23 December 2020

All Things Father Christmas - including Santa and NORAD

Here I am, back again with my  traditional Christmas post, because, as with all good Traditions, it has the right amount of fact while not taking itself too seriously. 

And after a year of Covid do we need a bit of not taking oneself too seriously! 

Let it raise a smile as snippets are retold over a glass of something warming and yet another mince pie.

Wishing all my readers, of this blog and of my books, a wonderful festive season, whatever your beliefs.

Who will be leaving gifts at your hearth?

Here in the UK it is definitely Father Christmas who will be visiting, and despite his title he has nothing to do with Christianity, or parenthood, or even humans. It is the spirit of Mid-Winter, a personification clothed in evergreen, wrapped in holly and ivy, and garlanded in red berries and mistletoe. It is a jovial spirit, come at the solstice to partake in the mid-winter’s frivolities. The people welcomed it with entertainment, plied it with food and alcoholic beverages, and gave offerings so that it might not linger too long but instead beat smooth a path for an early spring.

Not a terrible lot changed when the Roman Legions made a home in these lands. They brought with them Saturnalia, a festival of light accompanied by a good deal of partying under the watchful eye of the god Saturn, often depicted with a scythe. So far so good.

Enter Christianity and a need by the early church to leverage ‘Jesus the Christ’ against entrenched Paganism. No one knew Jesus’ birth date, so the Pope of the time decided Jesus should be given one. The Pagan equinox celebrations of spring and autumn had already been coveted, so why not align the day to the biggest celebration of them all? A bishop from the Middle East, recently raised to sainthood for his good works, was also pressed into action: Nicholas (more or less). In the face of such worthiness the Brits remained steadfastedly wedded to their eat, drink and make merry.
The Romans assimiliated or left, and the Saxons and Jutes invaded, bringing along their Woden and winter’s Father Time. They also believed in eat, drink and make merry. A later invasion by the Norse and Danes (Vikings) – who also believed in eat, drink and make merry (can you see a pattern developing?) – brought along their Odin, who during mid-winter took on the manifestation of Jul – Yule – in that he was portly, white-bearded (signifying age), had the ability to see into people’s minds and know if they’d been good or not-so-good, and rode a horse, Sleipnir, which travelled at terrifying speed due to it having eight legs. Father Christmas as we know it was beginning to coalesce.

Saint Nicholas didn’t truly put in an appearance on British shores until the islands were invaded yet again, this time in 1066 by ex-Vikings, the Normans. However, no matter how the populace was “encouraged” to be pious, once out of the church doors after celebrating Jesus’ birthday, eat, drink and make merry remained the national stance. Not even the Puritans, who in the mid-17th century took the field and the country during the English Civil War, could fully ban Christmastide – ie the eat, drink and make merry – and Father Christmas, as he was by then known, made appearances in Mummer’s Plays, basically to raise a glass [ie two fingers] to the Puritan Parliament. And what happened to the Puritans? We happily waved them off to America (more or less).

It was there, after the War of Independence in the 18th century, that the populace began to embrace a Sinter Klaas from the Dutch tradition, doubtless because it wasn’t English (ungrateful individuals). In 1810 the New York Historical Society held a dinner in honour of Saint Nicholas, and twelve years later Clement Moore, drawing on Norse and Germanic folklore, wrote a poem A Visit from St Nicholas which was subsequently published as The Night Before Christmas. Thus Santa Claus came into his own, wearing the vestiges of Father Christmas/Jul. Even the reindeer and sled mentioned in the poem came from the Sammi people of Lapland, who the Viking peoples to the south of them firmly believed were ‘magicians’.

The Coca-Cola Company? Bah humbug! Late to the party. Santa Claus and even Father Christmas were wearing red before it showed up with its non-alcoholic beverage. But it had, and still has if its vivid red pantechnicon is anything to go by, damned good copywriters.
Which finally brings me to NORAD. Yes, I do mean the North American Aerospace Defence Command based in Colorado Springs. In 1955 Sears Roebuck & Company, also based in Colorado Springs, placed an advertisement in the press inviting children to phone Santa. Except the phone number was misprinted. Guess who was inundated with phone calls? CONAD – the Continental Air Defence Command and forerunner of NORAD. Despite being in the grips of the Cold War and it supposedly watching for in-coming missiles from you-know-where, the Defence Command put diplomacy to the fore and gave radar updates to children on the progress of Santa from the North Pole.

And thanks to the late Colonel Harry Shoup, Director of Operations at the time, it still does. Check on Santa’s progress at https://www.noradsanta.org/ Arrive before Rudolph gathers the other reindeer and there are activities and games to keep you enthralled. Yes, honest. [Aren't these people supposed to be protecting the Western World??]

So wherever you are, and whatever spirit of Nature you believe in, be sure to eat, drink and make merry this festive season.

With grateful thanks to Wikipaedia, History Today, Time-Travel Britain, Museum of UnNatural Mystery, and NORAD for their assistance in producing this tongue-firmly-in-cheek blogpost.

11 September 2020

When Your Health Turns On You: #Hypothyroidism --- 8: Vitamin D – The Results!

Vitamin D3 capsule

It’s been a while, 20 April to be precise, since my last post in this series. But it has been worth the wait – on a personal front, and a Covid-19 front. The results are in!

The backstory for those just joining me:

During 2017 I was suffering lots of weird health symptoms, the most concerning being that my brain refused to function properly – hardly a useful trait in a novelist. April 2018 a lump developed on my neck: a swelling on my thyroid. A GP’s blood tests indicated I might develop Hypothyroidism, whereas symptoms and antibodies emphasised that I was suffering Hashimoto’s Hypothyroidism, an autoimmune disorder. There are lots of autoimmune disorders – a common denominator tends to be a low Vitamin D level.

Note: I’m British and live in the UK. We have a National Health Service, free at the point of access, paid for via our taxes. Your mileage may differ, even if you live in the UK.

For the reasoning as to why, in January 2020, I joined a Facebook Vitamin D Support Group, you’ll need to read the back posts listed at the bottom of this page. In February I started on its suggested Protocol: a careful ratio of fairly high level Vitamin D3 and three ancillary balancing co-factors. I added in an Omega-3 capsule, a multi-vitamin & mineral tablet for my age group, which I’d been taking for over a year, this on top of my blood pressure medication. Yes, I rattled.

In March I had to take time off this cocktail when I had a hip replacement operation, but continued as soon as I was free of its medications and their side effects. The intention had been to take the Protocol for four months and then pay for a private finger-prick blood test (currently £39), but Covid-19 made an appearance – thankfully not in my family – and my mind focused on other things.

So it was the very end of July before I realised I was late with my intended test. I believe in stopping for at least a week beforehand any supplements. If I kept up supplementation to the hour of the blood test the result would be distorted.

14th August I had my result: 124nmol/L. I was ecstatic! I knew the supplementation was having an effect as I had been feeling so much better, more me. Back in May 2019 my level had been 48nmol/L. The given “within range” in the UK is 50-175nmol/L whereas the body needs it at 75+ to work at cell level. My level was now optimal. No wonder I was feeling better; no wonder the main swelling on my thyroid (I have one on each lobe) had diminished so much as to be almost unnoticeable. Hurrah!

The decision became: should I stay on the full supplementation level or drop the dosage, and if so, by how much so as to produce a maintenance level? Within days the decision was taken for me. An odd, slightly sore throat became a prominent sore throat, I had an increase in phlegm and the return of a nasal drip (all flags for hypothyroidism), and the swelling on my thyroid started to increase in size. Damnit.

I took advice from the Vitamin D Support Group and immediately the answer came back: Vitamin D has a half-life of approximately three weeks. If it is not constantly topped up, via sunshine on skin and/or supplementation, its potency fades. It was August, the height of the British summer. Damnit.

