Pernicious Anaemia Society

Help with vitamin results please

Hi I am 12 months diagnosed with hypothyroid and finally near getting my levels sorted, however I think I may have a bit of a conversion issue, as my thyroid hormones are out of balance with a TSH that low and FT4 that high I would have expected a much higher FT3 too. I have just had a thyroid and essential vits checked and was pointed in direction of PA forum for some vitamin advice:

TSH - 0.051 (0.27-4.2)

FT4 - 21.85 (12-22)

FT3 - 4.8 (3.1-6.8)

B12 - 164 (140-724) pmol/l

Folate - 6.54 (3.89-26.8) ug/l

25(OH)D - 15.24 (50-200) nmol/l

Ferritin - 141.2 (13-150) ug/l

My GP is very good and willing to accept medichecks results for FT3 and willing to leave levo alone til we sort out vits. I know the loading and maintenance doses for vit D. ferritin is already high in range. I believe B12 needs to be at least 500 and preferably near top end of range and folate should be middle of range to achieve good FT4 conversion but dont know what that means from a dosing point of view, both loading and maintenance.

I have been taking a decent multivit (allegedly with 100% of daily need), a cod liver oil, an evening primrose oil and a 'high strength' glucosamine + vit c daily but only since new year.

I have had terrible trouble with reflux and indigestion which is improving now we are getting to grips with thyroid but suspect it has been causing absorption issues ☹️☹️

3 Replies

Serum B12 isn't a good test to use as the only marker for B12 deficiency - people vary a lot in how much B12 they need in their blood for enough to be getting through to the cells where it is used - so the normal range will result in missing about 25% of people who are deficient, but also picking up 5% who aren't if it is used as a single measure.

The question is really whether you are symptomatic of a B12 deficiency or not - though that is quite a difficult question to answer if you also have thyroid problems as there is a huge overlap in symptoms. If you are feeling okay on the thyroid medication you are on at the moment then the level reported is probably okay for you so no need to supplement - if not then it may or may not be an issue.

You can find a checklist of symptoms of B12 deficiency in the pinned posts on the PASoc forum - along with guidance on other checks that can clarify the situation - if you look through the posts on the forum

if you are vegetarian or eat very little meat/fish/egg/cheese then you need to supplement as B12 is only found in animal products - but you can do this with a multivitamin from the chemist - containing a few mcg of B12 (RDA 2.4mcg in US and lower in the UK)

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I was treated for B12 deficiency when my level was 176. Do you have symptoms? Your folate and VitD look low too. Unfortunately, those of us with one autoimmune problem often have others. They like to come along in groups!

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With your reflux problem you may wish to try some HCL with pepsin before meals. I had a terrible problem with it until my nutritionist said to take it. Without adequate stomach acid, b12 absorption is limited. There are other things to do such as apple cider vinegar but I am not fond of that.

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