I feel like I am falling apart and I am a 29 year old female.
Symptoms are tiredness, difficulty with sleep, dry eyes, hair loss, anxiety, feeling cold, pins and needles, weight loss but most recently easy weight gain, breathlessness, heavy periods. Taking 800iu D3. Any advice would be appreciated.
May-2017
Ferritin - 21 (30 - 400)
Folate - 2.3 (2.5 - 19.5)
Vitamin B12 - 134 (180 - 900)
Written by
808j
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So sorry that you are feeling so badly. I see you have had labs done; What has your Dr. Diagnosed you with? I would strongly strongly suggest you be checked for Hashimoto's. I know. I know when you feel so bad it is hard to see light at the end of the tunnel but hang in there. You can feel better. It takes digging and time but there is certainly hope.
You have the symptoms of B12/folate deficiency. You have low serum levels of B12, folate and iron. You need to see a doctor and get treated.
You should be on a course of B12 injections. According to the British National Formulary (BNF - your doc will have a copy) the treatment for those with neurological symptoms (anxiety, pins and needles) is:
Injections every other day until there is no further improvement in symptoms, followed by one injection every 8 weeks.
You should also be on folic acid supplements. I would ask to be prescribed 5mg tablets, once per day, for a month to get levels up. Then take 400ug a day bought from a supermarket.
You also need iron supplements. Try to get something other than iron sulfate as that is not easily absorbed.
Your B12 result is very low 808J, as is ferritin and folate, so it's no wonder you're feeling so poorly. I'm wondering whether your GP is treating as per the BNF (in the BCSH guidelines) for neurological symptoms - without delay.
It could also be that you have an absorption problem and need to be referred to a gastroenterologist. Autoimmune thyroid disease symptoms often overlap so I agree with the above suggestion that your thyroid should be checked to rule out Hashimoto's (TSH, FT4 and FT3 and Thyroid Anti-bodies should all be tested).
Here are some helpful links in case you need to show GP and it might be advisable to take someone close with you to your appointment for extra support.
The findings in the above link highlighted an increased association of PA with other autoimmune diseases, such as type 1 diabetes, vitiligo and in particular, Autoimmune Thyroid Disease . Atrophic Gastritis and autoimmune thyroid disease are closely linked with ATD being present in about 40% of ABG patients[41]. "These data suggest that, in patients with autoimmune disorders, in particular ATD, a possible association with PA should be suspected and excluded."
"The diagnosis of concomitant autoimmune thyroiditis and PA may have an important clinical implication, in particular, in those patients who require replacement therapy with thyroxine. Recently, it has been reported that patients with impaired acid secretion may present with thyroxine malabsorption that requires an increased dose of the drug[42], and in patients with PA, associated hypochlorhydria is always present, due to the loss of oxyntic mucosa[4]."
"CONCLUSION
"PA is an often silent and under-diagnosed autoimmune disease, because its onset and progression are very slow and patients may become used to their complaints. Nevertheless, the clinical consequences of undiagnosed PA may be serious, including gastric neoplastic lesions. Thus, gastroenterologists should increase their awareness of this disorder, whose definite histological diagnosis may be preceded by reliable noninvasive serological screening."
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Very best wishes for early and adequate treatment.
Your TSH looks a bit too high but I expect TUK will advise on this - I only began to feel well when my TSH was suppressed and found Dr A Toft's little book, 'Understanding Thyroid Disorders', written in conjunction with the BMA, invaluable in persuading GP to raise my dose of Levo and not cut it!
Here's another important link first posted by 'Diogenes' - Dr John Midgley, advisor to TUK. It again shows how Hashi's progresses to PA/B12 deficiency through damage to the gut (often silent), hence malabsorption of B12 as well as other essential nutrients:
Flowchart above makes it clear that in UK, people who are symptomatic for B12 deficiency should have an Intrinsic Factor Antibody test and start initial B12 treatment. IFA test can help diagnose PA (Pernicious Anaemia) but IFA test is not always reliable and it is still possible to have PA even if IFA test result is negative (called Antibody Negative Pernicious Anaemia).
2) BMJ B12 article
Emphasises the need to treat people who are symptomatic for B12 deficiency in order to prevent neurological damage.
3) BNF British National Formulary Chapter 9 Section 1.2
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