Whats going on?

[Bexg]

Hi new to forum.

I suffer with Hypothyroidism (secondary)

Have been feeling really strange for weeks, tired, dizzy, brain fog, weird sensations in feet, sometimes arms... and insisted my GP checks B12.

Serum vitamin B12 198ng/l (180-886)

Serum Ferritin 57 (13.0-150)

Serum folate 9.8 (3.9-26.8)

[clivealive Forum Support]

Hi Bexg having thyroid problems may put you at risk of developing a Vitamin B12 deficiency.

Your doctor may say that the above results are "Normal".

However the British Society for Haematology guidelines say on the Diagnosis of B12 and Folate Deficiency "In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment".

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. for over 45 years and I wish you well.

​

[Gambit62 Administrator]

you need to make sure that your GP is aware that

a) 25% of people who are B12 deficient don't present with macrocytic anaemia

b) the serum B12 test is not a sensitive test and will miss 25% of people who are B12 deficient so should not be taken as a single measure

c) prompt treatment is recommended if you have neurological symtpoms

reference is the BCSH guidelines which your GP can access through the BNF but can also be found here

onlinelibrary.wiley.com/doi...

this is assuming that your thyroid medication really is optimised - which I guess means looking at T3 and T4 in your case (as your pituitary gland isn't producing TSH) but sure that TUK have provided you with support on this.

If you have previous B12 levels it would be useful to put them in the mix as you should see a clear drop in levels, but as it is something that isn't regularly monitored possible that you don't have that.