Folic Acid And Vitamin D Timings

[thyreoidea]

I have to take 5mg of Folic acid a day which I take straight after breakfast which in turn is usually between 1 1/2-2 hours after Levothyroxine. I have now been told by GP to take 25mcg of Vitamin D3 daily. I asked my Haematologist if I can take the VitD3 with the Folic acid, the answer was yes, can you good folks corroborate this or is there any other considerations to take into account.

[SlowDragon Administrator]

What was vitamin D result

25ug vitamin D is only 1000iu and a small dose and quite likely no high enough dose

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Mouth spray vitamin D can be taken an hour after levothyroxine

Vitamin D tablets should be at least 4 hours away from levothyroxine

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

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

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...

But, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease 

newscientist.com/article/23...

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

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator]

No supplements or other medications within 2 hours of levothyroxine

How low was folate

What was B12 result

Low vitamin levels suggests you’re perhaps/likely not on high enough dose levothyroxine

What were most recent thyroid results and ranges

TSH, Ft4 and Ft3

Once you finish prescription folic acid

To maintain good B vitamins levels recommend to be 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 

healthline.com/nutrition/fo...

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-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

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 folate supplement (eg Jarrow methyl folate 400mcg)

[thyreoidea in reply to SlowDragon]

Hi SlowDragon,

My haematologist prescribed Folic acid to help with red blood cell creation with a daily dose of 5mg, saw her yesterday and gave her my most recent folate result after 78 days of taking it which was taken at GP's surgery a week ago and she didn't seem to think the level was important has it is not not prescribed due to insufficiency

Serum folate level (42U5.) > 19.5 ng/ml [> 3] 19/05/23

Serum folate level (42U5.) 4.4 ng/ml [> 3] 21/03/22 before diagnosis

Serum total 25-hydroxy vitamin D level (Xabo0) 44 nmol/L 19/05/23

Serum vitamin B12 level (XE2pf) 420 ng/L [197 - 771] 19/05/23

I think my Vit D level is classed as insufficiency rather than deficient. I have spent a lot of time outdoors recently but wearing sunscreen and a hat would reduce skin absorption of the components to produce it.

I have a very rare Anaemia so do not want to supplement anything without going through my consultant. I told her about my Vitamin D and said when asked I could take it with the Folic acid.

So I am advised to take it 2 hours after Levothyroxine but can take out with Vit D then.

Thank you for your reply

[SlowDragon Administrator in reply to thyreoidea]

Ask haematologist if you could/should take a vitamin B complex after you finish folic acid prescription

Vitamin D

NHS Guidelines on dose vitamin D is 1600iu per day

[thyreoidea in reply to SlowDragon]

Will do re B12 question, I think I may be on Folic acid long term. I am averse to taking anything to be honest unless having to, though I will spend a few hours each day outside for the next few months covered up most of the time but will uncover for a safe period to help with Vit D and take the 25mcg (1000iu) daily and will try and get a new level before autumn as GP's only test after a certain period, most likely have it tested at next clinic appointment.

I take it there is no issue taking the Folic acid & Vit D together then, I did check on the NICE interaction website and was asking for confirmation from experienced people.

As usual only TSH reading on the 12/01/23

0.57 (0.3-4.2)

[SlowDragon Administrator in reply to thyreoidea]

vitamin D mouth spray absorbed in mouth thereby avoiding interactions

Most thyroid patients need to supplement vitamin D continuously to maintain good vitamin D levels

Government recommends everyone supplement vitamin D daily at least October to April

gov.uk/government/news/phe-...

[Riggles46]

My sons latest folate results were low and I mentioned this to our private Functional Doctor/Naturopath. My son was also prescribed 5mg of folate, by our GP. My FD wanted to see what type it was. He mentioned Methyfolate and how the body can absorb it better due to the process it has already undergone. Please read this as it explains it better than what I can. Also make sure you are getting enough B12 too as this goes hand in hand. He only needs a fraction of Methylfolate compared to the 5mg he was prescribed:

methyl-life.com/blogs/methy...

[Marz]

When it comes to the production of red blood cells B12 and Folate work together. Your B12 result includes both bound and unbound B12 so not all is available to reach the cells where it is needed. Maybe the Active B12 test would be more helpful...

[thyreoidea in reply to Marz]

I have asked my Haematologist on more than one occasion if I could have the different check of B12 due to symptoms being similar, I have the the antibody that causes my condition so it was a gone conclusion as to the diagnosis along with much improved results when on steroids.

[Marz in reply to thyreoidea]

Active B12 test not done in the NHS 😮‍💨

[thyreoidea]

Thank you, will read the link in depth when having more time.

[SlowDragon Administrator]

Medichecks offers Active B12 testing in Thyroid and vitamin test

just testing TSH is completely inadequate

Suggest you get FULL thyroid and vitamin testing 6-8 weeks after starting folic acid and vitamin D

Always test early morning and last dose Levothyroxine 24 hours before test

Do you always get same brand Levothyroxine at each prescription

[thyreoidea in reply to SlowDragon]

Thanks for the info

My folate level is 11 weeks after starting the 5mg so already have that one.

[SlowDragon Administrator in reply to thyreoidea]

What’s the range on folate 3-20 or 8-60 or something else

B12 and folate work together. Always important to test both at same time

[thyreoidea in reply to SlowDragon]

Serum folate level (42U5.) > 19.5 ng/ml [> 3] 19/05/23 this is after 11 weeks