Low Vitamin D & B12 - Causes? What to do?

[Ameena]

Yesterday I had an appointment with my endocrinologist for my thyroid. As part of the bloodwork, she tested both Vitamin D & B12. My vitamin D was borderline low last time, but this time was critically low - 15. My b12 was borderline low as well.

 

What could be causing this? I eat a fairly balanced diet. The Vitamin D I understand being low, as I know it comes from sunlight & I am a very modest dresser covering all but hands, face & feet. I was taking both Vitamin D & B12, but stopped as they were making me feel really yucky.

 

What can I do to raise my levels naturally?

[SarahW]

Take Cod Liver Oil.

 

Eat lots of red meat.

 

If the Cod Liver Oil also makes you feel yucky, it may be because the company added in synthetic D in order to standardize the amount. The only company that I know of that doesn't do that is Green Pastures. They have a new product out that has lots of goodies emulsified into coconut oil. It's not tasty, but it's not awful either.

[Ameena]

Take Cod Liver Oil.

 

Eat lots of red meat.

 

If the Cod Liver Oil also makes you feel yucky, it may be because the company added in synthetic D in order to standardize the amount. The only company that I know of that doesn't do that is Green Pastures. They have a new product out that has lots of goodies emulsified into coconut oil. It's not tasty, but it's not awful either.

 

Is the red meat for B-12? If so I don't understand how I possibly could be low - we eat beef at least a couple of times a week if not more. I tend to alternate beef nights with chicken or fish nites, but we go for more beef as i have a history of being anemic if I don't get quite a bit of beef/bison in my diet.

 

[texasmama]

Google pernicious anemia for info on B12 deficiency. (I have it and require injections of B12 monthly.)

[Joker]

I think the B 12 can be hereditary. Many in my family have had to have the injections no matter how much red meat they eat. I haven't had to have those yet but I do have to take a good supplement in addition to eating red meat often. I also eat a breakfast cereal with 100% B 12 added.

[Soror]

I'm just starting on this road and sorting everything out but I would say that low stomach acid goes hand in hand with hypothryoid making it difficult to absorb what you do eat. I know I'm crazy low on iron and I eat meat ALL the time. I'm having tests run now to see what else I might be low in and why but that is one problem for those with thyroid issues. For some of us just eating the right food isn't enough. I'm curious to see my b and d levels. I know when I added in sublingual b's in Jan it made a big difference in how I feel, so I'm anxious to see what the tests say. Someone just mentioned pernicious anemia to me on another thread and I'll be investigated that as well.

[idnib]

I'm just starting on this road and sorting everything out but I would say that low stomach acid goes hand in hand with hypothryoid making it difficult to absorb what you do eat. I know I'm crazy low on iron and I eat meat ALL the time. I'm having tests run now to see what else I might be low in and why but that is one problem for those with thyroid issues. 

 

 

I found Betaine HCl/Pepsin helped me with this problem. I need to stop being lazy about it, though.

[Liz CA]

Have you been checked for MTHFR?

This can deplete a lot of these vital hormone levels along with glutathione.

 

[Ameena]

Have you been checked for MTHFR?

This can deplete a lot of these vital hormone levels along with glutathione.

 

What is MTHFR? I've never heard of it, so probably have never been checked.

 

I'm just starting on this road and sorting everything out but I would say that low stomach acid goes hand in hand with hypothryoid making it difficult to absorb what you do eat. I know I'm crazy low on iron and I eat meat ALL the time. I'm having tests run now to see what else I might be low in and why but that is one problem for those with thyroid issues. For some of us just eating the right food isn't enough. I'm curious to see my b and d levels. I know when I added in sublingual b's in Jan it made a big difference in how I feel, so I'm anxious to see what the tests say. Someone just mentioned pernicious anemia to me on another thread and I'll be investigated that as well.

 

I am HYPERthyroid, fairly well controlled with medication. I have high stomach acid & take a high dose of Zantac twice daily to keep it in check {Otherwise I am the fire breathing dragon & get ulcers}.

 

My Endo ran the following bloodwork last time:

 

TSH 1.698 normal

Free T3 3.0 normal

Free T4 1.1 normal

Sodium Serum 139 normal

Potassium Serum 3.8 normal

Chloride Serum 102 normal

Carbon Dioxide Total Serum 30 HIGH

Anion Gap 7 normal

Glucose Serum 82 normal {wasn't fasting}

Blood Urea Nitrogen Serum 11 normal

Creatinine Serum 0.70 normal

Calcium Serum 9.2 normal

Phosphorus Serum 3.5 normal

Albumin Serum 3.9 normal

Vitamin D 25-Hydroxy 15 LOW

Vitamin b12 Level 367 {test says normal, but she called it borderline low}

GFR >60 Normal

White BLood Cell Count 7.7 normal

RBC Count 4.82 normal

Hemoglobin 14.2 normal

Hemacrit 41.1 normal

MCV 85.3 normal

MCH 29.5 normal

MCHC 34.5 normal RDW 13.1 normal

Mean Platlet Volume 11.1 normal

Platlet Count 245 normal

 

Half of that stuff I don't know what is, honestly lol.

