Hashimotos and Vitamin Deficiencies

[Xanthi]

When asking a dr. for a thyroid (& platelet) blood test, as I have not had it tested for well over two years, I asked if ft3 & 4 could be tested, plus possibly vitamins as I have hashimoto’s. She gave me the classic reply that I only needed tsh and said that only parathyroid conditions cause vitamin deficiencies. I argued that my vitamin D when I first tested it (many years ago) was 10. So needed loading doses when last tested by nhs, even though I was self supplementing. So she’s going to try and test that, but not for any other deficiencies. I wondered if anyone could suggest any learned articles that show hashimoto’s can cause vitamin deficiencies. As if so, I’d be very grateful, as I could then share this with her.

[SlowDragon Administrator]

Try this lot

Links about autoimmune thyroid disease and low vitamin D

Yet still most Hashimoto's patients struggle to get NHS to test vitamin D

All Patients with autoimmune thyroid disease should have vitamin D tested annually

pubmed.ncbi.nlm.nih.gov/286...

Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.

pubmed.ncbi.nlm.nih.gov/273...

Vitamin D insufficiency was associated with AITD and HT, especially overt hypothyroidism. Low serum vitamin D levels were independently associated with high serum TSH levels.

pubmed.ncbi.nlm.nih.gov/300...

The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

ncbi.nlm.nih.gov/pmc/articl...

Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.

Same applies to low B12 - extremely common in hypothyroid patients

All patients who are hypothyroid should have B12 tested

ncbi.nlm.nih.gov/pubmed/186...

There is a high (approx 40%) prevalence of B12 deficiency in hypothyroid patients. Traditional symptoms are not a good guide to determining presence of B12 deficiency. Screening for vitamin B12 levels should be undertaken in all hypothyroid patients, irrespective of their thyroid antibody status. Replacement of B12 leads to improvement in symptoms, although a placebo effect cannot be excluded, as a number of patients without B12 deficiency also appeared to respond to B12, administration.

ncbi.nlm.nih.gov/pubmed/169...

Patients with AITD have a high prevalence of B12 deficiency and particularly of pernicious anemia. The evaluation of B12 deficiency can be simplified by measuring fasting serum gastrin and, if elevated, referring the patient for gastroscopy.

Folate supplements can help lower homocysteine

ncbi.nlm.nih.gov/pmc/articl...

Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.

Low ferritin frequent in hypothyroidism

healthunlocked.com/thyroidu...

Links about gluten connection

Coeliac

ncbi.nlm.nih.gov/pmc/articl...

Among autoimmune disorders, increased prevalence of CD has been found in patients with autoimmune thyroid disease, ..........., 2% to 5% in autoimmune thyroid disorders ......in prospective studies. …..Screening high risk patients for CD, such as those with autoimmune diseases, is a reasonable strategy given the increased prevalence.

sciencedirect.com/science/a...

Screening for celiac disease in patients with hypothyroidism requiring elevated levothyroxine doses warrants further investigation.

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

88% benefit from strictly gluten free diet

thyroidpharmacist.com/artic...

Going gluten free is a strategy that everyone with Hashimoto’s should try. In some cases, we see a complete remission of the condition; in other cases (88% of the time), the person feels significantly better in terms of bloating, diarrhea, energy, weight, constipation, stomach pain, reflux, hair regrowth, and anxiety.

todaysdietitian.com/newarch...

Many clinicians report that eating a gluten-free diet may help improve thyroid function in nonceliac gluten intolerance. “Getting gluten out is primary for patients with Hashimoto’s, even without celiac disease,”

Lactose intolerance is also very common with Hashimoto's

ncbi.nlm.nih.gov/pubmed/240...

Lactose intolerance was diagnosed in 75.9 % of the patients with HT

read.qxmd.com/read/24796930...

These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.

[Xanthi in reply to SlowDragon]

Thank you SlowDragon, I’ll certainly look into these. From first glimpse, looks as though there is a wealth of info linking low vitamin D and hashimoto’s at least. So hopefully the dr. will enjoy reading some of it! 😊

[SlowDragon Administrator in reply to Xanthi]

Suggest you print out or email her the actual research papers

[Xanthi in reply to SlowDragon]

Thanks. Yes I will.

