B12 Ferritin and Folate: Hi everyone, Can anyone... - Thyroid UK

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B12 Ferritin and Folate

Marigold57 profile image
15 Replies

Hi everyone,

Can anyone help me to interpret my latest Medichecks results. I did Active B12, Ferritin and Folate as recommended on here due to my thyroid results being on the low side. I will repost thyroid again to help and the others below.

ENDOCRINOLOGY

Thyroid Function

THYROID STIMULATING HORMONE 0.995 mIU/L (0.27 - 4.20)

FREE THYROXINE 14.6 pmol/L (12.00 - 22.00 )

TOTAL THYROXINE(T4) 77.1 nmol/L (59.00 - 154.00)

FREE T3 3.96 pmol/L (3.10 - 6.80)

THYROGLOBULIN ANTIBODY 19.300 IU/mL (0.00 - 115.00)

THYROID PEROXIDASE ANTIBODIES 22.9 IU/mL ( 0.00 - 34.00)

HAEMATOLOGY

Vitamins

ACTIVE B12 56.700 pmol/L (25.10 - 165.00)

FOLATE (SERUM) 6.73 ug/L ( 2.91 - 50.00)

BIOCHEMISTRY

Iron Status

FERRITIN 33.1 ug/L (13.00 - 150.00 )

Also does anyone know what the B12 really means as I am used to thinking of the old measurements where 500 is optimal.

All my results seem on the low side which figures as I have CFS/ME and have been sick for over 20 years. I am also a lifelong vegetarian. Should I be supplementing b vitamins or iron?

Vitamin D tests due in this week. So I will publish them when I get them.

Thank you all for you help. it is appreciated so much.

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SeasideSusie profile image
SeasideSusieRemembering

Article about Active B12 viapath.co.uk/our-tests/act... - according to that a level above 70 is preferable.

With Serum B12, 500 isn't exactly optimal. An extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

The top end of the range is preferable for serum B12.

FERRITIN 33.1 ug/L (13.00 - 150.00 ) - this needs to be at least 70 for thyroid hormone to work. I don't advise on iron supplements as there's much more to iron than just Ferritin. I only every suggest eating liver but I realise that is not something you can do as a vegan.

FOLATE (SERUM) 6.73 ug/L ( 2.91 - 50.00) Folate should be at last half way through it's range. Eating leafy greens can help raise folate but a good B Complex is probably best with such a low level. I would recommend Thorne Basic B.

Marigold57 profile image
Marigold57 in reply toSeasideSusie

Just a note to say thank you so much for your very kind reply which is appreciated so much.I will do as you suggest and take some B supplements.

Marigold57 profile image
Marigold57 in reply toMarigold57

Also Seaside Susie can you say how long to take the Thorne Basic B for as I am quite reluctant to take overdoses of vitamins- would you say a couple of months and then go onto a more normal dose like the one offered by Vitabiotics for example? I read in a British Dietetic Association leaflet on Folate that you shouldn't take too much if you are over 50 as it can increase the chance of bowel cancer.bda.uk.com/foodfacts/FolicA...

I am just thinking with my low levels that I need to get them up with diet and supplements quickly. What would you recommend about Ferritin?

Marigold57 profile image
Marigold57 in reply toSeasideSusie

Hi Seaside Susie - do you have any idea how long to take these Thorne Basic B for before retesting levels? Also my vitamin D was 27.9 - not good either any suggestions there? Would you think getting all these levels up will help me to convert T4 to T3 as this seems to be the problem in the bloods I have so far. When would you retest thyroid?

SeasideSusie profile image
SeasideSusieRemembering in reply toMarigold57

Hi Marigold

I would give it 3 months. My folate went from bottom of range to top of range in 2.5 months taking 1 x Basic B a day, so you should see a difference in 3 months. I wouldn't take Vitabiotics B Complex personally, I don't think they're good quality, the B12 is cynacobalamin not methylcobalamin and the folate is folic acid not methylfolate, the list of excipients and fillers is excessive.

The article you are referring to about too much folate says

Also some research suggests that folic acid at doses greater than 1 mg/day may increase the risk of developing colorectal cancer in people with a history of colorectal cancer or in older people.

Thorne Basic B contains 400mcg methylfolate so way off the dose suggested to cause colorectal cancer. Once I reached the optimal level I have kept it in range by sticking to Thorne Basic B but taking it 4 or 5 days a week rather than 7 days a week.

