Testing

[Michelle82]

I have been advised from thyroid uk to get advice from here. Under active thyroid, nutrient levels deficient.

Gp not helping.

[ITYFIALMCTT]

Can you post the results from your blood work, with their reference ranges, so that people might be able to comment, please? Please mention any medications or supplements that you are currently taking.

[Michelle82 in reply to ITYFIALMCTT]

Vit D 3- 55.5 >50

Serum ferritin 83 (11-200.00)

Serum Vitamin B12 168 >140.00

Serum folate 7.8 >4.00

[clivealive Forum Support in reply to Michelle82]

Hi Michelle-82 do you have any neurological symptoms to those of a Vitamin B12 deficiency?

Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:

Weakness and fatigue

Light-headedness and dizziness

Palpitations and rapid heartbeat

Shortness of breath

A sore tongue that has a red, beefy appearance

Nausea or poor appetite

Weight loss

Diarrhoea

Yellowish tinge to the skin and eyes

If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:

Numbness and tingling in the hands and feet

Difficulty walking

Muscle weakness

Irritability

Memory loss

Dementia

Depression

Psychosis

Having thyroid problems may put you at risk of developing a B12 deficiency and although your level is probably flagged as "Normal" if you have the above symptoms your doctor should be treating you not just looking at the computer screen.

The BSH guidelines say "In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment". (See clause 4)

google.co.uk/url?sa=t&rct=j...

Make a list of your symptoms and present this to your doctor and ask him to treat you according to your symptoms and (perhaps) even start you on loading doses "until there is no further improvement" according to the N.I.C.E guidelines below.

Click on the link, then on "Scenario: Management" and scroll down to "Treatment for B12 deficiency"

google.co.uk/url?sa=t&rct=j...

If possible take someone with you who can validate your neurological symptoms as the doctor is less likely to pooh pooh you in front of a witness.

I am not saying that this is an easy thing to do but try to stay calm, write out what you want to say and keep to the script and be confident that you are "in the right" and your facts are correct.

I'm not a medically trained person but I've had P.A. (a form of B12 deficiency) for over 45 years and I wish you well.

[Michelle82 in reply to ITYFIALMCTT]

Hi

Can you tell from my results if pernicious anemia?

Thanks

[ITYFIALMCTT in reply to Michelle82]

Clive's post outlines that when it comes to B12 deficiency, the diagnosis is often a combination of interpreting any blood work results in concert with clinical symptoms.

Pernicious anaemia is one of the potential causes of B12 deficiency and you can read more about it here: healthunlocked.com/pasoc/po...

I'm not knowledgeable enough to suggest an interpretation of your test results.

[Michelle82]

Yer will do now.

Basically wanting to supplement. On 100mcg Levothyroxine and 80mcg propranolol. Not taking any supplements at moment. Was hoping to get dosage advice today from thyroid uk but sent me here.

I saw gp this afternoon and telling me vitamins in range but I and thyroid forum disagree. They need to be optimal!

Thanks

[Gambit62 Administrator]

your results are inconclusive for B12 deficiency. PA is one absorption problem and the most likely one if you have a B12 absorption problem - there are specific tests but they aren't ones that are reflected in the results above ... and they are also quite prone to give false negatives.

[Michelle82 in reply to Gambit62]

Thank you

I am going to start supplements and repeat blood tests in six weeks.

Do you have an idea where my b12 reading should be at all

[Gambit62 Administrator in reply to Michelle82]

serum B12 is not a gold standard test. it will miss 25% of people who are B12 deficient and catch 5% who aren't - you really need to go by symptoms

I wouldn't recommend supplementing with very high doses of B12 as this can cause problems if you don't have an absorption problem. some people respond to high levels of B12 in serum by shutting down the mechanism that allows it to pass from blood to cell leaving them deficient at the cell level. raising serum levels to the point where enough gets through works as a treatment but that would mean needing to supplement at very high levels forevermore. Supplementing may also makes it very difficult to detect an absorption problem and get it diagnosed. Usual treatment for an absorption problem is injections.