folate with folic tablets for 3 months but I've been told they aren't as good so ordered methyl folate. As b12 was within range he wasn't too bothered about that x
jan61
Doc wanted to supplement folate with folic tablets for 3 months but I've been told they aren't as good so ordered methyl folate
So he must be treating you for folate deficiency. What dose of folic acid? Usually it's 5mg.
What dose are your methylfolate supplements?
As b12 was within range he wasn't too bothered about that
As I expected, but you still need to heed my reply above as it is considered too low.
Yes 5mg dose. Methyl folate supplement is 400 mcg
So there's a very big difference there. Why not take the prescription folic acid to start with and see how you get on. You may find that your body converts the folic acid well enough. You can always change to methylfolate if necessary but 400mcg is said to be a maintenance dose.
There's a discussion about this on the PA forum here:
healthunlocked.com/pasoc/po...
Ok yes will give it ago x
Still not sure what times of day to take the supplements, do I need to take supplement away from t3 and hc? X
Jan61
B vitamins can be stimulating so it's usually suggested they are taken in the morning, no later than lunchtime, to avoid any possibility of evening/nighttime stimulation and affecting sleep.
All supplements should to be taken 2 hours away from thyroid meds, some need 4 hours and as mentioned in my reply above this includes D3 and magnesium. This is to avoid any possible problems with thyroid meds being absorbed.
I can't help with hc as I've never used it.
Ok that's great thank you x
Re B12 1000 pg/ml. 100% agree
Looking back on old posts ...you had extremely high thyroid antibodies
Are you on strictly gluten free diet?
Persistent low vitamins suggests gluten intolerance
approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
If not gluten free.......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 strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
chriskresser.com/the-gluten...
amymyersmd.com/2018/04/3-re...
thyroidpharmacist.com/artic...
drknews.com/changing-your-d...
restartmed.com/hashimotos-g...
Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease
ncbi.nlm.nih.gov/pubmed/296...
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
ncbi.nlm.nih.gov/pubmed/300...
The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease
nuclmed.gr/wp/wp-content/up...
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
Ok that's great thank you. I did go gluten free for 3 months and to be honest I didn't notice any difference at all I will read through the links you have posted. Thanks again x
You might only see slow drop in TPO antibodies.....this can eventually improve symptoms and may stop vitamins dropping so fast
Ok thank you that's good to know xx
You wont feel any difference. But you don't feel auto immune problems, until you loose an organ, like - thyroid gland, eye sight, kidneys etc . Getting TPO antibodies into normal range is important.
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