RDAs and suchlike

[Lucyr]

Could be worth checking in with your GP on it.

My GP said to take a standard multivitamin to cover vitamin d as it wasn’t super low, and prescribed a 3 month course of iron followed by the standard multivitamin containing iron

 

[Dragonheart]

My GP said to take a standard multivitamin to cover vitamin d as it wasn’t super low, and prescribed a 3 month course of iron followed by the standard multivitamin containing iron

As someone iron deficient (without anemia) for many years and having done a lot of research all I can say is there’s a lot of ignorance on the subject. Finding and treating the root cause of the deficiency is important or else it’s filling a leaking bucket. Retesting to check effectiveness of treatment is also essential.

For example, ferritin is the measure of iron storage unless inflammation is present (which can be excluded by other tests). The typical lab reference range (95% of usual results - note not ideal or optimal results) has a minimum of around 13 in most places. NICE guidelines state under 30 is absolute iron deficiency. Yet drs repeatedly say a reading above 13 is just fine. All it really means is a lot of people are iron deficient and dismissed. Symptoms are common below 50 and not unusual below 100 even when haemoglobin is in range and no anemia is diagnosed. https://www.rcpjournals.org/content/clinmedicine/21/2/107


Replenishing a deficiency takes a different, more intense approach compared to maintaining normal levels with any vitamin or mineral.

 

[Lucyr]

For example, ferritin is the measure of iron storage unless inflammation is present (which can be excluded by other tests).

Ferritin isn’t accurate for me as I have a permanently high white cell count so I don’t often have that checked. I have an iron panel instead every 3 months, which I think is just an indication of the iron level in your blood at that moment?

 

[AndBreathe]

My GP said to take a standard multivitamin to cover vitamin d as it wasn’t super low, and prescribed a 3 month course of iron followed by the standard multivitamin containing iron

Has your GP retested you to ensure that the recommended strategy is working for you? If not, in your shoes, I'd be requesting it, unless the suggestion was less than a month ago.

Did you have full bloods done alongside your Coeliac panel?

 

[Lucyr]

Did you have full bloods done alongside your Coeliac panel?

Yeah I have full bloods and iron done every few months because of the high white count. Vitamin d wasn’t retested but iron has been. Last few serum iron results were

September 15.3
November 7.6
March 11.9
All with a normal range of 11-25

There are other tests as part of the iron studies but they did the same pattern of movement really. So seems the iron supplements helped but I need to still make sure I’m getting the RDA to keep my levels up.

 

[AndBreathe]

Yeah I have full bloods and iron done every few months because of the high white count. Vitamin d wasn’t retested but iron has been. Last few serum iron results were

September 15.3
November 7.6
March 11.9
All with a normal range of 11-25

There are other tests as part of the iron studies but they did the same pattern of movement really. So seems the iron supplements helped but I need to still make sure I’m getting the RDA to keep my levels up.

To be honest, personally, I'm not interested in RDAs. They're "interesting", but not necessarily a driver/influencing mechanism for me. A bit like those using insulin need what they need to keep their levels in a decent place, I need what I need (in supplements, or whatever) to keep my levels where they need to be.

As someone with a significant thyroid challenge and a borderline osteaopaenia (monitoring re-scan in a couple of weeks), I need my vitamins and minerals in a good place which I interpret as being towards the higher (or lower, as appropriate) end of the ranges, to allow some wiggle room.

 

[Dragonheart]

Ferritin isn’t accurate for me as I have a permanently high white cell count so I don’t often have that checked. I have an iron panel instead every 3 months, which I think is just an indication of the iron level in your blood at that moment?

Serum iron fluctuates throughout the day and can be misleading in some cases. Bit like glucose can be high or low in relation to meals and their contents.

Haemoglobin for anemia, and for iron levels and storage there is Transferrin %, serum transferrin and sol transferrin receptor and sTr/ferritin index tests - all more informative and don’t suffer the issue of inflammation confabulation ferritin can.

 

[Lucyr]

Haemoglobin for anemia, and for iron levels and storage there is Transferrin %, serum transferrin and sol transferrin receptor and sTr/ferritin index tests - all more informative and don’t suffer the issue of inflammation confabulation ferritin can.

Of those I have the haemoglobin and transferrin % and some others done, did have ferritin done last time (44) but don’t usually. All the same pattern of being out of range in November and in range in March suggesting supplements helped, but results at the edge of the range so keeping up the supplements.

 

[Dragonheart]

Of those I have the haemoglobin and transferrin % and some others done, did have ferritin done last time (44) but don’t usually. All the same pattern of being out of range in November and in range in March suggesting supplements helped, but results at the edge of the range so keeping up the supplements.

Yeah saturation is low as well as iron, and ferritin isn’t wonderful especially in light of wbc. Can’t see hb. I’d maintain the supplements (including ensuring b12 and folate are in optimal ranges too) in your shoes as well, whilst trying to identify why they are low and fix that if possible. Diet, blood loss (menstrual/digestive system), malabsorption from medications/gastric issues are common things to explore with your dr.