Please can I have some advice on my posts of 3 days ago?

[Molly161018]

Hello all, I'd be really glad of some advice on my questions I posted a few days ago...pls see links below

Many thanks in advance 🙂

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Ferratin - 40 ug/L (Optimum Ferritin level for females : >27 ug/L (Range: 13 - 150))

Folate - 4.2 ug/L (Range: > 2.9)

Vitamin B12 - 114 pmol/L (Range: 25.1 - 165)

Vitamin D -110 nmol/L (Range: 50 - 200)

TSH - 0.06 mIU/L (Range: 0.27 - 4.2)

T3 - 6.6 pmol/L (Range: 3.1 - 6.8)

T4 - 21.6 pmol/l (Range: 12 - 22)

Thyroglobulin antibodies - 50.3 IU/mL (Range: 0 - 115)

Thyroid peroxidase antibodies - 71.2 IU/mL (Range: 0 - 34)

Are you on strictly gluten free diet

As you said

Ferritin is still low

What’s your diet like

Are you vegetarian or vegan

Look at increasing 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-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Why low ferritin needs improving

healthunlocked.com/thyroidu...

Iron/ferritin and restless legs

healthunlocked.com/thyroidu...

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

Folate

Presumably you stopped taking vitamin B complex a week before test. (As B complex contains biotin)

So Folate likely higher when supplementing

Which vitamin B complex are you taking

You could take a separate folate in the week before blood test

[Molly161018 in reply to SlowDragon]

Hello Slowdragon,Thanks for your reply. No I am not vegetarian or vegan, and I eat plenty of meat, dark chocolate and take a vitamin c supplement daily.

Thank you for the links too, these are very helpful.

Re folate, yes I did stop taking these a week before. I take Thorne Vitamin B complex. So you have any recommendations for a folate only supplement?

[pennyannie]

Hello Molly :

Just a thought :

I now find I feel at my best when my ferritin is up at and maintained at around 100 :

Asda sell little tubs of frozen chicken livers :

They are very clean and mild to the taste :

1 tub a week as an additional " top up " to the supplement will help get your levels up faster.

Defrost, flash fry in a little olive oil for around 5/10 minutes and then blitz into a pate with a little mayo if mixture looks too dry.

Keep in the fridge and have a spoonful a day throughout the week helps this medicine go down.

[Molly161018 in reply to pennyannie]

Thanks for the suggestion pennyannie, I'll have to give that a try!

[humanbean]

Inflammation/CRP HS - 1.6 mg/l (Range: 0 - 5)

Ferratin - 40 ug/L (Optimum Ferritin level for females : >27 ug/L (Range: 13 - 150))

Folate - 4.2 ug/L (Range: > 2.9)

Vitamin B12 - 114 pmol/L (Range: 25.1 - 165)

Vitamin D -110 nmol/L (Range: 50 - 200)

CRP-HS - This is an inflammation marker, and your result is well within range, so it isn't too bad. Optimal is less than 1, so you aren't far off.

Ferritin (iron stores) - The NHS and testing companies have really got their knickers in a twist with ferritin. I've seen comments saying "Optimal for females is > 27 ug/L" quite frequently, but in the NICE guidelines for iron deficiency it says :

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

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

So, your result is deficient according to one source, but optimal according to another, which is clearly nonsense.

According to us (thyroid patients), however, optimal for ferritin is mid-range or a little bit higher. The rule of thumb I use is 50% - 75% of the way through the range is okay, which works out with your reference range as roughly 80 - 120 ug/L.

Ideally you would get an iron panel done. This is the one I use :

medichecks.com/products/iro...

The reasons for suggesting that an iron panel is helpful are explained in this thread :

healthunlocked.com/thyroidu...

If you decide to supplement iron at any time, the ones easily sourced in the UK are described in this reply to another member (ignore the pregnancy stuff) :

healthunlocked.com/thyroidu...

Folate - Yours is too low. Optimal is difficult to specify when there is no upper limit to the range. Without any other info to go on I would suggest aiming for double figures i.e. 10+, with the possibility you may need a result of 15 - 20. If you ever have an upper limit for a folate range then optimal is somewhere in the upper half of the range.

For info on supplementing folate see this link :

chriskresser.com/folate-vs-...

Vitamin B12 - Your test is an Active B12 test. (you can tell by the reference range). Optimal for this is 100+, showing that your result is already optimal.

Vitamin D - Optimal is described in a couple of different ways ...

1) 100 - 150 nmol/L

OR

2) 125 nmol/L

Your vitamin D is already optimal according to criteria one, so that may be enough for you, but some people keep theirs higher - say, 150 nmol/L.

If you ever want to supplement vitamin D in order to raise it to a higher optimal this link is worth keeping :

grassrootshealth.net/projec...

[humanbean in reply to humanbean]

Just noticed this from your earlier posts :

My Ferratin has come up a bit but I guess could be better...(have been on gentle iron for a few months as the prescribed stuff made me constipated)...I take Solgar iron bisglycinate 20mcg which the dose is 1 capsule a day... don't know if it's ok to take more of this to boost my levels? Or is it a fairly slow moving thing that I just need to keep working at?

Also, my folate has dropped - what should I do about this? I take a b complex currently, but my B12 levels seem ok and obviously these would rise if I increased this...

Regarding your folate and B12, it isn't a problem if your B12 gets high. It isn't poisonous.

stichtingb12tekort.nl/engli...

As for folate, it is quite common for B12 to be okay but for folate to suffer. You should supplement with 1000mcg methylfolate per day until your level has risen as much as you would like. This is in addition to a B Complex.

Once your folate is at a level you are happy with you could reduce your intake of additional methylfolate to one or two tablets a week, say, one on a Monday and one on a Thursday and see if that maintains your level where you want it. Keep taking the B Complex.

When I was supplementing iron all the time I was taking one tablet, three times a day of ferrous fumarate 210mg. This was maximum dose and gave me 207 mg pure iron per day. Your Solgar iron bisglycinate 20mg apparently gives you 20mg iron per day. If you can tolerate it then there is not likely to be any harm from taking 1 tablet two or three times a day.

[Molly161018 in reply to humanbean]

Hello humanbean,

Thanks so much for your very comprehensive and helpful replies.

Re my Ferratin, you say "So, your result is deficient according to one source, but optimal according to another, which is clearly nonsense" - but my result is 40ug/L and the Nice guidelines you quite says less than 30 is deficient and the range on my results says <27 so I'm a bit confused..sorry if I'm being dumb!

Thanks for the link to the iron panel - I will get this done.

And your advice re folate is very helpful too - do you have any recommendations for a methylfolate supplement?

[humanbean in reply to Molly161018]

You're not being dumb, I am. Sorry, I got fixated on that > 27 being optimal for females, and didn't notice the rest of the sentence.

A level of 40 ug/L is still too low, so you would still need to supplement, but don't forget that iron is poisonous in overdose so do test fairly often if you supplement. Also, do some research into iron-rich foods. This link might be helpful but there are many more if you google :

dailyiron.net/

Eating food that supplies iron is the best way of getting it into you, but some of us just don't absorb it well and are forced to supplement.

You might find these links of interest :

cmaj.ca/content/cmaj/184/11...

onlinelibrary.wiley.com/doi...

restartmed.com/hypothyroidi...

ashpublications.org/hematol...

[Molly161018 in reply to humanbean]

No worries!! Thanks for the clarification!