So I went back on the supplementation, though not quite at the high level I’d been on. I have, however, stayed with the same amount of co-factors, plus the multi-vitamin & mineral tablet and the Omega-3 capsule. Within the week the sore throat had abated, and the phlegm is gradually lessening.  It is my intention to pay for a full Thyroid & main vitamin panel blood test in early November, and depending on that result I’ll increase or maintain the supplementation level over winter.

November is when I usually have my annual “full” [pause for laughter] blood tests done by the GP to monitor my blood pressure medications, so we will be having a discussion about my Vitamin D level. Not that the results from privately bought blood tests will be added to my NHS record – y’know, in case I’m rushed into hospital and the medics want a “full” history of my health – but that’s a whole different argument I’m not going into here.

More important, at the top of this post I mentioned Covid-19 + Vitamin D results. While contemplating this post I watched a YouTube video by Dr John Campbell, who I’ve mentioned in previous posts, a lot in updates to Post 7. His video Covid-19: Vitamin D, First Clinical Trial uploaded on 6th September should be required watching for everyone, whether or not you have underlying health issues.

In the video he talks about a pilot trial run in one hospital in Cordoba, Spain, where a small number of patients admitted with Covid-19 and who had a low level of Vitamin D registered in the previous year were split into two groups. Both were given the hospital’s best available therapy for Covid-19, but one group had an added ‘active’ Vitamin-D. Out of both groups fourteen patients had to be transferred to ICU, but only one of those had been given Vitamin-D; the other 13 hadn't. The video is 27 minutes long, the eye-opener at 15 minutes, so watch until at least that point. It might save your life, or the life of someone you love.

As Dr Campbell asks, why isn't the UK initiating trials? Why isn't the World Health Organisation? I'd like to know why my region's Clinical Commissioning Group refuses to allow GPs to request testing for Vitamin D.


UPDATE 15 September:  The East Yorkshire Clinical Commissioning Group held its AGM online due to Covid-19, so I put that very question. As expected the response was a pat dismissal and buck-passing to Public Health England and NICE.

UPDATE 01 October: Dr John Campbell has a very interesting video "Vitamin D News & Science". Go watch https://youtu.be/B01ZlRfMnmU 

UPDATE 06 November: The result from my privately purchased Vitamin-D test shows 109nmol/L, down from 124nmol/L in early August, despite my being on a high-dose supplementation throughout.
Q: so what has changed? A: lack of sunshine due autumn.
What would have been the drop if I hadn't been taking a high-dose supplementation? It doesn't bear thinking about.


Image from PublicDomainPictures via Pixabay

 When Your Health Turns On You #Hypothyroidism series:

1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube
6: Covid-19 Coronavirus 

17 August 2020

Trialling Audio for a Virtual FantastiCon

What a weekend that turned out to be, sitting drink in hand for six hours each day watching FantastiCon unfold on my laptop. Covid-19 has a lot to answer for, but Dan Grubb is a can-do kind of fella, and he will not be beaten by a mere world-wide pandemic. 

He and his wife run Fantastic Books Publishing and their annual FantastiCon is an in-person event held at Cleethorpes, just south of the Humber, with attendees travelling in from far and wide, including Hungary and the USA. This year it was held on a computer screen near you via TwitchTV. This rather curtailed the usual nerf wars and gaming extravaganzas, so it became more of a Litfest with extras. After all, there were six new titles to be launched.

My involvement came about when I was approached to do one of the short readings to be used as fillers. Using your smartphone will be fine. It might have been if I owned one. But if FantastiCon could go Virtual, surely I could use my laptop to video myself reading an excerpt or two. Mmm. Perhaps not. Well, I did, but let's just draw a veil over the result. I attempted to back out but Dan was having none of it. He was also compiling audio recordings. I had a go using software integral to Windows 10. Er... no.

My deadline was looming. It was then that I bit the bullet and downloaded Audacity, the free open source "easy to use cross-platform audio editor and recorder". Yeah, right. But it was! In a single afternoon I found my way round the basics, recorded two tests and a very passable final, then followed instructions to remove the inevitable ums, ers, and fluffed words. I amazed myself. Dan added book covers and it was good to go. 

If you should wish to listen to my rather non-dulcet tones, start at 6hrs 30mins HERE of Day 2. The recording of the event should stay live until mid September.

What this has done for me, of course, is open up a whole new world. I have languishing a YouTube channel carrying a couple of book trailers. All I need to do is learn how to add music and graphics tracks to audio files and I shall be uploading some of my short stories. First, though, I need to take lessons in speaking proper. Isn't there always a problem?

1 July 2020

Life of an Anglo-Saxon Warrior at #Bamburgh

Covid-19 may have curtailed travelling and cancelled events, but it has opened a plethora of online talks, lectures, and instructive how-to demonstrations, most available on YouTube.

For the writer and the reader the Society of Authors has run a series of Afternoon Tea With… as well as useful talks on marketing. York Festival of Ideas took its annual festival online with talks on a wide range of subjects. The medieval history of Whitby’s Penny Hedge proved engrossing, but for me the crowning glory goes to Warrior: A Life of War in Anglo-Saxon Britain.

The television programme Time Team, first airing in 1994, brought the fascination of archaeology to ordinary people. It ran for twenty seasons and raised the profile of history programmes. With Warrior: A Life of War... writer Edoardo Albert gets together with York archaeologist Paul Gething to talk about an archaeological dig at what is now Bamburgh Castle, but what in 650AD was the royal residence of the kings of Northumbria.

The hour’s video is introduced by Edoardo Albert who hands over to a rather reluctant Paul Gething. But as with all archaeologists I’ve either seen or spoken to, once on his subject the pure passion of his calling ignites everything it touches. Within thirty minutes I’d ordered their book and I am so very pleased I did.

It is part riveting exploration of the odd breed of self-taught ‘gentleman antiquarians’ – Basil Brown of Sutton Hoo fame being one – who laid the foundations of modern archaeological techniques, also explored in detail, and for context the piecing together of known 7th century history, when Christianity was fighting for minds via the monks of Iona as strongly as royal households were fighting to extend their kingdoms and trade routes. As does Paul Gething in the video, the book brings the period and its people to life in colours worthy of the Book of Kells.

The Dark Ages? More like Arrogant Propaganda.

If you are interested in other aspects of the Anglo-Saxon period, you'd do worse than watch a five minute introduction on the breath-taking craftsmanship of the Staffordshire Hoard.

10 June 2020

Native American Plains Decoration Techniques

Today on her Happy Ever After website Sharon Booth is hosting my guest post explaining how I came to research Beneath The Shining Mountains. If you’ve just hopped across from there, Welcome! If you’ve arrived here first, please follow the link above to read the original post – it’s not long and this one will then make more sense (probably).

It seems that I was almost born with an interest in Native American Plains peoples. My mother, who cut my first coup bonnet from newspaper when I was four, doubtless rolled her eyes and thought I’d grow out of it. I didn’t. I ended up making a tipi, haggling with the local tannery for sheepskins (no bison or antelope skins being available), and dragging my own family to weekend pow-wows and week-long summer camps. Yes, in the UK. The British are renown for their eccentricity.

If a writer’s watchword is What if…? then a re-enactor’s must be How did they…? closely followed by Why did they…? Why did the native peoples of the northern plains decorate just about everything they owned? Good question. Some of the colours and designs were tribal, some denoted status, some had religious significance, some encapsulated a bit of all three. Click on the images for a larger view.

Parfleches c1880-85. Left a Brulé Sioux design; right a Cheyenne design.
The two peoples lived in relatively close proximity, sometimes trading, sometimes skirmishing, 
yet the distinctive designs are particular to each.

