Blood test results.

[v6mikey1]

Hi. I have been advised to come over here from the thyroid forum to show my results from Medichecks.

Along with my thyroid results they checked my B12, Folate, Vit D and Ferritin. Results are.

B12 45 range 140 - 724

Folate 3.08 range 3.89 - 26.8

Vit D 14.98 range 50 - 200

Ferritin 56.71 range 30 - 400

My GP is currently upping my thyroxine to keep my TSH down, but she hasn't done any other test other than TSH and T4.

Any advice would be much appreciated.

[Polaris]

Your B12 is extremely low v6mikey1.....

BCSH guidelines also state you are at higher risk of PA/B12 deficiency if you have Hashimoto's thyroid disease and, although many symptoms overlap, reading through your past posts, I note you have also been experiencing neurological symptoms of memory loss and brain fog. Therefore, this v. low B12 and folate result, plus any other neurological symptoms you may have from reading the list of symptoms in the *B12def. link given at the bottom of page, should be treated urgently according to the UKNEQAS guidelines:

ukneqas-haematinics.org.uk/... :

“In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed. Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord."

...........

Not to treat urgently and adequately according to BNF guidelines and latest BMJ research document ** 'until no further improvement' would be risking irreversible neurological damage:

"the expert consensus for standard treatment in the United Kingdom is to begin parenteral treatment with intramuscular hydroxocobalamin. This bypasses the possibility of the debate about whether the treatment will be adequately taken, absorbed, and metabolised.

Standard initial treatment for patients without neurological involvement is 1000 μg intramuscularly three times a week for two weeks. ** If there are neurological symptoms then 1000 μg intramuscularly on alternate days should be continued for up to three weeks or until there is no further improvement. In irreversible cases, for example, pernicious anaemia should be continue d for life."

cmim.org/pdf2014/funcion.ph...

The above latest BMJ UK research document is supported by many research papers:

"Summary points:

Vitamin B12 deficiency is a common but serious condition

Clinical presentation may not be obvious thus leading to complex issues around diagnosis and treatment

There is no ideal test to define deficiency and therefore the clinical condition of patients is of the utmost importance

There is evidence that new techniques such as the measurement of holotranscobalamin and methylmalonic acid levels seem useful in more accurately defining deficiency

If the clinical features suggest deficiency then it is important to treat patients to avoid neurological impairment even if there may be discordance between the results and clinical features"

.......

* b12deficiency.info/signs-an...

b12deficiency.info/b12-writ... Templates for writing to GP and an excellent film)

Very best wishes

PS More information in pinned posts on right hand side of the forum.

[v6mikey1 in reply to Polaris]

Thanks for your reply Polaris. Lots of reading and more stuff to worry about!

[Polaris in reply to v6mikey1]

So sorry Mikey but the good news, as the Dutch link in the pinned posts shows, is that with good treatment, people do recover. Come back here if you have any problem with getting treatment as many can give advice on self injecting.

"Most importantly, with a rapid diagnosis and treatment, irreparable damage from a B12 deficiency, with unnecessary remaining symptoms, can be prevented in a simple manner."

Good luck.

[jpar]

I too have Hashimotos thyroiditis and I have to say to be careful raising your thyroid for these symptoms. Any thyroid meds revs up your system and actually causes more stress to the system. B vitamins are used up faster when you have too much thyroid hormone and can go to an hyper state with extra thyroid. I think getting the vitamin b12, iron, etc levels up as soon as possible will start helping your body. That is what I'm experiencing now. Hope this helps.

[v6mikey1 in reply to jpar]

Hi jpar, my results on the thyroid forum shows negative for Hashimotos. The doctor is raising my levo in line with my TSH level at the moment.

It's all a bit difficult knowing what is causing what at the moment.

To be honest, I was just expecting my results to come back showing a poor conversion to T3 therefore me maybe needing to take T3 or ndt.

This b12 result and reading all about pernicious anemia has floored me!

[Gambit62 Administrator]

Is your B12 level correct. If so it is an exceptional low reading and your GP should definitely be acting on it.

Even if it is a typo and should be 145 that would be a low reading -

[v6mikey1 in reply to Gambit62]

Hi Gambit62, yes 45 is correct, according to Medichecks. Hopefully should have another test next week at my doctors.

[Gambit62 Administrator in reply to v6mikey1]

possible that it might be a sample error - its the sort of result I really wouldn't expect to see in someone who isn't showing very serious signs of B12 deficiency.

[v6mikey1]

Well I managed to get my gp to test b12 and their results were

207ng/L Range 170-730. This test was taken 2 weeks after my first test.

The gp went onto say that the lab at the local hospital that they use has had some strange consistency recently! What the hell! She will restest again in a few weeks, but it is within range.

Anyway, I have a good idea what has happened between the first and second result. Up to the first test I was drinking red wine quite heavily, after that result I cut back massively. I have read that alcohol will reduce your b12. I have since started taking b12 supplements and feel a lot better.

Thanks for everyone's help.