Advice please - Hashimoto and Low Vit D

[Tired2022]

Hi

Please could I have your advice.

I was diagnosed with Hashis in 2022. I take levothryroxin 100.

I have been struggling with low Vitamin D:

In Dec 2022: Total 250H Vitamin D 18.5 nmol/L; 25OH Vitamin D <25 nmol/L is consistent with deficiency. I was prescribed a loading dose then told to take a multivitamin.

In March 2023: Total 250H Vitamin D 64.6 nmol/L; 25OH Vitamin D >50nmol/L generally considered adequate.

In Feb 2024: Total 250H Vitamin D 47.8 nmol/L; 25OH Vitamin D 25-50 nmol/L is consistent with insufficiency.

In Sept 2024: Total 250H Vitamin D 44.2 nmol/L; 25OH Vitamin D 25-50 nmol/L is consistent with insufficiency

The GP said they don't prescribe Vit Da and I advised me to take multi-vit. I am taking multi-vit. So advised me to take 4000iu per day. I have bought tablets off amazon Vit D3 4000iu.

Please could anyone advise me what else I can do? I have heard 100 is better for people with low thyroid.

Thanks

[TiggerMe Ambassador]

This is a great calculator for working out the dose you need to achieve your optimal level... grassrootshealth.net/projec...

Aiming for 100-150nmol/L

I find sublingual works well and Vit C helps with absorption

[Tired2022 in reply to TiggerMe]

Thank you. That calculator is perfect.

[TiggerMe Ambassador in reply to Tired2022]

We don't rate multi vits as they rarely have enough of what you need and other things you don't.... I'd aim for a loading dose of Vit D for a few weeks to kickstart things 🤗

[Tired2022]

Yes. That calculator suggests 25,000 as a loading dose and the biggest I can see on H&B is 4000.

I’m pretty sure I was prescribed 40000 as a loading dose last time, but that was on prescription.

[SlowDragon Administrator]

I was prescribed a loading dose then told to take a multivitamin.

Multivitamins NEVER recommended on here …..most are cheap poorly absorbed and inadequate doses to correct deficiencies

Test and supplement separate vitamins as necessary

with Hashimoto’s you’re always going to need a separate daily vitamin D continuously all year

Aiming to maintain at least over 80nmol minimum and between 100-125nmol might be better

To correct low vitamin D suggest you take 3000iu daily and retest in 2 months …..it might be high enough dose or you might need more

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...

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

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

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

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...

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...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

As your vitamin D is regularly low…..likely other vitamin levels may be

When were B12, folate and ferritin levels last tested

What other vitamin supplements are you taking

[Tired2022 in reply to SlowDragon]

Thank you. It is hard to know what to order, when there is so many. I was also prescribed folate. These are from Sept 2024:

Serum vitamin B12 level 606 ng/L [197.0 - 771.0]

Serum folate level 2.4 ng/mL [3.0 - 20.0]; Below low reference limit

Total 250H Vitamin D 44.2 nmol/L; 25OH Vitamin D 25-50 nmol/L is consistent with insufficiency.

I had ferratin done in 2022 and not repeated:

Serum ferritin level 245 ng/mL [13.0 - 150.0]; Above high reference limit.

Grateful for any further advice. Thank you

[SlowDragon Administrator in reply to Tired2022]

so only add one supplement at a time

Then wait 10-14 days to assess before adding another

Suggest you start with vitamin D mouth spray

Then add separate magnesium in afternoon or evening at least 4 hours away from Levo

Then for 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

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 supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose and may need separate methyl folate couple times a week

Post discussing different B complex

healthunlocked.com/thyroidu...

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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 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)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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

[Tired2022]

Thank you. That's great advice to start off one by one.

I am already prescribed folate. I will start with Vitamin D

[SlowDragon Administrator in reply to Tired2022]

So don’t add vitamin B complex until you have completed prescription for folic acid

[Tired2022 in reply to SlowDragon]

Ok. Thank you. I have that for four months.