Earth and vegetable pigments were used most often on items of luggage, which was usually made of rawhide for strength and durability. The pigments were crushed, mixed with animal fat or tallow and applied to the rawhide by brush and/or stick by pressure so the dye impregnated the rawhide. Parfleches were often made in pairs and carried whatever was needed, from clothing to the winter’s dried meat supply. They were tied to a travois platform when moving camp, hence the need for durability.

 Moccasins with porcupine quillwork decoration.
Left Seneca 1808; right Crow (Apsaroke) or Sioux 1882. 

The Seneca are an Iroquoian Great Lakes people whose territory abutted the plains. They favoured the one-piece soft-soled moccasin against the separate, often rawhide-soled moccasin of the plains. The central strip of decoration masks the seam. By the 1880s enforced reservation life was a reality and the bright yellow pigment of the moccasins on the right may have been from a traded dye. The design was for a religious Sun Dance ceremony, the old-style of decoration probably part of the vow rather than using quicker beadwork which would have been the norm by that time.

Before the influx of fur trappers and traders, porcupine quillwork was the most extensive form of decoration for clothing and small bags. It involved a great amount of work. Porcupines were trapped or, if in abundance, sought and a skin thrown over them so their hooked quills came away. The quills were boiled in a natural pigment mixture and dried for future use. Decoration involved holding several in the mouth so they softened, flattening one between the teeth, then folding it between two sinew threads pushed through a fine hole in the skin punched by a thorn or bone awl. Adding further quills constructed a band of decoration as thin as the width of your smallest fingernail. It wasn’t so much hours’ as days’ or even weeks’ of work.
Left Yanktonai, Nakota woman’s strap dress, early 19th century.
Right Crow or Nez Perce man’s exploit shirt 1860.

The dress is made from two very soft and whitened deerskins and is unusually tailored; certainly more ceremonial than everyday. It carries both traded early pony and some later, smaller, seed beads alongside the fine quillwork hoops. Pairs of tin cones adorn the lower skirt so the woman would ‘tinkle’ as she walked. Small sheets of tin, or later even food tins, were sought as trade items for this purpose. Pony and seed beads were made of glass and produced in Venice and Bohemia. The man’s shirt was worn to exemplify his worth among his people to visitors and to enemies during conflicts. The ‘strap’ decoration, made separately and sewn as separate pieces to the shirt, are made from quill-wrapped horse-hair edged in both pony and seed beads.

 Two dresses from the Sioux confederacy: left 1875-1900; right c1870 Lakota or Teton

Trade routes between the peoples of North America extended long before Europeans arrived, and shells were a highly-sought exotic: abalone, cowrie, and shown left dentalium. Most women might have aspired to earrings or a necklace; this blue trade-cloth dress was owned by a woman of a powerful family, the dentalium shells probably gathered over generations, re-used and added to. Again, the skin dress shows social standing. Even by the 1870s glass beads imported by traders from Europe were not a cheap item, and to have an entire sleeved yoke decorated in seed beads was a mark of prestige. Sky-blue designs were a feature of the Sioux peoples.

I hope you have enjoyed this small snapshot of the decorative techniques of the northern plains peoples. Read Beneath The Shining Mountains if you’d like to hear how these were used in an everyday setting.

All images are from the Metropolitan Museum of Art and the Brooklyn Museum and used under a Creative Commons License.

3 June 2020

Dissecting the Opening of a Short Story

I am finally digging myself out of Covid-19 procrastination with a short story which is fast turning into a novelette, as much of my short fiction seems to do. It’s quite a while since I uploaded a how-to post, so I thought I’d share the beginning of my work-in-progress. Upfront I’ll say that I am more of a pantser than a plotter, so when I started I knew little more than what you’ll read.

What is needed for an opening? Many writers just write, then see what they have, re-write it, and edit that into shape. I can’t work that way. I need more than a character: I need to know his/her general backstory and, most important, find the tone necessary for the character to embark on his/her journey.  If these aren’t in place when my imagination makes the leap then the whole thing has a tendency to go awry. Have a read:

The Forever House
    There’s an old saying that you never truly know a house until you remove its wallpaper. It’s proved correct with every house we’ve owned, from our first Victorian two-up, two-down with its dicey electrics, to the oak wainscotting discovered behind a botched plasterboard job in the house at Rutherford.
    So when the damp wallpaper lifted to reveal the message pencilled on the plaster, I didn’t think, just smiled and turned to call over my shoulder, ‘There’s nine—’
    I recall the metal scraper ringing against the wall as the jolt seared through me, and somehow my shoulder coming to rest in the corner of the walls, the smell of old glue and powdery plaster in my nostrils.
   That’s the problem with doing something rhythmic, something mindless. You sort of slip into a parallel reality where a normal action still means what it’s supposed to. Nine lengths to door. In that reality Jason would have looked up and grinned. In this reality, my reality, he’s no longer here to respond. 

A double-blank line follows, which even for me is some going after only 170 words. However, due to what comes after, it fits. I have given the title because it isn’t just a title, it’s a recurring motif which impacts both on the house and the character’s evolving mindset. Even at this stage, when I had little idea of genre, subsidiary characters, and only a glimpse of a possible ending, my creativity was adding depth. As an aside, the title’s phrase was passed to me in conversation by a friend, and immediately lodged in my subconscious for future use. Occasionally it happens like that; most times I’d need to write the complete story and then mine it for a suitable title.

The story is a first person narration, chosen because there will be a lot of internalisation and it is easier to convey that on the page using first person viewpoint. During the writing, the hurdle I need to watch for is the number of uses of “I”. At a pinch the character could be construed as male, but it was always destined to be female. There is no name, or description of her, because at this point I don’t want to detract from the importance of The House, hence going into such detail in that first paragraph, even to naming a non-existent town.

The exception to this is in the use of contractions to give a sense of an ordinary person narrator. [You thought the use or not of contractions was ad hoc? LOL!] The tone I wanted was one of bittersweet reflection, hence beginning with There’s an old saying… rather than straight in with You never truly know… At the very start the bittersweet slant might be more in my mind than on the page, but it grows as the story progresses and the character starts to question not just the house but her perception of her life and those who lived in the house before her.

A word about characters in general: I hardly ever describe them. The picture I wish to conjure in a reader’s mind comes from what characters say, or do, or hold, and that picture will be different for every reader. Instead, I try to convey glimpses of the characters’ lived lives to act as scaffolding.

Here the narrator and partner – the we – have bought and renovated a series of properties, moving up the price ladder as they did so. As much as this emphasises a type of person with the traits necessary to bring such to fruition, it excludes others. This reading-between-the-lines is for the reader to assimilate as they progress, thus building and continually adjusting their own mental picture of the characters, and in this case the house: ...the smell of old glue and powdery plaster...

The section finishes with the information that the narrator is recently widowed, fighting denial while both grieving and rationalising, thus I start to put across the turmoil of her emotions which will become a mainstay of the story. I deliberately slam on the brakes in the final paragraph via the multiple use of commas and the word reality – I use it four times and may yet edit it to three – but its use is as much about the house as the narrator. It is also the only occasion in the entire story when I pull the reader into the moment by the use of second person you.

Did I plan this conclusion to the section? No, I was madly creating as I went. Does what follows continue the tone and the character’s internal thought processes? No, it is real-world exchanges, hence the need for a double-blank line.

Other facets you may be interested in – well, this sort of thing interests me – is that by the time I’d reached this point I knew the genre, subsidiary characters, the house and its previous occupants, and the ending. The initial seed? I was scraping wallpaper and uncovered a long-ago decorator’s note pencilled on the plaster. Immediately it pinged the gifted title-phrase lodged in my subconscious and I stood back, scraper in hand, with What if…? roiling through my mind.