**

vitamin D was 27.9

Assuming that is nmol/L (and not ng/ml) then you might want to speak to your GP as it is within the NICE recommendation for loading doses NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

If your GP wont prescribe the loading doses then I would suggest you do the equivalent yourself by taking 10,000iu daily for 4 weeks (280,000iu) then reducing to 5000iu and retesting 3 months after starting the supplement.

You don't appear to have Hashi's so you should be fine with a D3 softgel such as Doctor's Best or Now Foods, both only contain D3 and olive oil for absorption. If you had Hashi's then an oral spray would be best for better absorption.

There are important cofactors needed when taking D3

vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds

naturalnews.com/046401_magn...

Check out the other cofactors too.

**

Optimal levels of vitamins and minerals all help, ferritin being most important to be at least 70 for conversion, and supplementing with selenium l-selenomethionine helps conversion.

I don't think there's much point in retesting thyroid for a few months. If you want to retest vitamins and minerals in 3 months then the best value is the Medichecks UltraVit bundle anyway and that will include the thyroid panel.

Marigold57 profile image
Marigold57 in reply toSeasideSusie

I just want to thank you with all my heart for this help which is absolutely fantastic. One final question do you think I have hypothyroidism given my low T3 or simply a conversion issue due to the low vitamins which will correct itself. Also although I am not Hashi's my TPO antibody levels are 2/3 of the upper end of normal 22.9 IU/mL ( 0.00 - 34.00) do you think that is a cause for concern? In ME/CFS relapses my temp drops to 35.5 but my normal is rarely over 36.2.

SeasideSusie profile image
SeasideSusieRemembering in reply toMarigold57

I think what I would do in our circumstances is maybe repeat the thyroid test in 3 months (do the UltraVit bundle again). You will then get your current nutrient status and you can see if your antibodies have changed at all. I'm not Hashi's and I've had my antibodies tested about half a dozen times over the years, they are always around 12 or less so I am confident that I don't have Hashi's. As your TPO Abs are higher in range it will be worth checking them again, one negative doesn't rule out Hashi's.

You can also see your thyroid levels and see if they are the same. Low TSH and low free Ts can indicate central hypothyroidism which is where the problem lies with the pituitary or hypothalamus. We can look into that further if necessary next time, it's not very common so many doctors haven't a clue about it.

Marigold57 profile image
Marigold57 in reply toSeasideSusie

Many thanks,

Yes hypothalamus issues are what I suspect as I also have autonomic dysfunction, breathing difficulties at night and many things that are related to HPA axis. Dr Myhill the CFS/ME expert always finds patients with T4 in lower ranges according to her website. It will be interesting to see if my T3 improves on the vitamin regime. Hopefully this dialogue between us will help someone else in my boat so thank you so much.x

SeasideSusie profile image
SeasideSusieRemembering in reply toMarigold57

You're welcome :)

Marigold57 profile image
Marigold57 in reply toSeasideSusie

Also I wanted to say I hope you are doing well yourself.x

SlowDragon profile image
SlowDragonAdministrator

Your Thyroid levels are on low side. But I guess you know that.

Marigold57 profile image
Marigold57

Hi SlowDragon- yes I know and thank you so much for answering my post it is appreciated so much. I am trying to do something proactive about it, as with these results my GP isn't going to be interested in giving me anything for the thyroid yet! I am going to supplement Vit B complex - have just ordered those recommended by SeasideSusie and will then retest in the summer. Also waiting for my vitamin D test results. Do you think I am doing all I can?

Gambit62 profile image
Gambit62

your active B12 is well into the range so shouldn't be a problem.

Are you symptomatic?

Active B12 generally accounts for 20% of the B12 in your blood.

Marigold57 profile image
Marigold57

Hi Gambit62. Many thanks for your reply it is so kind of you and I appreciate it so much. That is very interesting, so are you saying my B12 in the old scheme of things would be about 280 then ie 5 times as much as the active level reported of 56.7?

As regards symptoms it is difficult as I have CFS/ME, so many of my symptoms are things you see in low thyroid like low body temperature, extreme tiredness, autonomic dysfunction etc affect me due to my illness. The ME association now advises folk with the disease to keep a regular check on their thyroid function. ME also causes low cortisol which I am sure is significant. They often see values for all the thyroid tests at a low normal level so no surprise with my results.

Marigold57 profile image
Marigold57

Ok so vitamin D results are in and I am deficient at 27.9 nmol/L. Any ideas how this would affect the thyroid and recommended dose to correct this please?

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