Ferritin, folate, etc for 15 yr old how to proceed - Thyroid UK

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Ferritin, folate, etc for 15 yr old how to proceed

camomile9 profile image
15 Replies

Hi, got medichecks results for my 15 yr old. GP says results are fine. Private doc focused on supplements e.g. CoQ10, PQQ.

Folate 5.4, Ferritin 30.

She is very pale and can do very little day to day (which is said to be behavioural)

Active B12 seems ok (176). Vit D low (48) but she is taking D3 now daily.

Cells, HbA1c, CRP ok.

TSH 0.73, T4 22.3 (T3 was last done Aug 2020 3.8). On 100mg levo.

I can see the problem I think. It's how to get her to take anything. She will only take what is prescribed by a doctor. Advice?

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SlowDragon profile image
SlowDragonAdministrator

What’s the range on folate and ferritin results

Is she vegetarian or vegan?

She needs to increase iron rich foods in diet.

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

Does she suffer from heavy periods, obviously tends to lower iron and ferritin levels

Ferritin at 30 is considered low. Request full iron panel test for anaemia

How much vitamin D is she currently taking

Does she always get same brand levothyroxine at each prescription

Does she take levothyroxine EVERY DAY, always on empty stomach and then nothing apart from water for at least an hour after. Can be more convenient taken at bedtime or middle of night if regularly gets up to the loo

Weekly pill dispenser makes it easier to see if missed taking one

camomile9 profile image
camomile9 in reply to SlowDragon

Thank you. She is not ready to take responsibility for her health or diet. She does eat meat but doesn't eat many proper meals due to nausea and low mood. So I have to do what I can. Thyroxine is supervised every morning by me, then she sleeps another few hours. Usually teva, more recently mercury but doesn't seem to make a difference. Vit D3 10,000 IU.

SlowDragon profile image
SlowDragonAdministrator in reply to camomile9

That’s high dose vitamin D

Needs to be retested in 6-8 weeks

SeasideSusie profile image
SeasideSusieRemembering

camomile9

I'm surprised you got a Medichecks test for a 15 year old, it's only Blue Horizon that do tests for anyone below the age of 16. I don't know if the ranges are different for that age group.

If you post the reference ranges we can see if they actually are different, unless of course Medichecks didn't know she was 15. I wouldn't like to pass comment on any results where the ranges may possibly be different and you may not have the correct range if age was unknown.

camomile9 profile image
camomile9 in reply to SeasideSusie

I think the private phlebotomist must have taken a year off the DOB cos the results show DOB a year earlier than actually is.

Iron 11 (7-26), Transferrin 15 (20-55), Ferritin 30 (13-150) Folate 5.4 (>2.9),

active B12 176 (25-165), Vit D 48 (>50), T4 22.3 (12-22), TSH 0.73 (0.27-4.2).

[IgE was way off 3076 (<100) which is odd for someone who doesnt have asthma or allergies but noone seems concerned.]

Thanks for your help

SlowDragon profile image
SlowDragonAdministrator in reply to camomile9

Hopefully humanbean or SeasideSusie will comment on these iron levels

Can you add liver or liver pâté to her diet

Hide liver in beef curry, shepherds pie, spaghetti bolognaise

Look at trying gluten free bread…..some are delicious toasted - eg Waitrose brown seeded

(in dedicated gluten free toaster…or use toaster bag in normal toaster)

Gluten free cereals by Ella are good

SeasideSusie profile image
SeasideSusieRemembering in reply to camomile9

camomile9

Iron 11 (7-26),

Transferrin 15 (20-55),

Ferritin 30 (13-150)

Assuming that those ranges apply to a 15 year old then this is what I would normally say if an adult member had those results.

From: cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

As her level is 30 then I would speak to her GP about this, if it was 29 then the above would apply.

Also, Transferrin Saturation % is recommended to be 35-45% (higher end for males) so at 15 her is low - again point out to her GP that she is below the range. Serum iron is recommended to be 55-70% through range (higher end for males) and hers is only 21% through range.

I think she may be looking at iron deficiency here. I would also ask for a full blood count to see if she is anaemic. You can have iron deficiency without anaemia.

Vit D 48 (>50)

Is her 10,000iu D3 prescribed?

Does she also take D3's important cofactors - magnesium and Vit K2-MK7?

Folate is on the low side although not deficient. I would normally suggest a good quality, bioavailable B Complex containing methylfolate. Her Active B12 is high so if she's not supplementing then she doesn't need a high dose B12 in the B Complex but 400mcg methylfolate would be a decent amount.

Are the TSH and FT4 results current and done with this Medichecks test? If so why no FT3. I think she really needs all 3 done together, her FT4 is over range but her FT3 could be low and causing symptoms.

camomile9 profile image
camomile9

Thanks so much.

Will try private GP re anemia. She is about 77kg so definitely adult size.

The D3 is recommended by private chronic fatigue doctors, not prescribed.

She does take Mg but on advice of others on the forum will check the proportions of ingredients (it is not only oxide but doesnt give proportions).

Will source K2MK7 and B complex. B12, CoQ10 and PQQ that have been recommended might have to stop for a while cos she is very reluctant to take supplements and 4 is about the most I can get in her. She will only take tablets all at once first thing when I give her thyroxine, so getting her to take iron is tricky. So I need a doctor to tell her.

