Help with optimising my Vitamins and Minerals

[LilyBloom]

Hi all, 5 weeks ago I came down with hyperthyroid.

My GP did B12, folate , ferritin and iron levels test.

B12 333 ng/L (160-925 ng/L)

Folate 20 ug/L (2.90 - 50 ug/L)

Iron 15.2 umol/L (11-36 umol/L)

TIBC 51.7 umol/L (53-85 umol/L)

Ferritin 140 ug/L (30- 200 ug/L)

Did not test vit D but will ask for this in my next blood test in 10 days.

Can someone please advise me how to proceed to optimal levels?

And suggest good way to supplement ...

I gather these vitamins and minerals are depleted with thyroid conditions AT medications.

I am on carbimazole 30mg for the past 3 weeks.

And propranolol 20mg x 3 per day and now reducing slowly

Thank you

[humanbean]

B12 333 ng/L (160-925 ng/L)

Folate 20 ug/L (2.90 - 50 ug/L)

B12 - Opinions on what constitutes optimal for vitamin B12 do vary. I've seen opinions suggesting the following :

1) 500 ng/L or more

2) Top half of range 543 - 925 ng/L (using your range)

3) Top of range up to about 1000 ng/L

Some links you might like :

stichtingb12tekort.nl/engli...

stichtingb12tekort.nl/weten...

The best form of supplement for B12 is methylcobalamin.

perniciousanemia.org/b12/fo...

Note that the body needs adequate folate in order to make use of B12.

Folate - Optimal is upper half of range which is approx 26 - 50 with your range. The best supplement for folate is methylfolate.

takecareof.com/articles/ben...

...

Iron 15.2 umol/L (11-36 umol/L) Approx 17% through the range

TIBC 51.7 umol/L (53-85 umol/L) Under range

Ferritin 140 ug/L (30- 200 ug/L) Approx 65% through the range

Optimal levels for iron-related tests are given here :

rt3-adrenals.org/Iron_test_...

Serum iron

• 55 to 70% of the range

• higher end for men

Your iron is 17% of the way through the range suggesting that your level is way too low and you need more iron.

TIBC (total iron binding capacity) or Transferrin

• Low in range indicates lack of capacity for additional iron

• High in range indicates body's need for supplemental iron

This suggests that you lack capacity for more iron, so you don't need more iron.

Depending on source, ferritin is usually considered to be optimal at mid-range or a little bit over.

According to this link :

thyroidpharmacist.com/artic...

Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

One of the problems with supplementing iron is that you can't tell in advance what will change. You can have any level of ferritin (iron stores) with any level of serum iron. And if you start supplementing with iron either one might go up. This is explained in this thread :

healthunlocked.com/thyroidu...

Info on iron supplements (ignore the stuff on pregnancy) :

healthunlocked.com/thyroidu...

So, you have a result for serum iron telling you that you need more iron. You have another result (TIBC = Total Iron Binding Capacity) telling you that your iron level is suggesting that you don't need any more iron. And you have another result which tells you that ferritin might even be a bit high. These contradictory results are quite common on the forum.

You could try supplementing iron for 4 - 6 weeks then retest in the hope that serum iron will rise. Don't let iron levels go untested in the early days of supplementing so you know what is happening. There is a risk that it will be ferritin that shoots up, instead of the iron going up.

[LilyBloom in reply to humanbean]

Big thank you humanbean for giving your time and attention in your in detail reply 🙏🏻 Great links I will dive into. Yes very confusing about iron. I will try what you suggested and keep an eye on the levels by testing.