 

I think the B 12 can be hereditary. Many in my family have had to have the injections no matter how much red meat they eat. I haven't had to have those yet but I do have to take a good supplement in addition to eating red meat often. I also eat a breakfast cereal with 100% B 12 added.

 

I know my mom was always anemic, but it was due to low iron. I've never heard of anything b-12 related.

[JumpyTheFrog]

I'd check to see if the Zantac interferes with b12 absorption. Also, some people get refluxfrom low stomach acid.

 

Your vit D levels are super low. You may need 5-10,000 IU daily for months to get them up.

[sbgrace]

There is a very good chance that the acid suppression of the Zantac is causing the malabsorption of b12. It's a known risk with those meds. http://www.npr.org/blogs/health/2013/12/10/249975706/popular-antacids-increase-the-risk-of-b-12-deficiency You'll want to supplement.

 

Supplement the D with a D3 supplement. Specifically, I'd take 10,000 IU per day to try to get that level up fast. In fact, I did just that myself when my level was almost that low. The vitamin D foundation online has good information, but the vitamin A in Cod Liver Oil can inhibit raising your level when you are that deficient. The D3 supplements are derived from food sources...so not terribly unnatural! Don't use D2 forms a doctor might prescribe.

[Soror]

re: betaine- I have started on this recently.

 

I'm being tested for the MTHFR gene as well. 

 

I'm curious about the hyper diagnosis as it seems from my reading that your t3 is still on the low end (depending on your range) and your TSH is certainly not too low (it seems I've read that many feel best around a 1), although I'm a total newbie here and can entirely be missing something. 

[bettyandbob]

Has your endocrinologist considered your parathyroid?

 

I am hypothyroid and hypo parathyroid. The parathyroid regulates absorption of calcium which affects fit D levels. In addition to thyroid meds, I take calcitriol which helps the body absorb calcium, high amounts of a calcium/D OTC supplement, and once a week prescription vit D supplement. There is no way diet could fix this for me. Additionally, taking mega doses of OTC supplements alone, even those of the highest quality will not help. If your parathyroid is not working your body will not absorb the calcium or vit D. This is why, for me, the calcitriol is needed.

 

This week my doctor added a B complex to my plan. Low B is new and I didn't get a chance to discuss the cause.

[Lizzie in Ma]

Our Lyme Doctor just tested dd for MTHFR and she is homozygous for the 1298.  As I understand it, it interferes with absorbtion and detoxification, still learning but found this useful.  It is useful even if you don't have Lyme.  (which, btw, can cause low d in a big way)

http://kimmiecakeskickslyme.wordpress.com/2013/11/22/mthfr-mutations-and-lyme-disease/

[Soror]

I'd like to comment on the clo as well, although I think it can be great in this instance you would (1) go broke buying enough to get the levels you need with that great of a deficiency and (2)you would reach vit A toxicity levels as the A to D ratio is really high and yes I know it is natural but there is still a limit to how much you need and fat soluble vitamins just don't pee it away. 

 

Sometimes food and natural sources aren't enough. My husband has had the hardest time believing that I'm iron deficient considering my diet and daily use of cast iron. When the one dr wanted to test I was a bit incredulous as there is no way I should be deficient but there are many things which can cause your body to need more than the average person, sometimes much, much more.

[Plateau Mama]

Have you tried the liquid vit-d? That is what we take at our house and no one complains, much. I feel it is gentler because it gets absorbed more quickly and doesn't cause stomach upset.

[Dory]

b12 isn't absorbed well in pill form. Under the tongue is the best one, but still not great. You need to get it naturally as much as possible. Red meat is not even close to being the highest carrier of b12. Shellfish (which we don't eat here), Mackerel, Crab, fortified cereals,  and Liver are all higher. Just under red meat there is also dairy products and eggs.

 

B12 problems can be hereditary. My Grandpa has pernicious anemia, my mom is starting to have problems that way, my aunt does as well. The older you get, the worse it can get as the body normally gets less efficient. A b12 shot every couple months could be all you need. Well, that and more sunshine.

 

Also, the body can not break down b12 if you don't have enough hydrochloric acid in your stomach. The effects of low b12 are not nice.

[Liz CA]

What is MTHFR? I've never heard of it, so probably have never been checked.

 

 

 

It is something genetic. Here is a website with a wealth of info. You can live a long time without knowing you have one or both genetic mutations.