FT3 wasnt in this test but I think I can persuade NHS to test it because they have before.

thyr01d profile image
thyr01d

Hello camomile, I'm wondering about your poor daughter's nausea and low mood and wondering if this is significant. Is there a reason for these? I feel really sorry for her, before I was finally correctly diagnosed I slept for hours during the day and in between sleeping felt awful, if she feels like that at just 15 that is really sad. Please pass on my sympathies and good wishes.

camomile9 profile image
camomile9 in reply to thyr01d

Hi thanks so much, that's really kind of you. I dont' know, I am still learning more and more to see how to help her. She sleeps 9pm to at least 12 noon every day. Misses most of school and has stopped all activities eg dancing, swimming. She is not anxious and really wants to go to school, she did want to be a vet but she has had to drop science and maths. She definitely got worse after diagnosis and starting on levothryoxine 2 years ago. Her T3 is good according to private holistic doctor. We have to wait until she is 16 to be seen by a private endocrinologist. Her dad is the same, on thyroxine, bloods are good, feels awful all the time. NHS say its behavioural, but what sociable 15 year old would want to go to bed early every night?? Thanks for asking.

thyr01d profile image
thyr01d

? Isn't that strange that her bloods are good yet she feels awful and apparently T3 is good. You haven't asked for advice so it's a bit rude of me to be offering it so please disregard all this if you like.

Have you been told, and does she observe, all the things like timing of thyroid and other meds and supplements, not eating or drinking (other than water) within an hour taking Levo, going easy on things like brassica and soy, all that sort of thing? It looks to me as if her ferritin is too low in range for good conversion however you say T3 levels are good. That IgE, is it the same as IgA? My son was diagnosed in his teens with IgA nephropathy and I'm wondering if there's something else, as well as the thyroid problem, going on in your daughter's body that's undetected.

I've seen that IgE results can be raised when the body is fighting off an infection from a parasite, a virus or with some immune system conditions - has she been checked for Hashimoto's? I'm asking because in the early days with Hashis our thyroid varies and we can swing from hypo to hyper, in which case, it could be that the blood test results are not 'true', but then, you'd expect her to have days of feeling good as well as bad. (Sorry to refer to he and she but I can't see your daughter's name).

camomile9 profile image
camomile9 in reply to thyr01d

Hi no I appreciate all the advice I can get. I supervise her thyroxine every morning then she falls asleep again for at least 2 hours. Doesnt eat much brassica or soy. She does have antibodies or at least did when she was diagnosed 2.5 years ago. How would that make a difference to treatment? Bloods were all over the place for first year because she didnt take her thyroxine but have settled down now. She is quite angry. Not ready to take responsibility for trying e.g. gluten free, and will not take anything I suggest. She will take pills prescribed by a doctor. So next step is to find a private GP who will prescribe iron etc (NHS said levels are fine). Any further advice very welcome!

thyr01d profile image
thyr01d

Poor lass, no wonder she is angry, she is taking her meds and yet still missing out on life. You don't by any chance live in a damp house do you? Why it would make a difference is because our blood tests may not show our true state because the blood might be taken when our thyroid is functioning just a little bit less than optimal or even well, but then soon after the blood draw the thyroid could be functioning very badly again. If that happens the medication will be appropriate for a thyroid that is just a bit less than optimal but will not be right for the subsequent state where the thyroid is functioning badly. Hope that's intelligible!

If your daughter were mine I'd do everything to raise the ferritin level and I'd post again, asking why she is still needing so much sleep in spite of being medicated. I was in that state, apparently well medicated and test results looked okay but I sometimes fell into a deep irresistible sleep. When given T3 I picked up and now very rarely fall asleep like that however your daughter's T3 doesn't look low. I have a feeling though that mine didn't look low either though. Do you by any chance live anywhere near Cardiff?

Should perhaps say, my GP thought I was fine and only referred me to an endocrinologist on my absolute insistence and it was the endocrinologist who changed me from Levo to Liothyronine (T3), so I'm wondering if something's being overlooked in your daughter and if she needs a very good endocrinologist to work out what's going on.

camomile9 profile image
camomile9 in reply to thyr01d

Her room might have mould, under all the mess, will have a look. Medichecks mould test was clear. We are in Scotland so not so much choice. She has NHS endocrinologist who is offering psychiatry. There is a private one she can see as soon as she's 16. Just trying to find private GP now who will discuss raising ferritin levels within range. So glad you are improved on the liothyronine. Do you know anything about the DIO gene issue? I just read about it.

thyr01d profile image
thyr01d

Hi, if your daughter's room is damp she may have a problem with T3 (which you probably know is the active form of thyroid hormone that reaches the cells and particularly the brain). I hardly know anything about the gene issue even though that could be why Levothyroxine didn't help me feel better even though my bloods looked fine. The Professor and Consultant I am under weren't at all interested in looking for a cause they just instantly (then and there in the hospital) prescribed and gave me T3. A lot of people want T3 then find it doesn't work so I'm not suggesting it but your daughter does sound just like I was on Levo so I'm wondering if there's something going on, like damp, and if perhaps she is one of those who does need a little, perhaps in conjunction with the Levo.

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