Pernicious Anaemia Society
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Thoughts please. Hypothyroid and ? B12 issue

please can someone have a look at my results.... had B12 done with GP early Jan, unhappy that GP/Endo weren't interested. Medicheck Active B12 today.....


Serum vitamin B12 level 198 ng/L [180.0 - 866.0]

Serum ferritin level 57.9 ug/L [13.0 - 150.0]

Serum folate level 9.8 ng/mL [3.9 - 26.8]Full blood count


Haemoglobin concentration 126 g/L [120.0 - 160.0]


Vitamins ACTIVE B12 68.600 pmol/L 25.10 - 165.00

Do I need to supplement or not????

7 Replies

Hi Bex, there are plenty of well informed members on here and I'm sure they'll be along soon to discuss your results with you; I just wanted to reply to let you know you're not being ignored in case you're new to the forum lol

Good luck, I get mine back this Friday, I hope, not very impressed with GP's performance so far.

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That's really kind. I am new and have been directed by Thyroid U.K.

Good luck for Friday, have you had a low B12 and opted for a private test too? How have you been feeling?

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Many people on here will tell you that the serum B12 test is unreliable and that the 'active' B12 test is better.

Your active B12 is well into the middle of the normal range. That would suggest that you do not have an issue with B12.


If you want to really be sure and have the finances, Medichecks also do Homocysteine and Methylmalonic Acid tests, £99 each last time I looked. I find these really useful and give a good insight where you are at cellular level. I know the Active B12 came back well in range but serum 198 does sound low. Just my pennyworth. :)

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Although the result of Active B12 does not prove B12 deficiency, there is no doubt that with high risk Hashimoto's and neurological symptoms, B12 deficiency is still highly probable. It might be worth putting your concerns in writing to your GP, so that they are on record, including the latest BMJ research document below - it clearly states that there is NO reliable test, including the MMA. It also points out information regarding frequency of injections for the neurological symptoms you've described in earlier posts as these need treatment with injections without delay to avoid permanent damage:

"every other day until no further improvement ". (British National Formulary). This is a link to the BMJ summary only but GP would probably be able to access the full document:

You could also include :

"The natural history of HT is the progressive reduction of thyroid function till overt hypothyroidism (24) with a rate of progression of 2–4% per year (23), while that of gastric atrophy features the progressive reduction, till disappearance, of parietal cells, leading to reduced or absent acid production (3, 22). These alterations interfere with absorption of essential nutrients leading, at first, to iron-deficient anemia, followed by PA if the self-injurious process involves the IFA (13). "

Dutch research:

"vitamin B12 deficiency can cause many different symptoms, among which are serious neurological problems. The treatment with high dose B12 injections is not only completely safe but fortunately also very effective. With the right treatment patients can recover completely. Starting straight away with treatment is essential, as is the continuing treatment in order to give the body enough B12 to fully recover. Therefore it is essential that patients are no longer exposed to the real danger of irreversible symptoms because of the imaginary fear of overdosing."

Very best wishes for better treatment or there is also the option of self injection Bexg

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Thank you, I think I will compose the letter to the GP. When you feel so unwell it's hard to fight your corner. Having thyroid antibodies, cortisol and vit D tomorrow so will have a full range of tests.

I will definitely include this research my endo completely disregarded it.


Know how you feel Bexg - to get started, you may be able to adapt this letter written by ktwing ?

I hope all goes well with this and tests tomorrow.


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