Please can anyone point me to medical authorities to show
1. That optimal levels of these vitamins are necessary for thyroid function and
2. What those levels are (ie B12 over 500)
I have authorities to show people tend to feel better with ferritin above 70 or 100, but no link to thyroid function
I have found a statement on Thyroid Uk website to say done drs think target B12 should be over 500, but there’s nothing to back that statement up.
I need to pursuade (he has asked for authorities) my Endo these things are important and we should be aiming for optimal levels, not just low but just within range.
On that, I have found lots of information about how important selenium and iodine are too, but no one has checked those. Should I be asking?
many thanks everyone
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Snowday
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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
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.
Interesting that in this research B12 below 400 is considered inadequate
Levothyroxine can decrease serum homocysteine level partly; still its combination with folic acid empowers the effect. Combination therapy declines serum homocysteine level more successfully.
Hi, Ive had a look at the information on the ncbi pages, but they are American. I can’t get GP to engage with NICE info certainly wouldn't entertain American.
I usually take a Solgar B-Complex daily but stopped it a few days before my test for a separate B12 and a Folate tablet (because of the Biotin in my usual). I was advised to do that here a long time ago.
I pulled this together from info on here in December - it is in excel if there is a way of sharing - updating It is a starting point I would say to try and make it all a bit simpler.
Helvella's blog is excellent.
I have not done a great job on saying what sources are.
The forum advises higher levels than standard non underactive thyroid, I do not not know source knowledge for each one. I have found the forum rigorous and I am happy to take on trust these "generally best levels"
You may want to update on the ferritin line - that it’s iron not ferritin that’s supplemented, and maybe update to 2-3 hours either side of Levo. 2 hours cuts it a little close, I actually leave 4 for this one to be clear. Also all iron supplements should be stopped a full 5 days before an iron panel, in addition to the note you have regards avoiding iron rich foods the day before.
re zinc (and copper)
Sometimes people ask about zinc and copper, pasting a previous reply I’ve done, as you may want to highlight the zinc:copper ratio as an important guardrail for that:
For copper and zinc it is both the absolute values, but more so the ratio of the two as serum tests, that should guide a supplementation plan for any one individual. They compete with eachother and actually deplete one another when not in balance.
There are fair amounts of zinc and copper in our daily diets, complicating how to define a supplementation program if one is needed.
As a broad guide, it is the ratio of copper to zinc that is referenced when assessing any individual’s status (and broadly one will see a 1:1 (or in the ballpark of 0.7-1.0) .
When it comes to supplementing it’s more in the ballpark of 10:1 (or in the ballpark of 8-15:1) zinc to copper.
Research shows that daily doses of zinc should not exceed 25 mg daily to be safe and effective, but obviously most would take much less.
Regards to timing, minerals in general compete for the same absorption pathways, especially at higher doses, although when taken in the right ratio many do take zinc and copper as a combo supplement.
fabulous chart. Thank you. I would not put vitamin A supplements on the list though. Taking it in supplement form is linked with increase in some forms of cancer. It’s a fat soluble vitamin like D so it’s one of those ones that’s possible to be overdosing without knowing. Increasing vitamin A in food form is the best option. There’s good health outcomes for this!
‘The association of vitamin A and carotenoids in the development of several cancers, including breast, cervix, skin, prostate, oral cancer, and leukemia, has been highlighted in many studies [10]. Retinoids affect the growth of malignant cells through growth arrest, apoptosis, and re-differentiation [31,32]. A study reported that vitamin A deficiency due to poor diet may be one of the contributing factors in cancer development [33]. Contrarily, high dose supplementation of carotenoids increased the risk of lung cancer in smokers [34,35]. ‘. pmc.ncbi.nlm.nih.gov/articl...
You need to be careful not to go above range with selenium Snowday.
Studies have shown that those supplementing high doses (400ug daily) may have toxic levels. As such, it’s recommended to take no more than 100ug daily as a supplement (or 200ug if you have active Thyroid Eye Disease) or eat 1-2 Brazil nuts (as each nut may contain 50-90ug selenium dependent upon soil type).
I shudder to think of the handfuls of Brazil nuts Id eat as a kid. There was always a bag of nuts - all I’d have to shell with a nutcracker, old school!
I associate them with Christmas too! I wonder why that is! I know I had them in the house growing up, but also I remember (I think at my grandmas) little ceramic bowls on the side tables at Christmas. Happy memories!
Selenium content of brazil nuts may not as fearsome as is being suggested here. I bought a bag of shelled brazil nuts yesterday from a high street store. The nutritional values on the back of the packet state 254ug per 100g of nuts for selenium. They are also an excellent source of magnesium.
That works out at something just over what we need for three days! In a hundred grams.
33 grams of Brazil nuts is quite a lot to eat every day. And I do not believe there is any sort of a problem in consuming more one day and less the next - or whatever. Only if we consume excess selenium regularly over longer periods.
thanks all that’s useful info - just returning to my original question though - I’m looking for medical authorities to support the target levels of vitamins/ minerals, preferable with a link to thyroid function?