If you have found this post of interest you may want to read Research 1 – Is It Necessary For Short Fiction? Or just scan down the titles of my Writing Tips page. I dissect entire stories in Reading A Writer’s Mind.

Image by Wokingham Libraries via Pixabay

22 May 2020

Procrastination for Writers – the uses and misuses of YouTube

My first attempt
As Covid-19 continues to waft non-too-benignly through the air, it seems I am not alone in being unable to knuckle down and concentrate. First I put my lack of discipline down to the physical exertion of remobilising after a hip replacement, then there was the housework to catch up on, then washing and altering curtains, then... baking bread. If the lack of flour on the supermarket shelves is anything to go by, I am not alone.

I’ve attempted to make bread in the past, loaves which could easily have doubled as house-bricks – bread machine or hand-knead mattered little. It was following a chance YouTube link to no-knead bread which re-started my fascination, and I am now a dab-hand at wholewheat, wholewheat & rye, and mixed seed wholewheat loaves, though the most scrumptious has to be the olive, lemon and thyme bread. With garlic & thyme butter, of course. It is easy to see where my time disappears to.

There again, it has given me an insight into medieval bread-making, when a woman would take her dough out into a meadow and leave it for several hours to attract natural yeasts, and doubtless an assortment of insects, but let’s not focus on that.

YouTube has become my go-to research tool for practically everything, despite the hundreds of non-fiction books lining the walls of my dining room. Whatever is my query someone has been there before me, and what point is there trying to reinvent the wheel? I’ve learned how to cultivate endless basil plants from a cheap supermarket tub, how to use photo editing software, where to find a tool annoyingly hidden in the depths of LibreOffice.

Its portal also offers a plethora of older television documentaries and some interesting lectures. The British Academy, as part of a series, has a ten minute talk by Diarmaid MacCulloch on How to understand Thomas Cromwell, even though so many of the man’s own letters have vanished (and why). My current favourite is a fascinating Timeline series on Building a Medieval Castle in France using the tools of the day.

For writers deep in procrastination mode, there are more talks on realising words and marketing them than can be jabbed at with a sharpened quill. And here I am, finally writing. At least it’s a start. The trick will be to ensure it continues.

Go on, own up - how goes your own procrastination? Or does the word never pass across your lips?

15 April 2020

When Your Health Turns On You: #Hypothyroidism –– 7: Covid-19 and Vitamin D

Image courtesy of Gert Altmann via Pixabay
Yesterday morning I caught an interesting interview on Sky News. Dr Gero Baiarda from GPDQ, a private GP service in the UK, was discussing the high proportion of Covid-19 infections and deaths among people of the Black, Asian and other minority ethnic backgrounds.

The numbers had become noticeable, he said, among those working in the National Heath Service, front-line or not, which was why he’d focused on it. The immediate assumption had been a socio-economic cause – such as crowded housing and multi-generational occupancy – but this didn’t explain why so many doctors were succumbing. What these people shared was the high amount of melanin in their skin, the body’s in-built safeguard for living in much sunnier climes than the UK. The more melanin the less Vitamin D is able to be produced in the skin by sunlight. It is understood, he said, that Vitamin D plays a pivotal role in the immune system, and that those of darker-skinned ethnic minorities were known to have low Vitamin D levels.

By this point I was shouting at the television. Low levels of Vitamin D in the UK population is hardly news – and it pertains to every ethnic background, including European Caucasians. It is particularly prevalent in the elderly. I believe it to be the smoking gun behind my Hashimoto’s Hypothyroidism, and I suspect a lot of other auto-immune disorders. But try getting a Vitamin D test on the NHS: it’s a postcode lottery dependant on whether the area’s Clinical Commissioning Group thinks such a test is important. Many don’t. For years the overriding belief of the medical profession has been that man-made medicines are the answer to every ill. Now the world has a novel Coronavirus – Covid-19 – a Severe Acute Respiratory Syndrome far more transmittable, and deadly, than the outbreaks of SARS-1 in 2002-2004, and there are no man-made medicines capable of touching it, which is why the UK population, along with many others, is in semi-lockdown.

As I mentioned in my Hypothyroidism-6 post, I am currently following Dr John Campbell’s YouTube videos. He highlighted the importance of Vitamin D to the immune system weeks ago, and even in a recent video was questioning why no one seemed to be picking up on it. He is quite open about his self-supplementing with a supermarket own-brand as a norm during the winter months. I am taking a much higher amount, with co-factors, due to my Hypothyroidism, but I've put other members of my family on 25mcg per day.

It is part of NICE’s recommendation that “...10 micrograms of vitamin D per day, throughout the year, for everyone in the general population aged 4 years and older...” 

Within the same recommendation, under ‘Specific Population Groups’ it is stated: 
Although the entire population of the UK are at risk of having a low vitamin D status, evidence was only considered in regard to increasing the supplement use for these specific population groups:
    • All pregnant and breastfeeding women, particularly teenagers and young women.
    • Infants and children under 4 years (breast fed, non-breast fed and mixed fed).
    • People over 65.
   • People who have low or no exposure to the sun. For example, those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods.
   • People who have darker skin, for example, people of African, African–Caribbean and South Asian origin...."
[Emboldened emphasis is mine.]

So why is this such a surprise? In his short Sky News interview, Dr Gero Baiarda mentioned that articles in the British Medical Journal (2017) and on Pubmed.gov add credence to his observations that Vitamin D reduces the risk of respiratory inflammation turning into pneumonia. (VitaminDwiki also has an impressive list.)

Looking at the Pubmed page, there’s an article written by a number of doctors in Italy (April 2020) stating that they were giving non-critical Covid-19 patients intravenous “multivitamin & multimineral trace element solutions” plus Vitamin D on admission in an attempt to avert them from becoming critical. They freely admit that this “straight approach may be debatable” but they were dealing with an emergency situation – which, considering the number of infections and deaths recorded in Italy (currently 162,000/21,000), I find something of an understatement.

In the UK a Vitamin D level of 50 nmol/L is regarded as “within range”, when it is known that a level of 75 nmol/L and above is needed for it to be active within the cells. Insufficiency is regarded as 25-50 nmol/L and deficiency less than 25 nmol/L. If many of the ethnic-background population are low in Vitamin D, as Dr Gero Baiarda maintains, due to their higher melanin level, no wonder there is a disproportionate number succumbing to Covid-19. It may also be an indicator as to why the elderly are being hit so hard, and so few among the very young.

I would like to think that when this pandemic is over the medical profession will rethink its emphasis, or lack of it, concerning vitamins and minerals across the entire population. Alas, I’m not holding my breath.

UPDATE 16 April 2020:
It seems I'm not the only one to pick up on this (thank goodness). There was a question asked at the government's No 10 Daily Briefing today, and catching up on my reading I find that Dr John Campbell has uploaded another YouTube video on it: Vitamin D and Immunity: Lots of Evidence.

UPDATE 09 May 2020:
Back to Dr John Campbell talking about dosages, complete with links to papers. Never mind Covid-19, anyone who doesn't have an optimal level of Vitamin D has a 50% higher risk of getting colorectal cancer and an increased risk of heart disease. Vitamin D Dose.

UPDATE 21 May 2020:
And yet again Dr John Campbell nails it, this time in conversation with Dr Shelton of New Zealand. They discuss how Covid-19 gets into cells and how having inflammation in the blood vessels (high blood pressure and others) is a metabolic syndrome in which a low Vitamin D level is always present. And who knew washing after sunbathing may not be a good idea? Dr Sheldon, Part 2, Vitamin D.

