Please help.

[JaneCooper67]

I have a 12 week wait to see the endocrinologist and I have to pay privately. I'd like some help understanding these results as they all report as 'normal range'. Am I wasting my time paying to see an endo?

[SeasideSusie Remembering]

JaneCooper67

Can you give us some more information so that we may try and help.

Do you have a diagnosis of a thyroid condition and, if so, are you on any thyroid meds - if so what and the dose.

Have you had key nutrients tested - Vit D, B12, folate and ferritin?

[JaneCooper67 in reply to SeasideSusie]

Hi. I haven't been diagnosed. Struggling with many syptoms. Had my adrenals checked after high cortisol levels. I'm not on any thyroid meds. I have a VitB12 shot every 3 months.

Serum 25-HO Vit D level = 79 nmol/l

Serun Ferritin = 28ug/l

Serum Folate = 23.3 nmol/l

Serum B12 = 499pmol/l

[SlowDragon Administrator in reply to JaneCooper67]

Please add ranges on these results

Ferritin is deficient

GP should do full iron panel test for anaemia

Are you pre or post menopause

Heavy periods?

Vegetarian or vegan?

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

Also See page 7 on here

rcn.org.uk/-/media/royal-co...

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

An article that explains why Low ferritin and low thyroid levels are often linked

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

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

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

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 and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron

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...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Good explanations of iron

theironclinic.com/iron-defi...

theironclinic.com/ironc/wp/...

Are you currently taking any vitamin supplements apart from B12 injections

[SeasideSusie Remembering in reply to JaneCooper67]

JaneCooper67

It's possible that at the moment this is your problem:

Serun Ferritin = 28ug/l

This is classed as iron deficiency by NICE - see

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.

You should ask your GP to do an iron panel to include

serum iron

saturation percentage

total iron binding capacity

ferritin

This test will show if you have iron deficiency, it will not show if you have anaemia.

You can have iron deficiency with or without anaemia.

To know if you have anaemia you need a full blood count so ask your GP to do that as well.

If you don't have iron deficiency but just low ferritin a lot of the symptoms are similar:

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Symptoms of iron deficiency include:

◾Persistent fatigue

◾Pale skin

◾Shortness of breath

◾Headaches

◾Dizziness

◾Heart palpitations

◾Dry skin

◾Brittle hair and hair loss

◾Swelling or soreness of the tongue or mouth

◾Restless legs

◾Brittle or ridged nails

and some of the symptoms do overlap with symptoms of hypothyroidism.

I have a VitB12 shot every 3 months.

Serum B12 = 499pmol/l

As you are having B12 injections, do you also take a B Complex to balance all the B vitamins?

Some people find 3 monthly injections not enough and need to either top up by self injecting in between times or use a sublingual B12.

Serum 25-HO Vit D level = 79 nmol/l

This isn't too bad but could be better as the Vit D Council, Vit D Society and Grassroots Health all recommend a level between 100-150nmol/L.

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 79nmol/L = 31.6ng/ml

On the Vit D Council's website you would scroll down to the 4th table

My level is between 30-40 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 2,500iu per day.

Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.

D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.

For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.

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.

If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form

natureprovides.com/products...

It may also be available on Amazon.

One member recently gave excellent feedback on this particular product here:

Here is what she said (also read the following replies):

healthunlocked.com/thyroidu...

Another important cofactor is Magnesium which helps the body convert D3 into it's usable form.

There are many types of magnesium so we have to check to see which one is most suitable for our own needs:

naturalnews.com/046401_magn...

explore.globalhealing.com/t...

and ignore the fact that this is a supplement company, the information is relevant:

swansonvitamins.com/blog/ar...

I think in your position I would maybe cancel or delay your endo appointment, work on optimising your nutrients and then see how you feel.

[JaneCooper67 in reply to SeasideSusie]

Thank you so very much. This is extrememly helpful. I appreciate your time

[SlowDragon Administrator]

It’s more likely low iron is causing symptoms at moment

But Ft4 is low in range

I would consider getting ultrasound scan of thyroid

Perhaps delay seeing endocrinologist until got iron/ferritin levels improved

[JaneCooper67 in reply to SlowDragon]

I am aenemic, and should be tkaing Iron tablets daily - I haven't been doing this over the last 6 weeks or so because I had to have a colonoscopy and an endoscopy and you're not supposed to take iron around these procedures. I have been slack at getting back to taking them.

[SlowDragon Administrator in reply to JaneCooper67]

Any obvious reason for low iron?

Thyroid can’t function well until all vitamins are optimal

[JaneCooper67 in reply to SlowDragon]

Bariatric surgery. A very big mistake, taking a sledge hammer to crack a nut instead of finding the cause.

[SlowDragon Administrator in reply to JaneCooper67]

Google “low vitamin levels after bariatric surgery”

Loads of links

You will need to work hard on maintaining good vitamin levels