vitamin d

[Gullysully84]

can you advise a vitamin d please

[RedApple Administrator]

Gullysully84, Have you had a vitamin D test? If yes, please add the details. Without knowing you current vitamin D status, members can't really help much. 😊

[Gullysully84 in reply to RedApple]

Iv not but I do remember a wile bk my bloods saying I was low on D , I’m going to ask for a copy of my bloods to post , iv really not had the help or information iv needed …

[SlowDragon Administrator]

2 years ago you were very under medicated on just 75mcg and anaemic with ferritin of 13

Did your GP increase levothyroxine to 100mcg and prescribe iron to improve extremely low ferritin

[Gullysully84 in reply to SlowDragon]

hi there thank you for replying, iv not actually been on any levothryroxine as my blood test said I didn’t need it anymore,so it’s been over a year without , they have me on iron 3 times a day but iv not been taken them as they make me feel sick. so Im on a slow release iron tablet once a day which also has b12 , I don’t no if there any good , iv had many recent blood test they always come bk with anaemia , but as recently for about 5 months iv had really bad hip pain I’m not sure if that’s a symptom.. ? Also twicky eyes ?

[SlowDragon Administrator in reply to Gullysully84]

Strongly recommend you get FULL thyroid and vitamin testing done

Low iron, low, B12, low vitamin D all suggest hypothyroidism

Low vitamin levels tend to lower TSH

low iron/ferritin in particular will lower TSH

Bloods should be retested 6-8 weeks after stopping levothyroxine……and repeat again in another 8-12 weeks

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[SlowDragon Administrator]

what are your most recent iron and ferritin results

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.

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

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 3-5 days before test

Medichecks iron panel test

medichecks.com/products/iro...

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

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.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as highly effective supplement

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

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...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

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...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

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

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Ferritin range on Medichecks

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

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. ‘

[Gullysully84 in reply to SlowDragon]

ok that’s a lot of information to take in , I’ll get my blood results this week and post them , I live in the uk so getting a blood test early morning is very difficult.. I also have M.E and fibromyalgia so I no that coincides with it …

[SlowDragon Administrator in reply to Gullysully84]

Both of which are frequently inadequately treated hypothyroidism and/or anaemia

Being an anaemic will result in crushing fatigue

This is a U.K. forum

Thousands upon thousands of members test privately to make progress and self supplement to maintain OPTIMAL vitamin levels

NHS only obligated to treat vitamin deficiencies

Never test thyroid levels later than 10am

Ideally always test before 9am

Optimal vitamin levels

Vitamin D at least over 80nmol

Serum B12 at least over 500

Active B12 at least over 70

Ferritin at least over 80

Folate at top of range

20% of Hashimoto's patients never have raised antibodies

Get ultrasound scan of thyroid

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue too.

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

[SlowDragon Administrator]

looking at previous posts you were never on high enough dose levothyroxine

And ESSENTIAL to test TSH, Ft4 and Ft3 together

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

[Gullysully84]

ok I’m

Going to get another blood test of what you suggested and get back to you , even go private.. would you mind if I posted my friend bloods as she’s just had her results… ?? Thank you

[Gullysully84]

Erythrocyte sedimentation rate

6.0 mm/h

Serum TSH level

0.61 mlU/L

Serum ferritin

25.8 ug/L

Serum iron level

10.2 umol/L

Serum vitamin D

45.0 nmol/L

5.0 10*9/L Total white cell count

3.97 10*12/L Red blood cell (RBC) count

121.0 g/L Haemoglobin estimation

0.36 L/L Haematocrit

91.5 fL Mean corpuscular volume (MCV)

30.5 pg Mean corpusc. haemoglobin (MCH)

333.0 g/L Mean corpusc. Hb. conc.

(MCHC)

13.2 % Red blood cell distribut width

272.0 10*9/L Platelet count

3.1 10*9/L Neutrophil count

1.4 10*9/L Lymphocyte count

0.4 10*9/L Monocyte count

0.1 10*9/L Eosinophil count

0.0 10*9/L Basophil count

[SlowDragon Administrator in reply to Gullysully84]

You need to add ranges

But Ferritin is deficient as below 30

Red cell count is low

Iron, MCV and MCH - need range

Vitamin D is insufficient

[Gullysully84]

2.4 mmol/L Serum calcium

2.26 mmol/L Corrected serum calcium level

1.07 mmol/L Serum inorganic phosphate

140.0 mmol/L Serum sodium

4.5 mmol/L Serum potassium

60.0 umol/L Serum creatinine

90.0 mL/min/1.73m^2 Glomerular filtration rate

0.0 AKI Stage

Liver function test

47.0 g/L Serum albumin

9.0 umol/L Serum total bilirubin level

22.0 u/L Serum ALT level

56.0 u/L Serum alkaline phosphatase

Serum B12 & Folate

284.0 ng/L Serum vitamin B12

5.18 ug/L Serum folate

[SlowDragon Administrator in reply to Gullysully84]

B12 and folate - again need ranges

Both look very low

Get her to join forum her self

And get thyroid levels and vitamins retested in 2-3 months after working on improving very poor vitamin levels

[Gingernut44]

Hi there, you need to press the blue reply button at the bottom of your reply for the person you are corresponding to gets notified. At the moment, you’re replying to yourself!! I’ll tag SlowDragon for you.