[Kowbie]

Hello I’ve just had a similar conversation with the dr my folate was 3.3 , I had been on tablets from them before she said everything was fine , i said about the folate she it’s ok I said it’s only 3 , she said 3.3 and we don’t prescribe if it’s over 3 , I just thought ,we’ll I won’t say

[SlowDragon Administrator in reply to Kowbie]

Yes NHS only obligated to prescribe if deficient

So you need to self supplement

What was B12 level

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 separate B12 supplement and a week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

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...

Low folate

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...

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

Other options

healthunlocked.com/thyroidu....

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

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) and continue separate B12 until over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

[Kowbie in reply to SlowDragon]

Thankyou slowdragon vit b12 526 (197/771) Iron 13.6(5.83/34.5)

Vit d 71(50/140). Folate 3.3(3/26.8). Ferritin 130 no range

Tsh 0.02(0.27/4.2) T4 19.1(10.5/22) she wanted to reduce thyroxine as she said I’m over medicated I told her I wouldn’t as my t3 had only been 4.2 I think it was , she we don’t do t3 it’s not important so I said well I hope you never have a problem with the thyroid because I think it would be important to you then , I haven’t put all the results just the ones you might be interested in thankyou again, hope your well

bloods done 30 th august

[SlowDragon Administrator in reply to Kowbie]

so I said well I hope you never have a problem with the thyroid because I think it would be important to you then ,

Great reply 👏😄

So work on improving low folate by taking daily vitamin B complex

And improving vitamin D to around 100nmol

[Kowbie in reply to SlowDragon]

Thankyou at the moment I’m taking b12 and vit d ,should I also take the b complex as well ,thanks for all your help

[samaja in reply to Kowbie]

Your folate is so low you are really deficient and you should be taking 5 mcg for 4 months and then retest. With such low folate your B12 will be higher in the serum and once folate goes up it will drop becuase the body will be finally able to start using some of it.

If your B12 was tested within 4 month of supplementing with B12, multivitamis with B12, energy drinks or B12 fortified foods the result is unreliable becuase any of these will falsely elevate it and it can stay like that formonths which you might be deficient at the cellular level.

Oral supplementation is only recommended if you are vegeterian/vegan but if your diet includes meat, diary, eggs and fish you should be investigated for malabsorption when your B12 is low and the only effective treatment then is regular B12 injections which NHS is desperately trying to limit/withhold even for people with PA.

If you wnat to know really what goes on with vit B12, folate, iron and vit D, conisder joining the FB Pernicious Anaemia/B12 Deficiency Support group because they have a lot of science and great info there and a lot of hypothyroid memebrs too.

[Kowbie in reply to samaja]

Thankyou for your reply I think the drs are fed up with me going on about vit deficiency and why do they keep going down so low , I had been on folate they took me of of them about 2 months ago but it now went down to 3.3 I spoke with the dr about vets she said all ok I said well I didn’t think folate was she then said yes it’s fine I said it’s only 3 she said it’s 3.3 and we don’t treat if it’s over 3 , that’s like my serum iron was only 10 she said it’s fine , it has gone to 13 now , but I don’t know if I should take some iron tablets to bring it up a bit , thankyou for your help

[samaja in reply to Kowbie]

Doctors are not trained in vitamin deficiencies and don't realise the devastating impact they can have on us so the best thing we can do is to start self treating. Folate needs to be over 16 and iron generally around 80 (assuming most common ranges) for a the body including thyroid and thyroid meds to work well. Your doctor is an idiot and you cannot go by what they tell you because you will only get better with proper treatment they are not prepared to give. If you have the option of going private there are doctors who know what to do but otherwise please join the group I mentioned and ask your questions there becuase they can point you in the right direction on all these fronts plus tell you where to source what you need. All the best!

[Kowbie in reply to samaja]

Thank you you’ve been very helpful I appreciate it will have a look at the other groups thanks again,hope your feeling ok as well