I've taken a few tests in the past weeks and am at a loss over how slowly iron has been going up.
First took an NHS test, which was taken at 11am on 18 Feb. I heard 10.15am on the phone, but turns out it was planned for 10.50am, yikes. Once I got seated the blood was drawn at 11am. No B12 a few weeks prior to the test, fasted and Levo taken the morning before.
TSH: 0.05 (0.27-4.2)
FT4: 21.9 (10.50-24.50)
Vit D: 99 nmoL (>50)
Vit B12: 805 ng/L (197-771)
Ferritin: 44 ug/L (13-150)
Folate: 16.6 ug/L (3.80-9999.00)
Haemoglobin estimation: 126 g/L (120-150)
CRP: 4 mg/L (0-5)
Bone and liver profiles came back in range (can share below if necessary) and the nurse said I had a good blood pressure reading of 118/76 mmHg.
GP wanted to reduce me to Levo 50mcg but I refused to take it as I struggled to be raised to 75mcg with private endo in the first place.
She also recommended stopping B-complex intake for a while, which I did. She said that since my haemoglobin has moved into range I'm no longer iron deficient anaemic having struggled with this for some time.
Later went private for tests. Taken on 7 March on a fasting stomach at ca 7.30am. Levo taken 24 hours before, no b12 in over a month.
TSH: 0.06 mIU/L (0.27-4.2)
FT4: 22.2 pmol/L (12-22)
FT3: 6.1 pmol/L (3.1-6.8)
TgAb: 72.7 kU/L (0-115)
TPOab: 205.9 kIU/L (0-34)
Vit D: 100 nmol/L (75-175)
Vit B12: 111 pmol/L (37.5-188)
Ferritin: 52 ug/L (13-50)
My iron panel heamolysed so took another test on 15 March, also around 7.30am (same as first private test):
Iron: 10.7 umol/L (10-30)
UIBC: 61.6 umol/L (24.2-70.1)
TIBC: 72 umol/L (41-77)
Ferritin: 50 ug/L (13-150)
Transferrin saturation: 15 % (20-55)
Folate: 31.1 nmol/L (8.83-60.8)
Main question is how to best supplement iron? I eat meat and leafy veg, and take liquid iron daily (see below), so I should technically be getting enough.
My period, which are usually heavy, was delayed by two weeks last month and it has yet to come this month.. Considering going on birth control with time as it just gives me so much grief and no doctor has bothered dealing with it.
I supplement with:
Spatone liquid iron, 5 mg (recommended by forum user). I used to take 1-2 sachets per day but will raise to 4-6 per day. I feel much better taking liquid iron and feel I have some more energy than before, and reduced my bloat.
Vitamin D (20,000 iU), once a week
Vitamin B complex, every other day or so. It contains 25 mcg (1000%) of B12.
Magnesium (375mg), daily
Introduced liver pate upon recommendation from the forum, so have been eating it daily.
Written by
glowing_cat
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First thing I want to say is that the two vitamin B12 tests you've had done are different types of test, so they can't be directly compared. The February one is a serum vitamin B12 test and the March one is an Active B12 test.
The February test is slightly over the range, but unlike other tests, I am not aware of there being a problem with over the range B12.
The March test of B12 that you had done is the more useful one. It tells you how much B12 you have that is directly usable by the body. For this test optimal is considered to be > 100 pmol/L.
So your B12 is fine in both tests.
As for the folate, I hate those tests where there is no upper limit on the range. Any suggested optimal is going to be total guesswork.
If there is an upper limit then I would suggest aiming for the upper half of the range. So, for the second folate test I would say optimal is approx 35 - 60.
In your shoes I would go back to taking the B Complex. You haven't mentioned what you take, so I would suggest taking one tablet a day of Igennus Super B, which is half the full dose and hopefully will maintain your B vitamins at a healthy level.
I've taken a few tests in the past weeks and am at a loss over how slowly iron has been going up.
Iron is poorly absorbed by lots of people and taking ages to rise is common. Some years ago my serum iron was under the range and my ferritin was bottom of range. I was supplementing maximum dose of ferrous fumarate 210mg for nearly two years just to get my ferritin up to mid-range. Despite achieving that my serum iron was still low in range, although with a maintenance dose I've managed to improve it over a number of years.
Someone with a good diet who is perfectly healthy and absorbs iron well, but who for some unknown reason has low iron and ferritin, can expect to raise their levels in about four - six months.
Ferritin --- Optimal is round about mid-range or a bit higher, say 80 - 120.
Haemoglobin --- Your level is in range, so your doctor is right that you don't have iron deficiency anaemia. But people can still have iron deficiency without anaemia. Improving your iron should improve your haemoglobin level too.
CRP --- Optimal is < 1 but such a value doesn't show up on the forum very often. Thyroid disease causes inflammation and this raises CRP. Optimising nutrients, eating a good diet, doing a moderate amount of exercise, and getting enough sleep will all help to keep CRP low.
Iron --- Optimal for iron is around 55% - 70% of the way through the range, which with your range is 21 - 24. Lower end of that for women, higher end for men.
TIBC --- Yours is high in range showing that you would benefit with a higher level of iron.
Transferrin Saturation - Optimal is 35% - 45%, and yours is way under the range, suggesting that you need more iron.
I think you need to supplement iron, but I want you to read these cautions first :
If it turns out you have Anaemia of Chronic Disease as mentioned in links 2 and 3 above you will know it if you start supplementing iron but your serum iron hardly changes and your ferritin rises quickly. If this happens you will need to stop supplementing iron and ask for help again.
How to supplement - this is a link to a reply I wrote for someone else on the subject.
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