Help with results please.

[BETD20]

Hi there,

I've received more detailed results - can anyone help me read them please?

[PurpleNails Administrator]

What time was test? 

You have no thyroid diagnosis & not currently on any replacement?

 Do you currently take any supplements? 

Your nutrients levels look low.  Ferritin very low.  You may need an iron panel. 

Vitamin D below range, folate & B12 extremely low in range.  

Such low nutrient may contribute to lower TSH.  

[BETD20 in reply to PurpleNails]

Thanks so much. Test was just before 8am.

[SlowDragon Administrator]

Take results to GP

Ferritin is deficient

Request FULL iron panel test for anaemia

And B12 and folate are extremely low

You need testing for Pernicious Anaemia before starting on separate B12 daily (or GP might agree to B12 injections)

And a daily vitamin B complex

Vitamin D is insufficient

GP should prescribe 1600iu per day for 6 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

Work on improving low vitamin levels

Retest again in 3-4 months

[BETD20 in reply to SlowDragon]

Thank you so much both.No, not currently diagnosed with anything thyroid related or on medication for anything.

[SlowDragon Administrator]

Ferritin - any obvious reason for such low result

Are you vegetarian or vegan

Or heavy periods

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-...

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 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...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

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...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

[BETD20 in reply to SlowDragon]

Definitely heavy periods. The test was taken last week before my period though. Had an awful heavy flow overnight last night. 😔

I feel quite overwhelmed with all the info. I need to go to the doctors and ask for a blood test to check for anaemia? Also mention my B and D vits are low? I've never done anything like this before and not the most confident to push for what I need at the doctors.

Thanks so much for all your help.

[SlowDragon Administrator in reply to BETD20]

Explain to GP how heavy your periods are

How exhausted you are

Give GP copy of this private test

Request testing for anaemia because of very low ferritin and heavy periods

And testing for Pernicious Anaemia

(autoimmune disease that results in low B12)

You can say you are self treating low vitamin D yourself

Take your husband with you for moral support?

[BETD20 in reply to SlowDragon]

Thanks so much.I am worried they might say it's also because of how heavy I am. 😔 BMI of 37/38. I need to be brave and go along. I will ring in the morning. Thanks so much for your help.

[SlowDragon Administrator in reply to BETD20]

Heavy periods common as approach menopause

B12

Do you eat plenty of meat and fish

If you do…..there’s no obvious reason for low B12

Vitamin D

Most of U.K. is low in vitamin D

Government recommends everyone supplement vitamin D at minimum October to April.

Being overweight does make vitamin D more likely

You can sort vitamin D yourself by supplementing

gosh.nhs.uk/press-releases/...

[BETD20 in reply to SlowDragon]

Thanks so much. I think I do eat a reasonable amount of meat but can definitely do better with fish.It's making me feel like I want to start running again and totally overhauling my diet but that is dodgy territory for me with previous eating disorder. I also just don't have the energy to do much more than my usual running around after the kids and working...Any tips?!

I really appreciate all your replies. Thank you very much.

[SlowDragon Administrator in reply to BETD20]

Update us on what GP is going to do after your appointment

Work on improving low vitamin levels and retest thyroid and vitamin levels in 3-4 months

Come back with new post once you get those results

[BETD20 in reply to SlowDragon]

Thanks so much.

[BETD20 in reply to SlowDragon]

I've just posted a new thread and have since found my original one - apologies! These are the blood results from the doctors. They have said all results are normal.Thanks so much for your expertise!

Test results.

[SlowDragon Administrator]

Low B12

GP may not agree to test as its “within range”

But it’s extremely low

Do you have any Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins)

once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

How other member saw how effective improving low B vitamins has been 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Note that improving folate when B12 is very low is not a good idea. Taking folate before B12 is good enough can lead to severe neurological problems.

en.wikipedia.org/wiki/Subac...

It is vital if you intend to supplement both B12 and folate that B12 is started a week before the folate.

Low folate

At least a week after starting B12

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20 

If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12

[SlowDragon Administrator]

only add one supplement at a time and then wait at least 10 days to assess before adding another

You can start with vitamin D now while waiting for GP to test others

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

Suggest you start with 3 sprays per day

amazon.co.uk/BetterYou-Dlux...

Retest in 3-4 months

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening

Calm vitality magnesium powder is cheap and easy to use. Brilliant for improving constipation. Start on low dose and increase until you get desired effect. Too much can cause diarrhoea

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[BETD20 in reply to SlowDragon]

Hello there SlowDragon,I have received this reply this morning. I started on the vitamin D spray yesterday. Should I push for further rests or try and remedy this by myself with supplements? Can I get a private B12 booster? So many questions, sorry.

Doctors notes.

[SlowDragon Administrator in reply to BETD20]

That’s completely unacceptable

Ferritin below 30 is deficient

Email in with link to guidelines and request full iron panel test for anaemia

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

If GP unhelpful, either see different GP or write to practice manager requesting guidelines are followed

Alternatively test full iron panel test privately

Medichecks iron panel test 

medichecks.com/products/iro...

B12 and folate are extremely low

Low enough for testing for Pernicious Anaemia before starting on supplements

Folate - Serum 9.90 ug/L (8.83 - 60.8) 

Just 2.1% through range

Vitamin B12  219 nmol/L (145 - 569) 

Just 17.5% through range

Vitamin D 40 nmol/L (75 - 150) -46.7%

All vitamins are very low

Suggests very poor gut absorption

Request coeliac blood test

[BETD20 in reply to SlowDragon]

SlowDragon, your replies are just amazing. I am so grateful you are taking the time to help me.I have emailed back and basically copied and pasted the info you have given me so we'll see...I just feel so strange that there could be an underlying issue and the stress is triggering my disordered eating and as much as I am telling myself - eat all the right things, lose that weight. It's when I put pressure on myself, it comes back with a vengeance.

Thanks again.