UPDATE 10 June 2020 (there are a lot of these, aren't there? I wonder why!)
Again, it is Dr John Campbell who is bringing this information into the open in layman's terms - this time from the French National Academy of Medicine: the correlation between lack of Vitamin D and high Covid-19 morbidity has a confidence rating of 95.4%. So why have northern latitude Scandinavian countries not been badly hit?  They have mandatory fortification with Vitamin D in up to 40 foods as well general population supplementation. Vitamin D Update.

When Your Health Turns On You #Hypothyroidism series:
1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube
6: Covid-19 Coronavirus
8: Vitamin D - The Results!

23 March 2020

When Your Health Turns On You: #Hypothyroidism –– 6: Covid-19 Coronavirus

A touch of Kew Gardens courtesy of Hornsea Writers
For the backstory to this series, see the links at the bottom of the post. 

Note: I’m British and live in the UK. We have a National Health Service, free at the point of access, paid for via our taxes. Your mileage may differ, even if you live in the UK.

When I wrote in Post-5 (28 February) that I’d give an update in a “few months”, I never thought I’d be back within four weeks to the backdrop of a whole new sobering world. But this Covid-19 pandemic is now the evolving “norm” and we need to get on with it.

The good news: I was lucky to get my replacement hip operation before non-essential surgery is/was cancelled. I am currently sixteen days the other side and doing fine.

The warning for anyone with a thyroid disorder: I had a bad reaction to post-operative morphine (Oxycontin) = projectile vomiting and the necessity for a catheter. These reactions stopped when I was dropped to 30mg of Codeine, but I still felt foul. Codeine metabolises into morphine in the liver, either well or badly dependent on how well the thyroid delivers a necessary enzyme. Mmm. Bear in mind that I am considered sub-clinical; my level of hypothyroidism is considered too slight for medication (Levothyroxine). I thought this reaction was just me, but a friend ten years my senior and taking Levothyroxine, and having a hip replacement in another hospital, also suffered: finding it hard to breathe. I know which I’d rather have, but we can’t choose. So be warned. If you find yourself needing surgery in the future ensure you emphasise your disorder. There is a rather bald note on the NHS medicines website, including a list of other health issues where taking morphine is not advisable. While in hospital I had expected the U2 nodules on both lobes of my thyroid to swell due to the trauma of the operation and subsequent medication, but thankfully that didn't happen. I'm grateful for small mercies.

Vitamin-D and Covid-19: readers of this series will know that I suspect Vitamin D deficiency to be the smoking gun behind the onset of my Hashimoto’s Hypothyroidism. It is well known that people with a thyroid disorder need their Vitamin D, Vitamin B12, Folic and Ferritin levels to be more than halfway along each individual range. My Vitamin D level is nowhere near, but I am working on it.

In the last few days I have been pointed to the YouTube channel of Dr John Campbell, a retired A&E nurse with a phd who taught student nurses in the NHS. He’s a straight-talking no-nonsense individual who is excellent at turning medical jargon into easy to understand layman’s language, complete with diagrams as necessary, and he’s been watching the upsurge of this Coronavirus since January. His video Vitamin D and Immunity is well worth a watch by anyone, as are his Reducing Fever, Good or Bad and Reducing Fever Part 2.

Social-Isolating or Self-Isolating: I am in an at-risk group and there’s no point whining about it: Hashimoto’s Hypothyroidism is an autoimmune disorder, I have high blood pressure, and my body is busy trying to make up for the inevitable blood loss incurred during my hip replacement. Being thirteen months below the arbitrary 70 years of age at risk group deemed by the UK Government will not help me at all. Therefore we have been self-isolating since I returned from hospital, and this will continue. We are also lucky enough to have Son able to shop for us. Not everyone will be in this position but we are, and we intend to do our utmost not to add to the rising strain on our National Health Service. It’s the least we can do, not just for ourselves but for everyone.

Finally, a smile: the image of the flowers which heads this post. The lilies were delivered to my house as tight buds by Hornsea Writers while I was in hospital. Over the intervening days they have slowly unfurled into these amazing multi-coloured blooms which now grace the dining table where my laptop currently sits. I only wish this were a scratch-n-sniff post as the scents are spectacular. It is like sitting among the exotic flowers of Kew Gardens. Many thanks Hornsea Writers; you are stars!

If you want to look at what Kew has to offer, visit remotely The Gardens.

Stay safe. And keep washing your hands!

When Your Health Turns On You #Hypothyroidism series:

1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube

28 February 2020

When Your Health Turns On You: #Hypothyroidism –– 5: Functional Medicine and YouTube

The backstory for those just joining me: 

During 2017 I was suffering lots of weird health symptoms, the most concerning being that my brain refused to function properly – hardly a useful trait in a novelist. April 2018 a lump developed on my neck: a swelling on my thyroid. A GP’s blood tests indicated I might develop Hypothyroidism, whereas symptoms and antibodies emphasised that I was suffering Hashimoto’s Hypothyroidism, an autoimmune disorder. I’m writing this series of posts because if you don’t recognise the signs your health could turn on you. I don’t recommend it. Read Post-1, Post-2, Post-3 and Post-4.

Note: I’m British and live in the UK. We have a National Health Service, free at the point of access, paid for via our taxes. Your mileage may differ, even if you live in the UK.

February 2020. Having joined a Vitamin D Deficiency support group, and deciding to follow its protocol of co-factors in an effort to raise my levels, there is now a 3-4 month wait before paying for a blood test to check both the Vitamin D and the Hypothyroid markers. I’ve also learned that raising Vitamin D to an optimal reading (75-150 nmol/L) may well pull up B12 levels, which wouldn’t go amiss.

Time to return to the outstanding:
    • lowish level of Zinc, ie less than a quarter up the range. [Note: see update at the bottom]
    • as I am eating the recommended good balanced diet why am I missing any nutrients?

During my research I’d come across quite a few articles calling for more nutritional education to be included in the training of UK doctors. Depending on the medical school (why isn’t there a UK standard?) it can be anywhere between 10-24 hours over five or six years training. No wonder my GP shrugged when I asked if I might have a vitamin insufficiency or an absorption problem. Add in the fact that local Clinical Commissioning Groups may refuse to fund the necessary blood tests to check, and a GP can be on a hiding to nothing even if well-read on the subject.

From my own reading it’s not much better in the United States. Except the US seems to have something which are very thin on the ground over here, Functional Medicine practitioners. These can be fully trained medical doctors, or nutritionalists, or quite often both. Their priority is not to relieve symptoms or cure, but to do this and discover the root of the problem so it can be adjusted in an effort to stop a recurrence. Many of them support YouTube channels.

Now, I’m the first to cast a wary eye over information gleaned from the Internet. After all, it’s part and parcel of being a historical novelist, never mind protecting my health. I’m particularly wary of content produced by people trying to sell me something, but when brain fog makes reading, never mind comprehending, an academic medical paper impossible, it’s less strain to assimilate information conveyed in layman's language from a scattering of sources, YouTube being one.

I’ve already recommended York Cardiology, the channel of British heart specialist Dr Sanjay Gupta. One I found fairly early in my research was American Dr Peter Osbourne, not a medical doctor, but a functional nutritionalist whose dietary specialism is gluten-free. His ten minute video Nutrition And Your Thyroid was a bit of an eye-popper, underlining much of what I was reading from UK Dr Barry Durrant-Peatfield’s book (see Post-2). If you are interested, and if you are reading this you should be, Dr Osbourne also has easy to comprehend explanations on Magnesium and Vitamin B12 Deficiency.

The other YouTube channel I now subscribe to is Dr Ken Berry, an American medical doctor with a nutritional leaning, a dry wit, and a no-nonsense approach. He also practices what he espouses. If you are looking for a diet regime he has road-tested several over the years, from Low Carb to Carnivore; currently it’s Keto. For me there are two playlists I was particularly interested in: Vitamins & Minerals and Thyroid Issues, each covering various aspects over a number of videos.

