Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: CE1976 on November 28, 2024, 05:45:26 PM
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Im after some advice please! For the last 6 weeks I’ve been experiencing palpitations and heart rate spikes and feeling very fatigued. Gp suggested it could be hormone related so I’m having a consultation next week about hrt (I’ve also had very irregular periods for the last 2 years).
However I’ve also just found out my vitamin D levels are pretty low. So now I’m not sure whether to go down the hrt route or just try vitamin D supplements for now?
Has anyone else had any experience of this? I’m worried the vitamin D will take a long time to take effect and am fed up with feeling rubbish but not sure about trying too much at once! Thanks.
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Hi! I would go for the discussion about HRT. MayB keeping a mood/food/diary would be useful, something to discuss. My periods waxed and waned for a few years - then went. After I had cold flushes from the back of my neck to the waist, this didn't last for many months. Itchy skin has been my main issue along with vaginal atrophy.
As oestrogen levels drop the body may become dry: inside and out ::); skin, vagina, deep in the ears, eyes, nostrils ....... and muscles may become lax = aches and pains.
Some GPs still don't think that we can be peri if we don't complain of hot flushes, because they believe that the loss of periods and flushes are the 'only' symptoms ::)
VitD is recommended in the Northern Hemisphere as we don't get as much sunshine as we require due to people not exercising outside as we did years ago.
Let us know how you get on.
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Thanks for replying. I’ve been to the gp a few times over the last few years with perimenopause symptoms but as I’ve not had hot flushes they’ve always been dismissed. This is the first time they’ve actually suggested hrt so I guess I’ll give it a try!
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You can increase your Vitamin D levels very quickly if you use loading doses.
Here's a handy calculator if you know your current level. Just pop your current figures in.
You should aim for VitD levels of about 100 nmol/L
https://www.grassrootshealth.net/project/dcalculator/ (https://www.grassrootshealth.net/project/dcalculator/)
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Thanks that’s really interesting. Didn’t realise you could take such high levels of vitamin D! Hopefully won’t take too long to recover then.
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Did your GP prescribe VitD capsules?
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Haven’t spoken to gp yet (saw the results on my NHS app) so going to ask at hrt consultatation. Level was 25nmol/L which looks quite low to me… going to self-prescribe supplements in the meantime!
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On this crazy journey I tested insufficient for vit d, for some strange reason I wasn't given loading doses and told to take a little supplement a day. Fast forward 11months and although HRT has stopped some symptoms others remain. I'm awaiting more bloods to see how my vit d is now and also check my b12 which was borderline but advised not to supplement.
At our age it could be a combination of everything but I would say especially in winter everyone should be taking some form of vit d, the amount will depend on your levels.
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The reference ranges for vitamin D, according to the NHS:
below 25 nmol/L – Deficient
25-50 nmol/L – Insufficient
50-75 nmol/L – Adequate
75 nmol/L or above – Optimum
JS79 is correct in saying the amount you need to take will depend on your levels. More is not necessarily better. You don't want to end up with hypercalcaemia (literally too much calcium) so you need to monitor and adjust until you find the maintenance dose your body needs.
Edit -- This is all from personal experience not just googling.🙂
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Thanks. Going to take a general supplement for now and see what the gp says… as I’m on the border of deficient I assume I’ll need something extra, but will see!
Just hard to know if the palpitations and fatigue are due to vitamin d deficiency, hormones or both…or when I’m really anxious, something even worse!
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I am midway through this situation.
In short I've been fatigued since I had lots of surgery in 2016/17/18. I also have an elevated heart rate for the last year
It was assumed to be peri but nobody tested Vit D, Folate, B12 etc. I was avoiding HRT (early breast cancer history) so it just seemed to be how it was and nothing to be done so I put up with feeling unwell constantly.
Started HRT last year in desperation as I felt so poorly. HRT helped with some symptoms (anxiety/ overwhelm/ joint pain) but the fatigue and elevated heart rate remain.
I've just had D, Folate, Iron, ferritin measured (amongst others) and my D (53.9) & Folate are both low, B12 is debatable. I've been taking a 1000iu D supplement since Feb anyway so who knows what it would have been without that.
I also have an odd thyroid issue which might be being made worse by the low vitamins or the thyroid might be effecting the vitamins 🤷♀️
Personally if it was starting this again, I would get bloods done for D, Folate, B12, iron, ferritin AND I'd get estradiol, progesterone, testerone and SHBG before I started HRT to understand the baseline. If you may have a thyroid issue I'd do TSH T4 and T3. This will give you an absolute baseline before you start adding anything. You will probably need to pay for these.
I didn't do this and I'm now trying to work out what is causing what. Taking HRT sends to have triggered some changes or is really coincidental. I really wish I had the pre HRT baseline to compare.
Sunday Girl know her stuff about this.
