Please help - not sure how to proceed following blood results

[CB1990]

Hi there,

I have had hypothyroid symptoms for years, requested 3 blood tests over the last approx 7 years but was told that I was borderline and therefore treatment was not required. I ordered myself a comprehensive private blood test and these are the results:

TSH - 6.9 (Range 0.27-4.20)

Free Thyroxine - 10.26 (Range 12.00-22.00)

T4 - 64.8 (Range 59.00-154.00)

Free T3 - 4.34 (Range 3.10-6.80)

Thyroglobulin Antibody - 437.900 (Range 0.00-115.00)

Thyroid Peroxidase Antibodies - 442.3 (Range 0.00-34.00)

Vitamin B12 - 88 (Range 140.00-724.00)

Folate (Serum) - 3.3 (Range 3.89-26.80)

CRP - 0.4 (Range 0.00-5.00)

Ferritin - 60.67 (Range 13.00-150.00)

My doctor put me on 25mg of Thyroxine and referred me to an Endocronologist but my appointment isn't until May. As for the B12 the doctor said I should have a course of treatment but that I should get my folic acid levels up to normal (5mg per day for a month) before commencing B12 injections because the B12 depletes the folate supply? I've since been told this may not be quite right. I've been taking folic acid for 3 weeks now and my B12 injections begin Monday, 3 times a week for 2 weeks.

Is this correct? Can anyone interpret these results? My symptoms include tiredness and lethargy, coldness, brain fog and difficulty concentrating as well as general social withdrawal. I should also add that I am vegetarian, and have been for 16 years.

Any advice, suggestions or just shared experiences appreciated. Thank you very much in advance.

[clivealive Forum Support]

Hi CB1990 I'm not medically trained but ideally it's probably best to have your B12 injections before supplementing with folic acid but as you say you start injections next week.

There are others on here who will be able to give you good advice so come back if you have any more questions.

I wish you well

[Gambit62 Administrator]

Ideally B12 treatment should start 24-48 hours before treating a folate deficiency as there is a very very very small risk of nerve damage if high dose folate is administered before B12. The number of reported instances where this has happened is very low - fingers of one hand - so emphasising it is a small risk but nevertheless it is a risk. However, I think that if you were going to be affected you would already have been affected so not something to worry about now.

Going forward you do need to keep your folate levels up in order to be able to use the B12 from the treatment - as the two are used together for a lot of the key processes

I can't comment on the thyroid tests - and assuming that these were covered in responses to your post on TUK.

Have you been tested for PA? - though IFA test is problematic as a negative is a long way from proving that you don't have PA. There are a number of possible causes of B12 absorption problems - some are treatable and others can have other medical consequences so its useful to know what did cause you to become deficient.

Possible causes of absorption problems include: PA, coeliacs, crohn's, a whole raft of drug interactions, h pylori.