 

http://mthfr.net/

 

Dr. Ben Lynch's website was recommended to me by my doctor as the foremost expert on this.

 

Also, I make sure I take a magnesium supplement in addition to my Vitamin D3 drops. They sort of have symbiotic relationship.

[umsami]

I have low vitamin D and B12 (as well as being hypothyroid…so maybe there's a connection).  Low D is very common in women who cover. (Lots of journal articles.)  To keep mine in the normal range, I need to take 50,000-100,000 IU of D3 per week.  (Usually 100,000 in the winter.)  Even then, I'm barely squeaking over 40.  I do it via 50,000 IU caplets, but there are some treatments which involve injections for people with fat metabolism issues.  Take your D with fat if possible.  Experiment with other brands.  Because I only take 1 D3 per week, it doesn't affect how I feel.

 

As for B12, I do sublingual tablets 2x/week.  They're cherry flavored. I think I bought them at Costco. :)

[JumpyTheFrog]

For B12, take a sublingual methylcobalamin. (Adenocobalamin and hydroxycobalamin are also okay for most people.) The cheap cyanocobalamin doesn't converted well into methylcobalamin by people with the MTHFR defect, which means they make take tons of B12, but not be able to use it. This defect also means your body can't convert folic acid or folate well into the active form needed to use B12 properly. Ben Lynch's website is a good place to learn about this.

[sbgrace]

Has your endocrinologist considered your parathyroid?

 

I am hypothyroid and hypo parathyroid. The parathyroid regulates absorption of calcium which affects fit D levels. In addition to thyroid meds, I take calcitriol which helps the body absorb calcium, high amounts of a calcium/D OTC supplement, and once a week prescription vit D supplement. There is no way diet could fix this for me. Additionally, taking mega doses of OTC supplements alone, even those of the highest quality will not help. If your parathyroid is not working your body will not absorb the calcium or vit D. This is why, for me, the calcitriol is needed.

 

This week my doctor added a B complex to my plan. Low B is new and I didn't get a chance to discuss the cause.

 

Betty, she wasn't running high calcium.

If you have parathyroid disease, you need surgery. That "cures" it, as you don't have the diseased parathyroid anymore.

Vitamin D is contraindicated with parathyroid disease, as is calcium. My sister had parathyroid disease.

It is worth mentioning that as a possible cause of low D, though. It's rare but extremely harmful to the body, and doctors often miss it.

 

So I'll link a great website for parathyroid disease. http://www.parathyroid.com/

[bettyandbob]

Betty, she wasn't running high calcium.

If you have parathyroid disease, you need surgery. That "cures" it, as you don't have the diseased parathyroid anymore.

Vitamin D is contraindicated with parathyroid disease, as is calcium. My sister had parathyroid disease.

It is worth mentioning that as a possible cause of low D, though. It's rare but extremely harmful to the body, and doctors often miss it.

 

So I'll link a great website for parathyroid disease. http://www.parathyroid.com/

 

 

The website refers to hyperparathyroid disease, not hypoparathyroid. 

 

For hyper Ca  and D supplementation would be contraindicated. However, it is the opposite for hypo. 

[kbutton]

I've read that anemia (iron or B vitamins) is one of the leading symptoms behind people getting tested for celiac disease. I've had some (not all) of your symptoms, and going gluten free helped me. I have not been tested because I wasn't trying to go gluten free (long story), but it's looking like others in the family are celiac, and pernicious anemia runs in the family. Some sites that talk about MTHFR show celiac disease as a possible comorbidity as well (I am not sure if this runs in my family, but I believe it was looked into as well). Best wishes figuring this out. 

[grantmeawish]

How old are you? It is recommended that people over 50 supplement b12. As you age your body's ability to absorb it lessens. This website explains it quite well.

http://www.health.harvard.edu/fhg/updates/update0406d.shtml

[Alenee]

That is a pretty low B12 level.  If your doc agrees, (s)he needs to test for the antibody.  I have pernicious anemia and give myself a shot monthly.  It's easy-peasy and has changed my life.  I can't believe how sick I was before getting the shots!

[Tiramisu]

I'm not sure how old you are but many people over 50 are B12 deficient, regardless of diet. For B12 absorbtion, the B12 in the food you eat has to bind with intrinsic factor which is produced in the stomach. As we age, we make less. Then, it is only absorbed in the ileum. So, even with enough intrinsic factor, if there's any problem in the ileum or if food is passing through it too quickly for it to be absorbed well, you can become deficient.

 

The US has a much wider range of normal than Japan. US normal goes down into the 200's, while in Japan the lower limit of normal is in the 400's.

 

I was found to be deficient around 40 and responded very well to oral supplementation of the typical B12 formulation (cyan-) you can buy in any drugstore. I tried the methyl form and it did not work any better for me.