Also worth mentioning is the Vitamin D Wiki, a website founded by Henry Lahore on which he indexes articles and papers relating to Vitamin D. It’s been going ten years, looks a bit clunky, but its content is mind-boggling.

So what did I discover about that normal balanced diet that’s constantly been emphasised? For me it equates to a mainly low fat, high fibre, whole-grain, mostly white meat, fresh fish, fruit & vegetables diet. I’ve been eating it for years, but where’s the Vitamin B12 coming from? The Vitamin D? And I’m now suspecting optimal amounts of Magnesium and a host of others? I used to have regular cravings for dark chocolate and sweet stuff, which cut drastically after three months on a multi-vitamin and mineral supplement. Mmm.

As to my lowish Zinc and white blood count readings, it looks as if they go hand in hand. Zinc is a co-factor in numerous biochemical reactions, including Vitamin D and Essential Fatty Acid Omega-3 metabolism. It will be interesting to see if its level, and my white blood count levels, rise alongside Vitamin D.

So there I go. Or am going.

Yet the proof of the pudding is... how do I feel? A hellova lot better than I did. I get the occasional sore throat, the lumps on my neck make themselves felt occasionally and I suspect both have an input from the adrenals (stress) as I can feel very tired at the time this happens. Again, it will be interesting to see if this abates with a rise in my Vitamin D. If not I shall look elsewhere. There's still a lot of research to go at.

Do I mentally feel able to pick up a pen and write again? Well, I’ve written this series of articles, though if you think they’ve been written in the five days you’ve read them, let’s all have a little chuckle over that. Writing non-fiction doesn’t use the same mental muscles as writing fiction, but yes, I feel ready to roll. Except…

...except I’ve just had a pre-operative assessment for a replacement hip, due early March. Oh dear, what a shame, but does this have a bearing on anything? Aren’t hips, and knees for that matter, replaced due to “wear & tear”? 

That’s what we are always told but I’ve become suspicious of such pat answers. My mother died aged 89; she never needed a hip replacing, neither did her sisters. I’m only in my late 60s and this will be my second. Unlucky my orthopaedic surgeon suggested. And no, he wasn’t interested in hearing about my sub-clinical Hashimoto’s Hypothyroidism, but did perk up when I told him about my insufficient Vitamin D, and therefore a probability of osteoporosis, or at least its precursor osteopenia. Don’t worry, he said expansively, if your femur cracks when we do the operation we’ll put you on non weight-bearing until it’s mended. Thanks. I think.

More to the point, like a lot of people I’ve had lower back problems since my mid thirties. Perhaps I’m just reaping the warnings I, and my succession of GPs, dismissed as “pulled muscles”. Perhaps I should have continued that foul-tasting Cod Liver Oil of my 1950s childhood: Vitamin A, Vitamin D and Omega-3 anyone?

I’ll add in the occasional update post, but don’t expect one for a few months. Following the blog by email (see top of the column) will have updates delivered to your Inbox. If you found these posts informative, drop me a line in the Comments, or hit the Share buttons below. Helping spread the word may just save someone undertaking my journey. Thanks. And let's all take an interest in our own health. It may save tears later.
UPDATE: October 2020 - Information about my low-in-range Zinc level
Who would have thought I'd be grateful to USA President Trump? Having contracted Covid-19 his medications and vitamin & mineral supplements have been made public and Dr John Campbell has scrutinized the list President Trump's medications in detail. The full 40 min explanation is very interesting; Zinc is discussed 25mins in: it is the second most abundant mineral in the body (after iron), is needed in hundreds of key enzymes, and the "reading of DNA in cell make-up", yet its deficiency is a known common problem gobally. And yes, Zinc deficiency compromises the immune system. Says it all, really.

When Your Health Turns On You #Hypothyroidism series:

1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube
6: Covid-19 Coronavirus
7: Covid-19 and Vitamin D  

27 February 2020

When Your Health Turns On You: #Hypothyroidism –– 4: Vitamin Co-Factors and the Microbiome

The backstory for those just joining me:

During 2017 I was suffering lots of weird health symptoms, the most concerning being that my brain refused to function properly – hardly a useful trait in a novelist. April 2018 a lump developed on my neck: a swelling on my thyroid. A GP’s blood tests indicated I might develop Hypothyroidism, whereas symptoms and antibodies emphasised that I was suffering Hashimoto’s Hypothyroidism, an autoimmune disorder. I’m writing this series of daily posts because if you don’t recognise the signs your health could turn on you. I don’t recommend it. Read Post-1, Post-2 and Post-3.

Note: I’m British and live in the UK. We have a National Health Service, free at the point of access, paid for via our taxes. Your mileage may differ, even if you live in the UK. 

October 2019. After accepting that the National Health Service was going to step up only if and when I hit crisis point, I knew I’d have to do my own legwork, not merely table a bit of proof – in this case a below range Vitamin D reading.

Unlike many health disorders, there doesn’t seem to be a UK charity dedicated to Vitamin D, except for children (diagnosis of Rickets is on the increase; Osteomalacia is the term used in adults). Canada isn’t so reticent. Its The VitaminD Society states: 97 percent of Canadians are vitamin D deficient at some point in the year… Its short intro page makes interesting reading. Bear in mind that London is further north than the main cities of Canada.

The UK might not have a dedicated Vitamin D charity, but Vitamin D insufficiency and deficiency scores highly among other health charities: lupus, multiple sclerosis, rheumatoid arthritis, fibromyalgia… yes, all the ones I noted in Post-3 as autoimmune disorders. That smoking gun continued to smoke.

While I trawled through the many blood tests available on Medichecks, I kept in mind my original considerations:

  • If my body was missing Selenium, and now Vitamin D, what other minerals and vitamins is it missing?
  • As I eat the recommended “good balanced diet”, why was my body missing any?

Vitamins and minerals are mostly drawn from our food in the stomach via Intrinsic Factor – most notably Vitamin B12 – and during transit through the small intestines. Did I have an absorption problem? There might also be a question over Cortisol, the fight or flight hormonal system. It plays a significant part in a person’s metabolism and when it isn’t functioning properly it puts stress on the thyroid. I added an Essential Fatty Acids Omega 6:3 ratio test to my choices. These are called ‘Essential’ because they have active roles in a person’s metabolism yet can’t be produced in the body.

I wasn’t looking for a smoking gun this time, but eliminating other possibilities. Most of these tests are not available on the NHS via a GP, only via a Consultant Endocrinologist. I didn’t want to wait months for a referral, even if I was allowed one. If I paid for a private consultation the fee would likely be more than for the tests, and I’d still have to pay for those.

The basic Cortisol – four saliva tests in a day – returned well within ranges (good); there were no Intrinsic Factor antibodies (brilliant); Zinc, which had been included in a test bundle, was low in its range so I needed to bear this in mind; Essential Fatty Acid Omega 3:6 ratio was 1:12 despite my good balanced diet (oh dear); and the Thyroid tests were all pulling back (fantastic).

Yet again, the big one was Vitamin D. Despite my being on 40mcg (about 1600iu – international units) a day for the previous three months, its test number had risen only five points bringing the result just inside the edge of the lower range. Something was definitely wrong. Time to find a support group specialising in Vitamin D deficiency and learn from the experience of members.

January 2020. With Christmas-3 behind me I got down to it. Facebook again provided a choice. I looked at a few but it was 'Vitamin D and Co-Factors UK' which drew my attention, initially due to ‘co-factors’ being in its title.

I’d learned a bit about co-factors. The absorption potential (bioavailability) of Iron is enhanced by Vitamin C, even a glass of orange juice will do. Vitamin B12 has a symbiotic relationship with Folate. If they are out of balance neither work as they should. The body is a complex organism and these explanations highly generalised, but they illustrate the concept.

