Vitamin D, Folate, TSH, FT4 Levels

[sadiethedog1]

Good afternoon, I wonder if anyone is able to advise me please? My Vit D was 57 (50-200) and Folate was 4.38 (>3.89) April 22, so on very kind advice here, I have been taking the recommended supplements. I had a blood test at the doctors 2 weeks ago, these are the results:-

Vit D is now high at 146 nmol/L >50 and

Folate >20.0 ug/L (3.9-20.00) which is at the top of the normal range.

I don't want to get into a situation where I go back to square one with Vit D & Folate so I wondered, what suggestions there are please to keep/get them where they should be (a maintenance programme). I felt so rough when they were low. A friend of mine stopped taking her supplements when she was within range and literally went backwards!!

The doctors also tested

TSH <0.01 mlU/L (0.27-4.2)

FT4 18.3 pmol/L (12-22) and

B12 >2000ng/L (179.0-2000.0) but just had B12 injection.

The last test for Iron that I had (April 22, Medichecks) was 27.5 umol/L (5.8-34.5) which is in the upper range so I think I need to be careful about taking any supplements with Iron in them.

Pre April 22, I had been taking Inessa Advanced MultiVitamin which does not have Iron in it. I felt quite good on this and wondered whether it would be a good Maintenance please? Thank you so very much for your time and kind help. xx

[SeasideSusie Remembering]

sadiethedog1

Obviously you don't stop taking your supplements, you have to find your maintenance dose.

Vit D is now high at 146 nmol/L >50

This is a perfect result if you feel with with it at that level as it's recommended to be 100-150nmol/L by the Vit D Council, Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health recommending at least 125nmol/L.

Your maintenance dose to keep it there is found by trial and error, and to a certain degree depends on what dose you are currently taking.

What dose have you taken to achieve this level?

Folate >20.0 ug/L (3.9-20.00) which is at the top of the normal range

What have you been supplementing with?

TSH <0.01 mlU/L (0.27-4.2)

FT4 18.3 pmol/L (12-22)

These look OK but it's missing the most important test - FT3 - as this tests T3 which is the active hormone which every cell in our bodies need. So if I were you if GP can't get FT3 tested and you don't feel optimally medicated then I'd do a private test to include TSH, FT4 and FT3, Monitor My Health is the cheapest, it's an NHS lab which offers this to the general public for £26.10 with code here:

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

B12 >2000ng/L (179.0-2000.0) but just had B12 injection.

If your GP is prescribing the B12 injections he shouldn't be testing, it's a waste of time, you just don't test once on injections.

Pre April 22, I had been taking Inessa Advanced MultiVitamin which does not have Iron in it. I felt quite good on this and wondered whether it would be a good Maintenance please?

No. Multivitamins just aren't recommended here.

It may be a decent make and it may not contain iron but it does have 30mg of B6 and the recommended amount for regular use is 10mg.

The Vit C it contains will stop the body using the B12 it contains, they need to be taken 2 hours apart.

It also contains iodine 150mcg which is the total daily recommended amount from all sources, you can get plenty of iodine from milk, yogurt, cod, haddock, scampi, etc., and every 100mcg levothyroxine contains about 65mcg iodine. Iodine solution used to be used to treat hypERthyroidism before the current radioactive iodine treatment so can cause hypOthyroidism or make it worse.

Advice here is to test key nutrients and supplement what's necessary at the appropriate dose.

Your serum iron level is good, what is your ferritin level? It's possible to have good serum iron but poor ferritin level.

