vitamin results help and advice please - Thyroid UK

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vitamin results help and advice please

Wilma76 profile image
14 Replies

hi there, I posted in December to say my GP had reluctantly agreed an increase in my Levothyroxine from 50mcg to 75mcg following a blood test which showed:

TSH 2.91 (0.35-5.5)

T4 13.9 (10.5-21.0)

He also requested some more blood tests and I asked for vitamin D,B12, Ferritin and Folate as per guidance from this site.

I felt really fatigued/and a bit strange over Christmas but I feel better now. I’m guessing change in meds.

Results are in, GP says all normal except Vitamin D for which I need to supplement 1000 units daily in winter months.

Please can I have advice on the others and if I need to supplement by how much?

Vitamin D - 34.9 nmo/l- range under 30 is deficient. 30-50 may be inadequate.

B12 - 344ng/l (211-911)

Ferritin - 73.2 ug/l (10-291)

Folate - 7.30 ug/l (>4.12) 6.13 is replete.

thank you!

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Wilma76
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14 Replies
Buddy195 profile image
Buddy195Administrator

When GPs say ‘normal’ this might not be optimal for you. I I personally aim for:

Vitamin D (100-150nmol/L)

Vitamin B12 (Total B12 needs to be at top of range or for Active B12 100 or above)

Folate at least half way through range- although I like mine in double figures

Ferritin (half way through range) although a ome point to 90-110ug as optimal.

I improved my B12 and folate with Thorne Basic B.

To improve ferritin via diet, it’s worth having a look at

dailyiron.net/

Wilma76 profile image
Wilma76 in reply toBuddy195

thank you for your advice and the links. I’ve been reading through and it’s been really useful

TiggerMe profile image
TiggerMeAmbassador

This is useful to work out how much Vit D you need to add, always choose one with K2 MK7 as this is good for your bones 🤗 tablets are ok but need to be taken with a fatty meal or go for a sublingual like Nature Provides or Better You spray

grassrootshealth.net/projec...

And as Buddy says you'd benefit from a good B Complex

Wilma76 profile image
Wilma76 in reply toTiggerMe

Thank you really useful

SlowDragon profile image
SlowDragonAdministrator

Vitamin D - 34.9 nmo/l-

range under 30 is deficient.

30-50 may be inadequate.

GP should prescribe 1600iu everyday 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...

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

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

But with Hashimoto’s, improving to around 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 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...

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...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon profile image
SlowDragonAdministrator

B12 - 344ng/l (211-911)

Folate - 7.30 ug/l (>4.12) 6.13 is replete.

Both too low

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

Highly effective 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

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

Post discussing different B complex

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) and continue separate B12 until over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Only add one supplement at once ….wait at least 10-15 days to assess before adding another

SlowDragon profile image
SlowDragonAdministrator

GP had reluctantly agreed an increase in my Levothyroxine from 50mcg to 75mcg following a blood test which showed:

TSH 2.91 (0.35-5.5)

T4 13.9 (10.5-21.0)

Which brand is 75mcg

Which brand of Levo was 50mcg

Retest again 6-10 weeks after increasing dose

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)

Wilma76 profile image
Wilma76 in reply toSlowDragon

Thank you for all of the information, it’s been really helpful reading through all the info and links.

I was on Teva brand for both. My new prescription is Teva for the 50mcg and Wockhardt for the 25mcg. I know there’s quite a few posts about people’s experiences using different brands on here. I have a stock of Teva so I will use those first whilst I’m still adjusting to the higher level.

Ellie-Louise profile image
Ellie-Louise

Yesterday I had to see the doctor about something else, but while I was there I asked him to add my list of vitamins etc. to my notes ready for when I need my blood test after a reduction that starts tomorrow.

He told me that the NHS don’t like doing D3 anymore because of the price, then he said he’d add it anyway and hope for the best. I don’t know if this is a new thing countrywide because testing my D3 has never been a problem before.

Best of luck.

humanbean profile image
humanbean

Folate - 7.30 ug/l (>4.12) 6.13 is replete.

That reference range for folate is unusual.

I've seen dozens of results reported on this forum from the NHS showing a folate reference range where the top of range is over 60. So to say that 6.13 is replete is, to put it mildly, very unexpected.

Personally I aim to get mine up to double figures, and preferably about 15 - 20 mcg/L. But others may find they get no benefit from levels that high, or they may need theirs higher. Experimentation is important.

A list of symptoms of folate deficiency, for future reference :

b12info.com/folate-b9-defic...

.

B12 - 344ng/l (211-911)

You should read these links on B12 :

perniciousanemia.org/b12/le...

perniciousanemia.org/b12/le...

There are several different kinds of B12 supplements available. This link discusses the issues and merits of each :

perniciousanemia.org/b12/fo...

A list of symptoms of low B12 :

b12deficiency.info/signs-an...

.

Personally I keep my B12 at 1000+ using methylcobalamin supplements. In doing so I have fixed a couple of almost lifelong health problems. I don't have Pernicious Anaemia.

wellness1 profile image
wellness1 in reply tohumanbean

A question for you humanbean, given all your impressive reading on this topic. Have you ever come across a discussion of an 'optimal' Active B12 result? The Medichecks range is 25.1 - 165 pmol/L.

humanbean profile image
humanbean in reply towellness1

I think the consensus is that an absolute minimum level should be 70 pmol/L and optimal is 100 up to top of range i.e. 100 - 165 pmol/L using the range you mention.

Evidence for the 70 minimum is here :

synnovis.co.uk/our-tests/ac...

I don't know where the 100 came from, but suspect it is just a nice round number above the minimum - I could be wrong though. :)

If you were interested in the optimal for serum B12 :

perniciousanemia.org/b12/le...

perniciousanemia.org/b12/le...

and for info on the best B12 supplements :

perniciousanemia.org/b12/fo...

Wilma76 profile image
Wilma76 in reply tohumanbean

Thank you for replying and all of the info. It’s been really useful reading through.

With regards to the folate result, I’ve checked my results and it does state please note new folate method and cutoff.

Wilma76 profile image
Wilma76

I posted on here a few months ago amongst other things about my vitamin results. Following blood tests my vitamin D result was :

Vitamin D - 34.9 nmo/l-

range under 30 is deficient.

30-50 may be inadequate

The GP initially said I should take 1000ui daily but then reverted and gave me a super dose of 20,000iu to take once a week for 7 weeks. I noticed within 2 weeks the dry, cracked skin on both my hands healed completely. I finished my super dose two weeks ago and it’s starting to come back already. I’ve been taking the 1000ui daily. But surely this is no coincidence?

Now I’m just not sure how to proceed?

The vit d calculator based on my test results says 5,000 iu daily maintenance and I would have needed 25,000iu daily for 6 days to bring me up to 75 nmo.

But I’ve now had the super dose would my levels have gone up? Can you take too much?

Not sure if the Gp would retest my vit d level so soon. Any advice appreciated. Thanks ☺️

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