Vitamin Test Results advice for GP call

[elsaldo]

Hello all, I will try to be brief...

Not many posts for a while, as I was working with Endo and it takes time between med changes and results etc.

Current meds:

100mcg levothyroxine Mon-Sat + 75 mcg on a Sun (since August 2021). Any previous increase and I experience symptoms which I believe to be over-medication. Only take Aristo as all other brands give me a rash on arms/legs/stomach.

1.75mcg Alphacalcidol for Hypopara - parathyroids / pth levels never fully recovered.

I also take magnesium each night, a brazil nut (haha) every 2nd day, I stopped my Jarrow B-Right as I was getting stomach pains - this happened with Igennus Super B too. Also take Better You Vit D +K2 (2 x sprays daily) and Better You B12 (2 x sprays daily) also Vit E and Vit A.

Since my operation I have experienced very bad dizziness / vertigo and tingling hands / feet. Had various scans of head/neck, eyes tested at Opticians and Hospital Ophthlamology Dept - all look normal.

I rarely have a day of feeling well. I asked my Endo about T3 but she brushes this aside and instead suggests as thyroid levels are "better" my symptoms may be anxiety or "something else".

Latest thyroid levels:

Oct 21: TSH 0.74 (0.27 - 4.2) T4 19.8 (12-22)

Nov 21: TSH 0.08(0.27 - 4.2) T4 19.8 (12-22)

No T3 tested - I know I need this and I am saving to do all thyroid levels myself but money is very tight.

I went to the GP as my dizziness is very bad again and asked him to check vitamin levels. The receptionist told me all good with results but when I requested a copy I noticed a few are low-ish and I booked a phone call with GP this wednesday.

Serum B12 - 1003pg/mL (Range 197.0 - 771.0) - HIGH

Serum Folate - 8.77ng/mL (Range 3.90 - 26.80)

Serum Ferritin - 28ng/mL (Range 14.0 - 186.0)

Serum Albumin - 46g/L (35-50)

Corrected Serum Calcium Level - 2.26 mmol/L (Range 2.20 - 2.60)

I attached my other results.

Any advice for my GP phone call (and in general) would be much appreciated, my brain fog is bad right now and I feel unprepared for the call / not sure what to ask for.

Many thanks for any help,

Sally x

ps. I had stopped my B12 spray 1 week before the blood test.

[SlowDragon Administrator]

Obviously you need to test TSH, Ft4 and ft3 together

Monitor My Health Is cheapest

Only do test early Monday or Tuesday morning and then post back via tracked postal service

Folate is low and ferritin deficient

GP won’t treat folate

You will need to self supplement. As you can’t tolerate vitamin B complex, try just separate folate (eg Jarrow methyl folate)

Ferritin is deficient and GP should be running full iron panel test for anaemia

[elsaldo in reply to SlowDragon]

Many thanks I shall ask the GP about your suggestions and get the Jarrow methyl folate

Sally x

[SlowDragon Administrator]

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

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

Medichecks iron panel test

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

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...

[elsaldo in reply to SlowDragon]

Thanks again, I shall work my way through that list and save for future reference

Sally x

[SeasideSusie Remembering]

elsaldo

Serum B12 - 1003pg/mL (Range 197.0 - 771.0) - HIGH

No need for you to continue your B12 supplement at the moment, it's just wasting your money.

Serum Folate - 8.77ng/mL (Range 3.90 - 26.80)

Quite low, really needs to be at least half way through range. If you can find a B Complex you can tolerate this will help raise folate and maintain your B12.

Serum Ferritin - 28ng/mL (Range 14.0 - 186.0)

NICE class this as iron deficiency - see 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.

Point this out to your GP as s/he will say your ferritin is in range. Ask for iron panel to include serum iron, total iron binding capacity, transferrin saturation as well as ferritin, this will confirm if any iron deficiency. Your haemoglobin level doesn't suggest anaemia. You can have iron deficiency with or without anaemia.

All other results show in range except for MCHC is a touch under range. Low MCHC can suggest anaemia but nothing else in your FBC suggests this. Here's an article about MCHC:

verywellhealth.com/mean-cel...

Sorry, got to dash, off to opticians.

[elsaldo in reply to SeasideSusie]

Many thanks SeasideSusie I shall arm myself with this info for the GP call,

Good luck at the opticians 🤓

Sally x

[Anthea55]

Has anyone suggested that you try the Epley Manoeuvre for dizziness / vertigo? It is based on the fact that crystals can form in the semicircular canals of the ear and cause problems. By doing the Epley Manoeuvre the crystals can be moved to a position where they are out of the way.

Google for Epley and you'll find further descriptions and videos, including handouts from various NHS areas. (just put in Epley - you don't have to spell manoeuvre / maneuver!)

Here's a selection

torbayandsouthdevon.nhs.uk/...

dorsethealthcare.nhs.uk/app...

I have used it and found it helpful to have a friend to help me. She read the instructions while I was doing it.

[elsaldo in reply to Anthea55]

I did previously try that (and a lot of different vertigo / dizzyness medication) quite some time ago.

However I didn't have all the information on those links you provided so I will give it another try, many thanks x

[elsaldo]

SlowDragon and

SeasideSusie

Thanks for the info / advice you both gave me.

I did read through it all and relay this info to my GP however she refused to do a full iron panel stating my levels are all fine/in range. I tried my best but she just wouldnt budge.

She did suggest a 2 month course of ferritin tablets just for a "boost" with no need for any further tests when the course is finished.

My question now is... with limited finances... should I pay for a full Iron panel (with the medichecks link SlowDragon suggested) just now OR wait until after my course and test then.

Many thanks Sally x

[SeasideSusie Remembering in reply to elsaldo]

Doctors are so ignorant of nutrients but I fail to see how she can ignore NICE guidelines and not check to see if you have iron deficiency. Personally I would do an iron panel with Medichecks. If they don't have any special offers on at the moment there is their permanent 10% discount code here:

thyroiduk.org/help-and-supp...

I actually did one on Monday, should hopefully get the results today.

[elsaldo in reply to SeasideSusie]

She just wouldnt agree unfortunately, but thanks I shall do that then once I save a few pennies x