With a D level as low as yours, your GP should prescribe a loading dose.
It's been suggested to me that low D and Folate could be making me feel as shocking as I do so I'd get baseline bloods. Take the loading dose, also take a good B supplement if those are down and then see how you feel.
HRT definitely helps me but I'd have done it differently if I knew then what I know now.
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Hi, thanks so much for your message. Sorry to hear you’ve been suffering too. I’m so fed up with feeling awful…
Just spoke to gp and she’s giving me a 4-week loading dose of vitamin d (not 7-weeks as my levels weren’t quite in the deficient range!). She’s also going to prescribe hrt but I’m seeing a cardiologist on weds so will probably see what he says first.
It’s so hard knowing what to do for the best. I’m so desperate to feel better I few like I’d try anything at the moment!
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That's how I felt when I started HRT, absolutely desperate.
Can I ask what loading dose the GP has prescribed? I'm going to see the pharmacist next week to see if they can advise on a loading dose, I'd be interested in what you've been given.
Did your GP check folate, B12, iron and ferritin? Both low folate and B12 can make you feel horrid. The in range figures may not be sufficient for you to feel well.
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The loading dose is one 40,000 unit capsule per week for 4 weeks.
Folate, iron & ferritin were all pretty much in the middle of where they should be, according to the NHS app anyway! B12 was low at the beginning of the summer but higher when re-checked 6 weeks later after I’d been taking supplements. It all feels a bit “trial & error” at tte moment :(
Hope you start feeling better soon too x
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Unfortunately making sure your vitamin levels are optimal, not just ok, is a bit trial and error and you really need to take matters into your own hands.
GP's know next to nothing about nutrition and will only prescribe supplements to get you into the bottom of the ranges. This doesn't mean that you feel better, just that they've ticked another thing off their list.
As Seasidegirl said, low folate and B12 can cause tiredness as well as vitamin d and make you feel bad.(Been there done that and felt like death warmed up ;D) I can now keep my D and Bs where I feel best but i always have issues with keeping my ferritin level up.
CE1976 - what were the numbers of those? The folate, B12 and ferritin I mean.
I can't really comment on iron panels. I'm not certain that I fully understand all the different parts of one but I'm happy to do some research if that will help :)
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Hi, I find it all a bit confusing! So B12 levels were 165 and went up to 600 ng/L and folate went from 7 to 8 ug/L. Is ferritin the same as iron serum test as I think that’s all I’ve had?
Thanks so much for your input x
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Ferritin is the bodies iron store and iron is the amount of iron circulating in the body. There is also transferrin which is relevant as well.
It's worth knowing exactly what you've had tested and what the numbers are as they all fit together.
As others have said there is a massive difference between "in range/normal" and optimal where you feel well. 165 for B12 was very low, in Japan and Europe apparently they regard under 550 as deficient and treat accordingly. One of the papers I read suggested the this may be part of the reason they have low levels of dementia.
You may also need to consider why your levels are low? Might you have a condition that needs to malabsorption? Coeliac, some auto immune conditions etc.
The NHS is really poorly at this stuff unfortunately which leaves many of us feeling really unwell. I wish I'd known this stuff 6 years ago!
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Seasidegirl is spot on and I totally agree with what she has posted. It seems like we're both doing a DIY approach and doing our own research.
CE1976 - your B12 was low at 165 but even at 600 you could increase this a little.
Your folate at 8 is still very low too. Obviously this is dependent on what ranges were used in your blood results. I'm assuming NHS ranges but I could be wrong.
A decent B complex would help. B vitamins are water soluble so you body will get rid of anything you don't need.
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Sunday Girl, I'm grateful to you and AmandaJR for your advice on my post about reference ranges. I can't remember which of you pointed me at Health Unlocked Thyroid forum but I'm grateful for that and the knowledge you burgh shared.
My (actually very good) GP is very glib and uninterested in these deficiencies.
I really wish I'd known the importance of vitamins and minerals before and the difference between"in range" and optimal
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Thank you both so much for your input. I’ve bought a high strength B vitamin complex and picking up the vitamin D prescription tomorrow. Do either of you know if I should take a vitamin K supplement with the vitamin D high load tablet? And if so, how much? I’m already taking Mg supplements too.
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Hi ladies, I’m on the DIY Vit D research bus too, my reading is 54, it was 150 the year before. I think we all need to research and advocate for ourselves.
I wish I’d known more about ranges too Seasidegirl.
Healthunlocked is amazing, members must give most of their day to helping others, it’s an incredible resource that I’m extremely grateful for, thank you SundayGirl for the intro.
I take D3 with K2 CE1976, mine is a combined pill. I’m not sure if GP’s prescribe K2 but it’s easy to get online.
