Supplement advice please for a newbie

[RosieRuggles]

I have had to cancel my GP appointment, that I have waited three weeks for, as I have contracted covid and the next one available is in four weeks. I want to feel as well as I can, as soon as I can. I had a total thyroidectomy late last year for thyroid cancer followed by RAI in March. I got through those treatments and became increasingly fatigued and have felt really awful. Following blood tests taken in May at the hospital, I was prescribed 800 IU cholecalciferol for vitamin D. My result was 34, sorry I don’t have the range but it fell in the ‘insufficient’ category, 25-50. I also take vitamin k2 and magnesium after reading about it here. Together with eating oily fish, egg yolks and sunbathing without sunscreen for 20 minutes around midday, three times a week (weather and circumstances permitting), I am pleased that I have turned a corner but there is room for improvement. Would you agree that I could do with taking something to improve my ferritin and folate? This is the question I had for my GP. Ferritin is 67. Again I don’t have the range other than, “>60, iron deficiency unlikely”. My folate is 8.4, range 3.89-26.8. I have read here that ferritin should be at least 100 and folate should be 14-20. I am not sure about the difference between supplementing for ferritin and folate. Unfortunately I hate liver but I do eat a diet rich in greens. I think B12 is okay at 495, range 145-569. I have learned so much about my new reality from this site. I’d appreciate a supplement recommendation please. The ferritin and folate results, which in my unqualified opinion are low, were not picked up on, just the low vitamin D result.

[PurpleNails Administrator]

Welcome to forum.

Sorry you have covid and have had to have a thyroidectomy & RAI for thyroid cancer.

What replacement do you currently take?

Are your thyroid levels right for you? If these are not good then nutrients will be affected too.

800iu doesn’t sound like a high dose taking K2 & magnesium will help.

For folate it’s recommended to take a B complex containing methylfolate active version not folic acid (synthetic version).

It’s possible to have high serum iron but low ferritin so it’s recommend to have an iron panel before supplementing iron. ferritin a little under optimal but as doctors only look at abnormal results they will be happy.

[RosieRuggles in reply to PurpleNails]

Many thanks for your reply. I take 125mcg Levothyroxine.

My levels are:

TSH <0.05 (0.3-4.5)

FT3 5.3 (3.1-6.8)

FT4 20.7 (10.0-22.0)

I will buy a vitamin B complex and look into getting an iron panel done privately.

[PurpleNails Administrator in reply to RosieRuggles]

They look good.

Do the levels compare to pre operation levels?

The TSH is kept low so the Frees (FT4 & FT3) tend to be good in range.

Seasidesusie has given you good advice about nutrients, increasing vitamin D dose and a good B complex.

This link lists private blood testing companies for you to look through & some have discount codes

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

Medichecks does an iron panel for example

& monitor my health does a single vitamin D test.

[RosieRuggles in reply to PurpleNails]

That’s good to hear. My TSH pre operation was 1.3. Unfortunately I don’t know what my T3 and T4 were. Thanks very much for the links. I appreciate your help very much.

[SeasideSusie Remembering]

RosieRuggles

Would you agree that I could do with taking something to improve my ferritin and folate?

Yes.

Ferritin is 67. Again I don’t have the range other than, “>60, iron deficiency unlikely”. .... I have read here that ferritin should be at least 100

At first glance ferritin isn't dire. It's recommended that ferritin be half way through range (not "at least 100") although some experts say the optimal level for thyroid function is 90-110ug/L. But you can't just take iron tablets unless you know you need them so you'd need to do an iron panel consisting of serum iron, transferrin saturation percentage, total iron binding capacity and ferritin. If serum iron and saturation are already at good levels then taking iron tablets will take them too high and possibly lead to toxicity so you'd have to try and raise ferritin through diet:bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

I am not sure about the difference between supplementing for ferritin and folate.

They are two completely different things. Folate is a B vitamin and ferritin is your iron store, iron being a mineral.

My folate is 8.4, range 3.89-26.8. I have read here that .... folate should be 14-20.

Folate level depends on range. It's recommended to be at least half way through range so with your range that is at least 15.3. One range from a private lab is 8.83-60.8 so with that range the aim is for at least 35. When there is no range other than something like ">3.89" then we suggest to aim for double figures.

To help raise your folate level you could eat folate rich foods and consider a good quality bioavailable B Complex containing methylfolate and methylcobalamin. My preference is for Thorne Basic B. If you look at different brands then avoid any that contain Vit C because this affects the absorption of the B12 that is included, Vit C and B12 should be taken 2 hours apart.

As for your Vit D, you can work out how much you should be taking, your GP is being very conservative but is sticking to the guidelines although he could have prescribed more.

You might want to check out a recent post that I wrote about Vit D and supplementing:

healthunlocked.com/thyroidu...

and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.

Your current level of 34nmol/L = 13.6ng/ml

On the Vit D Council's website you would scroll down to the 3rd table

My level is between 10-20 ng/ml

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).

So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 4,900iu per day.

Bearing in mind that your level only 34nmol/L / 13.6ng.ml you can see how little your GP has prescribed. He will not prescribe the amount you need so you will need to do this yourself if you wish to follow the advice of the Vit D experts.

Retest after 3 months.

[RosieRuggles in reply to SeasideSusie]

You have given me a lot to read into and work on here. Thank you very much for the clarity and guidance. I think I would rather follow the experts’ advice and increase my vitamin D and retest in 3 months.

[SeasideSusie Remembering in reply to RosieRuggles]

RosieRuggles

You'll certainly improve your Vit D level by doing it yourself than relying on your GP's rather measly 800iu.

My preference for D3 is Doctor's Best oil based softgels, these contain no excipients, just D3 and extra virgin olive oil. I used them to raise my severely deficient level of 15nmol/L to 202 in 2.5 months and now use them to maintain my level at around 150nmol/L.

For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.

Vitabay and Vegavero are either tablets or capsules.

Vitabay does do an oil based liquid.

Vitamaze is an oil based liquid.

With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.

They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.

Both D3 and Vit K2-MK7 are fat soluble so will compete for fat to be absorbed. If both are oil based supplements then they could be taken at the same time. If not then best to take them at different times of the day. D3 should be 4 hours away from thyroid meds, Vit K2-MK7 can be 2 hours away.

If you want to just test Vit D then there's an NHS lab in Birmingham who offer an easy postal dried blood fingerprick test to the general public for £29:

vitamindtest.org.uk/

[RosieRuggles]

Thanks very much for the recommendations Seaside Susie. I can’t wait to get started.