I am part of the thyroid community and a fellow member suggested that you lovely folks might be able to advise regarding some bloods I have recently sent off. My results are posted below. I would like to add that my GP’s have been very unhelpful regarding the treatment of my hypothyroidism, and refused to do the following blood test which is why I have had to get them done myself.
I would be very grateful for any advice.
Total B12 203.0 pmol/L (250 - 725)
Folate 11.3 nmol/L (8.83 - 60.8)
HbA1c 35.0 mmol/mol (0-42)
LDL Cholesterol 3.58mmol/L (0-3)
Cholseterol 5.61mmol/L (0-5)
Liver Function
Gamma GT 40.0 IU/L (0-42)
Alkaline Phosphate 85.0 IU/L (35-104)
Albumin 40.0 g/L (34-50)
Globulin 33.2 g/L (19-35)
Alanine Transferasse 35.9 IU/L (0-35)
Bilirubin 5.7 umol/L (0-20)
Total Protein 73.2 g/L (63-83)
Vit D 67.0 nmol/L (50-200)
Ferritin 64.7 ug/L (13-150)
Thank you Sarah 😊
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SarahG76
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Sorry to hear that your GP is problematic treating the thyroid.
have you had iron deficiency in the past and do you supplement iron? sounds from your post on TUK as if this isn't the case? Can see mention of Vit D.
Your B12 is below range and your folate isn't great. This suggests an absorption problem - and it sounds as if you do have problems with stomach acidity - being on a PPI won't have helped with this. Absorption of B12 (and most other vitamins and minerals needs a certain amount of stomach acidity).
whilst macrocytosis is a very common symptom of B12 deficiency it isn't present in 25% of people presenting with B12 deficiency so it's absence doesn't rule out a B12 deficiency.
also, serum B12 isn't a gold standard test so symptoms need to be evaluated but that is quite difficult when they overlap so much with thyroid.
Have you discussed these results at all with your GP?
Your cholesterol levels are a little high but I'm not clear if that is significant - it's not something I would associate with B12 deficiency so there may be something else going on.
I had a huge iron deficiency following the birth of my daughter in July 2015, I was not quite low enough for a transfusion, and was given an oral supplement, but once my levels were up this was not continued. I do not currently supplement, and unfortunately I do not like liver, which has been suggested in a post on TUK.
I was taking 5000 units of Vit D every other day prior to getting my blood results back, but I am now taking this daily.
I have stopped taking the PPI following a discussion regarding this and my stomach on TUK. I am not taking a supplement with my meals, I have only benn doing this for about 2-3 weeks, I am beginning to think that I may have an issue with wheat as I tend to get stomach discomfort when I eat wheat/gluten containing products.
I only got the results back on Saturday, I can contact my GP surgery tomorrow, I have to admit I am not looking forward to the discussion though, I have spoken to 3 GP’s regarding my thyroid, all of which want to treat the symptoms rather than the cause, because my bloods are “in range”. The last conversation was not a pleasant one as they refused to check my bloods as I had not been anemic on my last tests in May... I would imagine they will not be impressed that I have gone and done it myself, but I want my health to improve any they don’t seem to bothered to help.
if you want to be tested for coeliacs this needs to be done before going gluten free. coeliacs can also lead to B12 deficiency.
Coming off a PPI cold turkey really isn't recommended but if it hasn't caused you problems so far then you may be okay. You do have the option of speaking to a pharmacist about that one if you can't face speaking to your GP.
It does sound as if your GPs, like most, aren't very good at understanding the limitations and interactions of tests they are looking at just from the Thyroid results posted. Quite common that medics don't understand that normal range doesn't quite apply after treatment starts for some conditions.
Hope that the appointment goes well.
suggest that you ask about the B12 and the cholesterol ... and mention the problem with wheat.
Also suggest that you familiarise you ask GP to look at the BCSH guidelines on diagnosis and treatment of cobalamin and folate disorders which they can access through the BNF but can also be found here
Thank you so much for your advice. My hypothyroidism isn’t auto-immune which is a blessing, but a huge diet overhaul may be in order, by the looks of things. I don’t think I have coeliacs, to be honest, but my system definitely does not appreciate too many wjeat/gluten laden products.
I shall have a read of the information you have supplied before contacting my GP.
I'm sure I've read somewhere that B12 affects cholesterol. I'm hoping so, because mine was quite high when I was first diagnosed with B12 def, and it certainly isn't diet related because I don't eat most of the things which raise cholesterol (I had a letter from the GP surgery saying I should cut down on red meat, and I've been veggie since I was 14! :))
Thanks for your reply, i didn’t think I ate enough of the things that raise cholesterol either, so it was a bit of a surprise, I do eat animal products but not a huge amount. I will bare this in mind. My GP has agreed to retest my bloods so that’s something and the one I spoke to today actually did listen, which s a vast improvement upon recent discussions 😊
we have demonstrated that low vitamin B12 (a) is associated and independently predicted higher total cholesterol, LDL cholesterol, and cholesterol-to-HDL ratio in serum;
The effect seems to be related to particular genetic variants involved in processing of cholesterol which seem to kick into play when B12 levels are low ... or at least that is what I think is being said
Thank you so much for all the information. I shall have a good read tomorrow. No I haven’t been tested to be honest, may be worth looking into although I fear another argument with the GP 😐
Your GP might consider re-testing B12 levels if they see your results above.
I notice that the units used are pmol/L , in UK NHS serum B12 test units are usually ng/L.
Might be worth seeing if your GP would consider ordering MMA, Homocysteine and Active B12 (transcobalamin) tests. These tests may be affected if you are taking B12 supplements.
The BSH flowchart I gave a link to in above post, makes it clear that in UK, people with B12 deficiency symptoms should have an IFA Intrinsic Factor Antibody test and start initial b12 treatment . It also outlines when PA and Antibody Negative PA can be diagnosed in UK.
IFA test can help to diagnose PA but test is not always reliable and it is still possible to have PA even if IFA result is negative or normal range (called Antibody Negative Pernicious Anaemia).
I do get pins and needle in my hands feet and legs regularly and I have had a dining intermittently in my left ear for a while now, but I put that down too by jaw clicking out of place now and then. My memory has been horrendous for a while, but I put this down to being a mother and having hypothyroidism. I have bladder issues, again I put this down to child birth, I get irritable easily and my liver function has been out of whack for a while now, I had a scan earlier this year that indicated that I did have gall stones, but that my liver was also slightly enlarged also. So I guess I do have symptoms, I've just put them down to other things as we tend to do when we are uneducated.
I am in the UK but these tests were not done by the NHS.
My GP has agreed to retest so we shall see what units they are in when I get them done in January as this is the earliest I can get an appointment for bloods to be taken 😊
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Help with understanding test results?
Help with interpreting test results please