So I bet we have all at some point googled and found papers in these things. But also because most of us lean towards self treatment, like me for example, I gave up trying to convince my doctor of anything, and whereas I learn up topic by topic as needed I have never pulled things together in one place.
What are you trying to achieve? Are you trying to get a prescription for something in particular? If you were more specific about one thing, it would be easier to help.
This is all based on my personal experience and opinion...
When someone speaks to UK doctors about B12 or ferritin (iron stores) or serum iron or... The majority of them that I've talked to about nutrients throughout my life have always implied that the only thing they are concerned about is that a result for a nutrient is somewhere in range - anywhere in range. They have also suggested on occasion that my results are fine because they are somewhere close to the range, the attitude being "That's close enough".
Another problem I've had is that I've been in hospital for major surgery, blood tests have shown I was anaemic, and the hospital paperwork pointed this out on the assumption that a GP would read it and treat me - and they never did. And of course, in my youth I had no right to ask for copies of my medical records or test results. As a result I spent over 2 years being anaemic in my early teens due to iron deficiency before a doctor tested me again and finally treated me. So I remember this as a time in my life of utter misery, being blamed for my health problems, being accused of being attention-seeking, lazy, and greedy because I put on weight.
Many years later a doctor became absolutely furious with me when I begged for iron supplements because my ferritin was only 20 or 21. Bottom of range was 13, therefore it was in range, therefore there was nothing wrong with me in her eyes, and I was just a drug-seeker. I later discovered that my serum iron at that time was under range - but doctors think serum iron is irrelevant and they only need to know what the ferritin is - and even then if haemoglobin is in range the patient is fine. (Mine matched the bottom of the range.)
Looking at this from a patient's point of view with made-up numbers, if the reference range for ferritin is 20 - 200 and a patient's result is 20, many doctors think this is "fine" or "close enough" and the patient is told there is nothing wrong with them. Doctors really, really seem to believe that a patient with a result of 20 is going to feel just as well as one with a result of 100 or 200. They treat such results as if they are equivalent. And this nonsense is used daily in the UK, so they don't have to prescribe anything. I have seen evidence that this is equally true in the USA, where women have been told a ferritin level of 6 (I don't know the units of measurement) is absolutely fine and they don't need iron supplements.
I gave up expecting doctors to treat my nutrient levels over 10 years ago. They left me in a situation where I had to crawl upstairs and rest on every step for several minutes. The turning point for me was discovering that iron supplements prescribed by doctors in the UK can be bought from pharmacies without prescription. So I started learning how to interpret iron panel results to the best of my ability, and treating myself.
I have similar anecdotes about other nutrients where doctors beliefs have kept me feeling awful. I feel much, much better now than I ever did all those years ago, and have cured a couple of long-term health problems as a result. One of the (many) things that annoys me is that I spent my life from childhood onwards being believed to be a lazy, unmotivated, drug-seeking hypochondriac when what I needed was iron supplements and the right form of Vitamin B12 and folate.
I should also say that this has nothing obviously to do with making my T4/T3 conversion better or to keep my thyroid happier. This is me doing what I can to improve how I feel - something that doctors haven't noticeably cared about throughout my life.
And I should also point out that optimal levels of nutrients aren't all "top of the range". Optimal is more nuanced than that, and it can affect what levels people should aim for to feel well and to maximise their health long-term. Although maximising health doesn't mean we'll all feel 100% well in most cases - the long-term damage from low nutrients and untreated low thyroid hormones is not something I am likely to cure in my 60s - I can only do my best.
Sorry this turned into a rant. I have a tendency to do this from time to time.
You have every right to express your views in whatsoever way you wish. You have been treated so very badly by people who should have been making you well. Sadly this has been the experience of so many others. Some have found this forum. Unfortunately many have not and are treated for a diversity of conditions they do not have - depression, anxiety, obesity, chronic fatigue ….. I could go on. I won’t.
My heart sinks when I hear the dreaded words “in range”. Only now are a few enlightened doctors beginning to realise that “optimal in range” is key. They are few and far between - too lazy, ill informed or just plain arrogant to take that time to look at the patient, listen to what they’re saying, book appropriate blood tests and interpret the results correctly.
I don’t think this will ever change.
I read on another forum recently of a doctor who was similarly ignored by her own GP when she was suffering from severe iron deficiency. She had to have many months of sick leave as she was unable to work. As she began to recuperate (after treating herself) she wrote a detailed summary of all that she learned during her journey back to health.
If doctors won’t listen to their own, we have no chance.
I should also say that this has nothing obviously to do with making my T4/T3 conversion better or to keep my thyroid happier.
Oh but it does. Iron deficiency and low ferritin impairs conversion.
I just read your post out loud to my husband right now as it’s verbatim what Ive been saying recently and repeatedly, to him and another friend… for those who were healthy and haven’t yet needed healthcare, it’s actually hard to believe how misinformed the global healthcare system is.
Yes, we are more knowledgeable (less the ego) as the most credentialed doctors.
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