Some co-factors aren’t so specialised. Magnesium plays a part in 300+ biochemical interactions, including helping regulate calcium and insulin levels, blood pressure and the cardiovascular system, the nervous system, Vitamin D levels... basically, we need it. However, as with Vitamin D, there is considered to be widespread insufficiency, even deficiency, in the population.

During my reading I’d come across various articles suggesting one cause for the lack in the population being that intensive farming was depleting the nutrient, and others, from the land and therefore from food crops, but it was a video from York Cardiology Why Magnesium is So Good For Us which finally made me take notice.

York Cardiology is a YouTube channel run by UK heart specialist Dr Sanjay Gupta who takes time to explain conditions within his remit and the steps people can take to help themselves. If you suffer from any form of cardiovascular problem I suggest you take a look at his playlists. His short video on Hypothyroidism and the Heart is interesting, to say the least.

So did I need to take co-factors with an increased Vitamin D supplement? The answer seemed to be yes, which may come as a surprise to the endocrinologists who gaily prescribe large or even very large amounts of Vitamin D3 alone. (There are various types of Vitamin D; D3 is the easiest to absorb.)

One of the consequences of increasing Vitamin D to an “optimal” level (75-150 nmol/L) as opposed to being just “in range” at 50, is that it enhances absorption of Calcium – the reason it is prescribed to combat osteoporosis. The problem is Calcium and Magnesium work as buddies, so a substantial increase in Calcium needs extra Magnesium as a co-factor to help maintain their balance.

However, unless the rise in Calcium is guided it has a tendency to spread itself into places such as arteries, musculature, joints, and the kidneys. Think of it as limescale in a kettle. Kidney stones, anyone? Having enough to cope with, I’d rather not, thanks.

The co-factors suggested from group experience are Ionic Magnesium to balance the increase in Calcium, Vitamin K2-Mk7 to guide the increase in Calcium to the bones and teeth or the unused to be excreted, and Boron to enhance absorption of both the Vitamin D3 and Magnesium. For these to work optimally together they cannot be taken ad hoc but in a specific ratio. As with all supplementation, as long as no adverse side effects prompt a re-think, results can take three or four months to start to manifest. I’ll post how I get on.

Other Vitamin D support groups will advise slightly differently, dependent on their members’ needs and experiences. Many in my chosen support group also have thyroid disorders, so I feel the match is liable to be good.

Early February 2020. A major aspect coming from my ongoing research has been the importance of a healthy gut system, otherwise known as the Microbiome. Evidently we have between 300 and 1000 different species made up of viruses, fungi, yeasts and organisms. Not only do they help protect us from pathogens, but they aid food digestion, activate freed vitamins and minerals, and interact with the brain and the immune system (oh yes?). We need them all, but in the correct balance.

And herein lies the rub. Even a good balanced diet has a surfeit of sugars (think fresh fruit) and yeasts (think cereal-based carbohydrates). This is the starter kit to any fermenting system.  I find it interesting that sufferers of Irritable Bowel Syndrome, Crohn’s and Coeliac diseases, find respite in gluten-free or even full cereal-free diets. It is a suggestion often made to those with Hashimoto’s Hypothyroidism when options attempting to alleviate symptoms start to run low. All are autoimmune disorders and all show low Magnesium and Vitamin D levels. Add in daily ingested prescription drugs, and over-the-counter medications, to say nothing of the occasional nuclear-blast of antibiotics, and the surprise is that so many of us function well at all.

Can probiotics help? Yes, but three or four strains in a yoghurt-based culture can seem like a drop in the ocean. Multi-strain bacteria in freeze-dried capsule form, which I am currently trying, are available at a price. Kimchi, or unpasteurised Sauerkraut, may well prove a cost-effective alternative if it's available. After all, Hippocrates swore by the stuff. I may be inclined to argue with a modern endocrinologist, but not with the Ancient Greek 'Father of Medicine'.

When Your Health Turns On You #Hypothyroidism series:

1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube
6: Covid-19 Coronavirus 
7: Covid-19 and Vitamin D 

26 February 2020

When Your Health Turns On You: #Hypothyroidism –– 3: Blood Tests

The backstory for those just joining me: 
During 2017 I was suffering lots of weird health symptoms, the most concerning being that my brain refused to function properly – hardly a useful trait in a novelist. April 2018 a lump developed on my neck: a swelling on my thyroid. A GP’s blood tests indicated I might develop Hypothyroidism, whereas symptoms and antibodies emphasised that I was suffering Hashimoto’s Hypothyroidism, an autoimmune disorder. I’m writing this series of daily posts because if you don’t recognise the signs your health could turn on you. I don’t recommend it. Read Post-1 and Post-2.

Note: I’m British and live in the UK. We have a National Health Service, free at the point of access, paid for via our taxes. Your mileage may differ, even if you live in the UK.

Late April 2019 After GP-3 refused my request to check the levels of my Vitamin B12, Folate, Ferritin (iron storage) and Vitamin D, I did what many on the Hypothyroid-UK support group had done before me: I opened an account with Medichecks, a company based in the UK which offers private blood tests. It took a good half morning to complete its medical questionnaire, which impressed me.

I chose it (there are others) because of its easy to understand guides, articles, and especially explanations of what a high or low result might mean of any particular blood test. Some tests offered are covered by the NHS via a GP – Full Blood Count, Urea & Electrolytes, Lipid panel. As I began to acquire printouts of past test results via the GP, I created a table using the explanatory information from Medichecks to interpret what I was reading.

One thing became apparent almost immediately, many of my white cell counts were low within their ranges, and had been for some considerable time. Many of these rise significantly when the body is fighting an infection, but how low is depleted and how low is optimal? This question I kept on the back-burner.

I had the results of my last four blood tests:
April-18 when I’d first presented with the swelling on my neck and was hardly able to string a phrase together;
Aug-18 after I’d been eating Brazil and almond nuts for three months and felt so much better;
Nov-18 a routine annual check-up; 
May-19 when I’d been taking the vitamin & mineral supplement for three months, plus a month without them to clear my system of excess.

To my surprise, despite the huge differences in how I’d felt, there was hardly any difference between the dated results. As I maintain in previous posts, a person can be very ill but blood tests can return “within range”.

May 2019. Each Thursday is Thyroid-Thursday at Medichecks, when one of its listed Thyroid tests is discounted [Update: now occasionally, not every week]. This alone should give an indication of how many people in the UK use it, or perhaps I should say, need to use it. I’d chosen Thyroid Check UltraVit [Update: now called Advanced Thyroid Function Blood Test], a panel of the three main thyroid tests (TSH, FT4, FT3), its two antibody tests, an overall inflammation marker, and the default vitamin and mineral panel (Vitamin B12, Folate, Ferritin (iron storage) and Vitamin D). As luck would have it, that test was on offer. As this was my first experience I also paid for a nurse to come to the house to take the blood intravenously. I could have attended an associated clinic in my nearest city for slightly less. [Update: it's dead easy to do a finger-prick test, which is what I now use.]

As soon as my order was placed the company’s system fired up: first acknowledgement and information emails then a phone call from the agency matching nurse to client. Next day a small package was delivered containing everything the nurse would need plus detailed how-it’s-done information for me. The nurse arrived on the agreed day at the appointed time, and fifteen minutes later I was dropping the package into the postbox back to Medichecks. Next day I received email confirmation of arrival, the day after that notification that my results were ready to view on my personal dashboard, complete with a doctor’s assessment and recommendations. Yes, I was impressed again.

Despite slightly different ranges being used to those of the GP’s tests I was pleased to see that my thyroid results, the antibodies, and the inflammation marker, were holding steady. There may have been no drop, but at least there had been no significant increases.