[sadiethedog1 in reply to SeasideSusie]

Good Evening, thank you very much for taking the time to reply. The information is very useful indeed. To increase my Folate, I took Thorne B Stress Vitamins x 1 per day. I also take Doctor's Best 5000 Vitamin D and Vegavero K2 with that. I take Thyroid S, 2 on waking and 3/4 about mid-day. My FT3 was 4.72 pmol/L (3.1-6.8) in April 2022. My doctor won't do any other tests, I had to beg to get my Vit D and Folate checked again, after paying for private blood tests and self medicating. I would be very happy to organise a blood test through Monitor My Health, thank you for the link. My Ferritin was 206 ug/L (13-150) in April 2022. I had a complete Well Woman blood test then, I was advised to go to my doctor with all the results, I did but he said he couldn't help, they were high/low but they weren't critical. My diet isn't that varied, I like different salads, chicken, eggs, potatoes, peas and bananas and mandarins. Fuss Pot! With my sincere thanks for your help. xx

[SeasideSusie Remembering in reply to sadiethedog1]

sadiethedog1

I think for your Vit D and B Complex it might be worth trying a slight reduction.

For Vit D maybe drop off one dose per week. As winter is now upon us and we can't make Vit D naturally until about March/April, I wouldn't reduce this by any more. So have one day a week off and retest end of March. You could, of course, check level to see how you're doing after 3 months if you prefer and go back to 7 days a week if you think your level has dropped too much.

For the B Complex maybe try taking it 5 days a week (perhaps have weekends off). Folate is recommended to be at least half way through range so there is no problem having it high in range so it might be better to at least have a measure rather than too high for the equipment to give you a level.

Was CRP test included in your Well Woman test? I'm wondering why your ferritin level is rather high, if CRP is high that would be caused by inflammation and ferritin is raised when inflammation is present.

[sadiethedog1 in reply to SeasideSusie]

Good Evening SeasideSusie, thank you very much for the suggestion on my tablets. I didn't take them today as, until I had guidance, I was a bit worried to overdo it! I will do as you kindly suggest with the doseages/retest. My CRP was 2.09 mg/L (0-5) in April this year. With my best wishes xx

[SeasideSusie Remembering in reply to sadiethedog1]

My CRP was 2.09 mg/L (0-5) in April this year.

Mmmm, I wouldn't have thought that would cause your ferritin to be so high so I wonder why it's so much over range. I'd keep an eye on your ferritin level too.

[Wua13262348 in reply to sadiethedog1]

I had CRP of 1.91 mg/L (0-5) and ferritin 148.0 ug/L (13-150), 14/9/22.

I had CRP 0.33mg/L (0-5) and ferritin 113.0 ug/L (13-150) , 4/10/22.

In my case , by coincidence, rather than design, I can pinpoint it to inflammation.

I usually take 4 Naproxen, anti inflammatories per day.

I did the first test, 12/9/22, but had stopped the Naproxen 8/9/22. I think the week, or two previously, I had taken only two per day.

I restarted them, 4 per day, 18/9/22 as too painful to move fingers and hands, and hips so bad I thought I may end up immobile.

This accounts for the difference in my readings, test to test.

At 2.09mg/L (0-5) for CRP you are just a bit higher than me (1.91 mg/L in range of 0-5.)

Your ferritin is 206ug/L (13-150). Mine, with inflammation present and not on anti inflammatories was 148ug/L (13-150).

Looks as though your ferritin is too high and may not just be because of inflammation.

I have read liver problems affect ferritin?

This isn't something I really know anything about, other than what I've just said. I'm no expert.

Just pointing about the similarities and differences.

[sadiethedog1 in reply to Wua13262348]

Hello, thank you very much for taking the time to respond to my post. I saw a caring Endocrinologist several years ago now. He ran very many tests and was most helpful and supportive in finally diagnosing my Hypothyroidism. My tests also showed that I had cirrhosis of the liver and that it should be monitored. I have told my current doctors this and given them the letter from my ex-Endo. They do an annual blood test but say it's fine. I don't think it is fine but I seem to be just fighting a losing battle with the doctors. They vary rarely want to help and seem to be left to sort out my own health. Luckily we have this amazing group of very well informed and educated people who guide us and give us extremely helpful recommendations. With my best wishes.x

[Wua13262348 in reply to sadiethedog1]

Quote the information in the e mail I've sent you to g.p. if it helps- just say a friend had these results, and all in all based on your friend's results and your own , and your past liver results, you really do feel that your liver needs to be investigated. Good luck!