I’m really hoping we feel better as vit D increases. I’ve had hair loss which is really bothering me, I’m considering shaving what’s left off and getting a wig as I can’t wear a bobble hat or baseball cap at Xmas events. :-(
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Have any of you had issues with B12 too? I had two months of injections followed m by daily supplement yet a month later my B12 reading is still under 50%? A year ago it was over range with just daily supplements?
GP isn’t concerned but isn’t about vits/minerals in general ::)
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Thank you both so much for your input. I’ve bought a high strength B vitamin complex and picking up the vitamin D prescription tomorrow. Do either of you know if I should take a vitamin K supplement with the vitamin D high load tablet? And if so, how much? I’m already taking Mg supplements too.
Short term, taking vitD without K2 won't do much harm but for a maintenance dose, which you'll have to buy yourself once you're in range, get a combined one. Much easier as it's in the correct proportion.
Hi ladies, I’m on the DIY Vit D research bus too, my reading is 54, it was 150 the year before. I think we all need to research and advocate for ourselves.
I wish I’d known more about ranges too Seasidegirl.
Healthunlocked is amazing, members must give most of their day to helping others, it’s an incredible resource that I’m extremely grateful for, thank you SundayGirl for the intro.
We're going to need a bigger bus ;D
Healthunlocked is fab. I can spend hours reading it and gleaning tons of good info.
Have any of you had issues with B12 too? I had two months of injections followed m by daily supplement yet a month later my B12 reading is still under 50%? A year ago it was over range with just daily supplements?
GP isn’t concerned but isn’t about vits/minerals in general ::)
How about trying a higher strength one? Maybe your body isn't absorbing it as well. Or maybe you need to give it a bit longer for the full effect.
I know if I don't take my B complex my levels drop rapidly and it takes a while to get them back up again.
My GP isn't concerned about vitamins either. It took a review with a pharmacist to suggest a B complex when my folate was well below range.
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My gp wasn’t bothered about my B12 levels either as said they can go up & down all the time anyway…. They did test for pernicious anemia and coeliac disease though which came back fine - might be worth asking if they have already been done?
Hope you feel better soon too AmandaJR
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Vit b Complex. I’m use a daily B complex from Nutifilife. D3 5000mcg with Dr MYHILL’S multi MIX FORMULA and a Swanson 50000Ui D3 multi with K2.
I’m using this as a loading dose and will re test in 8 weeks.
Aiming for b12 and d3 high range.
I wish this was easier to do but using what I have available.
Yes SundayGirl,need a bigger bus!
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I've also been low on vit D just before they put me on HRT with terrible palpitations and other symptoms and vit D didn't do anything with regards to that.
Everything improved since starting HRT (that said, some people may be different and may react better to vit D).
Folic Acid deficiency can also cause palpitations.
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I despair about how we are ever supposed to get good advice on these issues.
My vitamin D is 53.9, because it's over 50 my GP is happy that it's fine. I reminded her that I've been taking 1000iu since February so it would suggest that either I was hugely deficient to start with (but not tested) or I'm not absorbing ( which might fit with my potential thyroid issues)
She suggested that I might just want to keep taking the 1000iu. She couldn't prescribe the loading dose as the result is over 50.
For the folate she suggested a multi vit.
She's really very good and is trying hard to understand what's wrong with me but it's clear she has little knowledge around these issues.
So, I thought I'd pop into our local pharmacist and chat to the pharmacist about how to create a loading dose over the counter as it's possible to buy high level D.
He suggested I should take 800 iu when I went back over taking 1000iu since February he said the 1000iu would be OK.
So I'm off to Amazon to buy 10,000 iu and I'll make it up as i go along 🙄
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You probably won't get help from your GP >:( and because your vit D is now in the ok range, it's left up to you. Once your vitD reaches 50, you're fixed ::)
1000iu isn't a huge dose for maintenance. Especially if you're not absorbing it well. It took me a long time to raise mine significantly as I was afraid of using more than the GP said was OK. Now you know your levels and where you want to be, use the calculator I posted earlier to fine tune. You may want to monitor your own levels using private testing.
Don't take a multi vitamin. A decent B complex is what you need.
So I'm off to Amazon to buy 10,000 iu and I'll make it up as i go along 🙄
😁 There's many people who do just that!! With the caveat of monitoring your levels of course 🙂
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Thanks Sunday Girl, I've looked at the calculator, I'm slightly wary of the bigger dose unsupervised. I don't know why really given that they don't seem to have any more idea than I do!
I'm now taking 4000iu daily but I'd really like to make quicker progress.
GP has said that she'll retest Ferritin in the new year (it's 200 above the 150 higher range). She'll then retest D, folate and I hope B12 in 3 months. I'll do them privately if there are any issues in getting them done.
I'm going to see an endo privately which GP has been encouraging of, she referred me to NHS endo but they rejected me as my TSH and T4 are in range . I'm hoping that he might see the bigger picture including my thyroid goitre and also includes high SHBG which is impacting on my free hormone levels.