The vitamin and minerals were a different matter: Ferritin (iron storage) was halfway up the range, Folate nearly two-thirds up, Vitamin B12 only a third up, and Vitamin D was just in the danger zone at 48 (range 50-175). The multi-vitamin & mineral I’d been taking for three months included 15mcg (micrograms) of Vitamin D. What on earth had been its reading in April-18 when I seriously couldn’t function? I knew from the Hypothyroid-UK support group, that each vitamin in this panel needs to be above halfway, that the optimal for Vitamin D needed to be above 75, preferably closer to 125. Had I found the smoking gun?

In the accompanying report the Medichecks’ overseeing doctor advised upping the Vitamin D supplement to 40-50mcg per day, re-testing in three months, and if it had risen enough dropping the dosage to the NICE recommended maintenance of 10mcg per day.

Er… pardon? What NICE recommended maintenance was this? Back to searching the internet. And there it was, hidden way down in Public Health Guideline 56 “Vitamin D: supplement use in specific population groups”; under 7: Glossary; under: Reference Nutrient Intake:

10 micrograms of vitamin D per day, throughout the year,
for everyone in the general population aged 4 years and older.

When had this ever been mentioned during my annual check-ups? Never. Was there a poster to this effect displayed among the many in the medical centre’s waiting room? No. I checked the town’s pharmacies: only one displayed a notice to this effect and the next time I visited it had been removed.

To say I was indignant is putting it mildly. So much for the oft-repeated mantra If you eat a balanced diet there’s no need for supplements. The UK’s National Health Service is groaning beneath the demand placed upon it. How much of that demand could be assuaged if the population was advised correctly? I had lost over a year of my working life because the people into whose hands I placed my continued health were ignoring the basics. Alas, I was soon to learn this was merely the tip of the iceberg.

I decided to continue for a further three months the multi-vitamin & mineral supplement, and added a named 25mcg Vitamin D3 supplement, also available over-the-counter. This brought my Vitamin D intake up to 40mcg a day, about 1600iu (international units).

Note: My ongoing research was showing that not all supplements are created equal; cheaper ones tend to use more binding fillers, hence again choosing a named brand. Individual vitamins and minerals aren’t created equal either. Vitamin D comes as two main types: Vitamin D2 (Ergocalciferol – derived from plants) and Vitamin D3 (Cholecalciferol – derived from animals). The former is cheaper and tends to be used in a mixed supplement, the latter is more easily absorbed by the human body, which itself makes D3 from cholesterol under the skin, if we get enough sunlight – which is why it is considered the “sunshine vitamin”, despite it not being an actual “vitamin” [don’t go there, Linda].  Alas, living in the northern latitudes, coupled with our home>car>work>home routine, a substantial percentage of the population is thought to be low, insufficient, or deficient in Vitamin D. 

I went hunting for Vitamin D in food, and that mantra of if you eat a balanced diet... looked ever more shaky. I dumped our rather sterile breakfasts for fortified cereals; the spreads ‘for reducing cholesterol’ for natural butter; the lower fat semi-skimmed milk for full-fat milk, and reintroduced red meat to the family’s diet to increase the consumption of both Vitamin D and Vitamin B12. Oily fish, such as mackerel, salmon, and tuna, was already part of the family’s menu, as are masses of greens.

I also took the arbitrary decision after a year of eating them, to drop the number of Brazil and almond nuts (taken for their massive amount of Selenium – see Post 2) from six per day to four to see if it would make a difference to how I felt [Answer: not that I have noticed to date].

End July 2019. Spending more of early summer outside, working mostly on our fruit and vegetable plot, I was feeling more energised and was able to do more. The need to doze during the day had totally left me and I was dismayed by how bad I’d been and thought it normal.

End of August 2019. I finished the three months and came off all supplements apart from the four Brazil and almond nuts. I wanted to leave it for a month then have my bloods retested. Vitamin B12 supplementation (from the multi-vitamin & mineral) stays a long time in the body, and the month lay-off was mostly to allow the excess to dissipate so I could gain a semi-reliable result. In truth, three to four months should be allowed, but I had no intention of staying off my other supplements for that long. Good decision.

September 2019. I felt as if I was winding down, and was definitely tired if I pushed myself. The skin on my lower legs and feet was drying out again, I had re-developed a continuous nasal mucus I’d forgotten about, and the lump on my thyroid, the size of a large egg split lengthways, quiet for so long, was making itself felt.

If the swelling was fairly flat I suffered a sore throat; if it enlarged the sore throat disappeared. Then chatting with friends over dinner one evening my throat became noticeably sore and then lumpy on the opposite side to my swelling, as well as across the front of my throat. My voice turned gravelly, and as I attempted to eat it felt as if a wedge was obstructing the oesophagus. Not nice. In fact, damned alarming. Cancer of the thyroid loomed menacingly in the background. It took two days to calm, but didn’t feel right. I made an appointment with my GP.

GP-1 listened carefully but I received a refusal when I asked for a further ultrasound scan, despite it being 17 months since the original. Only a consultant could request a second ultrasound, and I wasn’t bad enough to be referred to a consultant. Was I supposed to wait until I couldn’t swallow?! This elicited a shrug.

The report from the original ultrasound was brought up on-screen and it was then I learned that I don’t have a swelling on my thyroid, I have two swellings, one on each lobe.  Despite the casual dismissal by the ultrasound operative as… It’s nothing to worry about. Lots of ladies get them… I discovered I have two degenerative BTA U2 nodules, the largest measuring 41x29x25mm – at least that was the measurement 17 months ago. A U2 nodule is considered benign, ie non-cancerous. This somewhat startling information is why everyone should request printouts of all tests, not just blood results.

Perhaps I looked shell-shocked, for GP-1 quietly put the implications into perspective: as the degeneration progressed I’d need to be medicated with Levothyroxine – for life. I belonged to a support group of over 7,000 UK members, most of whom were being medicated with Levothyroxine. They weren’t members because the drug worked, they were members because they had no option but to take it and their quality of life was somewhere between sub-optimal and purgatory. Over the last 17 months I seemed to have come full circle: this was not a plan I intended to sign up to.

I dropped my colour printout of the Medichecks results on the desk, drawing particular attention to the low Vitamin D reading: that probably means I’m heading for osteoporosis. My assertion wasn’t disputed. I’d paid for one set of tests and proved my deficiency; I explained the increase in supplementation, stated the NHS guidelines, and asked for the NHS to do a retest to see if my course of action was having the desired effect.

It was then I discovered that the “postcode lottery”, where the prescribing of some expensive drugs for life-limiting conditions depends on where the patient resides, also extends to more routine blood tests. My cousin, living in the Midlands, was given a Vitamin D test as part of the Full Blood Count, but in my Clinical Commissioning Group area it is part of a cascade system, where if the first test returns “within range” – in this case TSH (Thyroid Stimulating Hormone released by the pituitary gland) – the laboratory is under obligation to refuse the subsequent tests in the cascade. So much for a National Health Service. Despite this, GP-1 agreed to try.

October 2019. I collected the requested printouts of results from the medical centre and opened the envelope in reception. Just as I’d been warned the tests had fallen foul of the cascade system. Not only that, of those done Ferritin and Folate had no ranges, just a number (making it meaningless), and Vitamin B12 was a Total Serum test not the more specific Active test (explanation via Thyroid-UK). However, it was the Vitamin D result which took the prize: “Normal. No Action Required. Not Tested”.

I laughed out loud. So much for relying on NHS blood tests. As soon as I arrived home I logged onto Medichecks, determined to hit this, once and for all.

When Your Health Turns On You #Hypothyroidism series:

1: Symptoms
2: Vitamins & Minerals
3: Blood Tests
4: Vitamin Co-Factors & the Microbiome
5: Functional Medicine & YouTube