I'll go back and look at the calculator
Thanks
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Taking 4000iu per day should mean you see an increase when you next test at 3 months.
That's a high ferritin level you've got. It can sometimes indicate inflammation in your body. Did you also get CRP tested?
Good luck with the private Endo. They're often more open to prescribing even though a lot of them also work for the NHS. Remember to give them your most recent blood test results or it's a waste of a first appointment.
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How did anyone manage to get loading doses from GP? My d level was 27, so really low and was told to supplement.
My b12 was just in normal range so at moment no way a GP will give loading doses, even though I have neuro symptoms.
I'm on fb chats and a lot of people do their own b12 injections but that scares me. I would rather a GP was involved.
I feel if GP gave vit d loading dose I could maintain on oral supplements.
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Taking 4000iu per day should mean you see an increase when you next test at 3 months.
That's a high ferritin level you've got. It can sometimes indicate inflammation in your body. Did you also get CRP tested?
Good luck with the private Endo. They're often more open to prescribing even though a lot of them also work for the NHS. Remember to give them your most recent blood test results or it's a waste of a first appointment.
Morning Sunday Girl, CRP HS is 1.01 so whilst it's not high, my research suggests it could be indicative of an inflammation or immune response.
I'm convinced my thyroid is overactive, the NHS ENT consultant who scanned my thyroid goitre said it might be producing thyroid hormone or it might have an autoimmune component. My antibodies aren't obviously showing an issue but I haven't had TSI tested which might point to Graves although I'm not sure I'm entirely symptomatic of Graves.
I'm leaning towards a toxic goitre causing high levels, this could tie in with the high SHBG which is messing up the benefit of HRT and the vitamin deficiencies or of course the deficiencies could be unhelpful to a borderline thyroid performance!
As an example of the impact of high SHBG, my testosterone is 1.48 nmol which is sightly over range, SHBG is 124 (down from 131 in July), meaning FREE Testosterone is 0.01 nmol!!!
The two GPs I've spoken to about high SHBG say it isn't relevant to anything 🙄.
Luckily my GP has just prescribed six months T and it was the private bloods that show the high T level or I'm guessing they'd be stopping or reducing that based on the high total T. I won't be sending that result in!
(Sorry I'm taking the bus down a SHBG cul de sac!)
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Re vitamin D, I've ordered the Better You 4000iu spray as I wonder if it is an absorption issue and the spray might be better.
I'm probably going to mix and match and go a bit higher for a few weeks in the hope of getting the level up quicker to see if I feel better.
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Morning Seasidegirl :)
You take our bus down any route that might help ;D
I'm pretty sure I read in my endless research surrounding thyroid disorder that high SHBG can be an indicator of hyperthyroidism. You may well be onto something there.
You can also be hyperthyroid without Graves. Then again you could be hypo and going through a hashi blip. Hopefully your Endo appointment will throw some light onto your situation. It's possible to have thyroid disease without having antibodies as well. Bloomin confusing stuff this thyroid thing. ::)
The Better You sprays are good as they get absorbed through the mouth. Can get a bit expensive in the long run though.
It's a nightmare that Thyroid issues often raise their ugly heads at this time of life.
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How did anyone manage to get loading doses from GP? My d level was 27, so really low and was told to supplement.
My b12 was just in normal range so at moment no way a GP will give loading doses, even though I have neuro symptoms.
I'm on fb chats and a lot of people do their own b12 injections but that scares me. I would rather a GP was involved.
I feel if GP gave vit d loading dose I could maintain on oral supplements.
I'm surprised your GP didn't prescribe a Vitamin D loading dose with those levels. They usually prescribe to raise your levels to 50.
You can manage it yourself though fairly easily. Work out your own loading and maintenance doses. Cheaper as well if you pay for prescriptions.
With a B12 within NHS ranges, GP's don't see a need for prescribing. They certainly wouldn't entertain B12 injections. Buy yourself a decent B complex. Don't worry about self-injecting. Only consider that route if you can't raise your levels with supplements.
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I'm in Scotland so prescriptions free.
Getting more blood tests this week and I have appt with GP on 13th so will discuss results then, hoping vit d still low, even though supplementing since feb/March.
I think I may go private for a b12 injection,hoping once a moth and then can daily supplement myself.
It's such a minefield and doesn't help that so many conditions have the same symptoms.
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It's a massive minefield, that's why I really wish I'd had a decent package of baseline bloods before I started HRT as I'm now struggling to see what might be cause or effect.
JS79 your doctor ought to prescribe a loading dose at that number. In England you can look up the Formulary for your Trust and that tells you the approach your trust host has. In England, mainly they do loading dose of you are under 50. I'm not sit if you have the same Formulary set up in Scotland.