Pernicious Anaemia Society
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Come from thyroid forum

Hi I have come from the thyroid forum suggested by some helpful members regarding my vitamin and mineral levels. I take no other medications or supplements except the 25mcg levo. I have symptoms of palpitations, high blood pressure, fast heart rate. Constipation, fatigue, puffy eyes, joint pain, gaining weight, memory loss as well. I eat a varied and healthy diet. I am based in Bristol, South West UK. 25mcg levo was reduced from 175mcg in October 2017. Vitamin and mineral levels below. Also positive for parietal antibodies? Thankyou

January 2018

TSH 5.2 (0.2 - 4.2)

FT4 14.6 (12 - 22)

FT3 3.2 (3.1 - 6.8)

Thyroid peroxidase antibody 553.1 (<34)

Thyroglobulin antibody 376 (<115)

Ferritin 13 (15 - 150)

Folate 2.2 (4.6 - 18.7)

B12 181 (180 - 900)

Vitamin D 13.3 (25 - 50 deficient. Supplementation indicated)

MCV 78.5 (80 - 98)

MCHC 365 (310 - 350)

Iron 5.6 (6 - 26)

Transferrin saturation 12 (12 - 45)

RBC count 4.41 (3.80 - 5.80)

WBC count 4.32 (4.00 - 11.00)

Platelets 241 (140 - 400)

Haematocrit 0.42 (0.37 - 0.47)

Haemoglobin estimation 115 (115 - 150)

MCH 28.1 (28 - 32)

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iron indicators are below or only just in range. MCV is low - so your red blood cells are smaller than they should be - iron deficient and microcytic anaemia

folate deficient

B12 is low.

vitamin D also deficient

you would seem to be developing absorption problems - quite common in hypothyroid patients.

your thyroid antibodies mean your thyroid problem is autoimmune which suggests that the absorption problems may also be auto-immune in origin- so could well be PA

you really need to speak to your GP and ask them to start treating you for the deficiencies with supplements. Think they should presume that you also need treatment (injections) for B12 deficiency as you are only just in normal range and the range is such that it will miss 25% of people who are deficient if it is used as a single indicator - and you are highly symptomatic, even if there is an overlap with thyroid symptoms. 25% of patients with B12 deficiency do not present with macrocytosis.

refer them to the BCSH guidelines in respect of B12 and folate. You can access here but they can access through the BNF.

onlinelibrary.wiley.com/doi...

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Hi and good morning Irishjay

Whatever does your doctor say about your test results?

Ferritin 13 (15 - 150)

Folate 2.2 (4.6 - 18.7)

B12 181 (180 - 900)

Vitamin D 13.3 (25 - 50 deficient. Supplementation indicated)

MCHC 365 (310 - 350)

Iron 5.6 (6 - 26)

Your thyroid problems may put you at risk of developing a Vitamin B12 deficiency and your level is bordering on that and you are Folate deficient. These two B vitamins help your iron to make red blood cells. There is a complex interaction between folic acid, vitamin B12 and iron. A deficiency of one may be "masked" by excess of another so the three must always be in balance.

Symptoms of a folate deficiency can include:

symptoms related to anaemia

reduced sense of taste

diarrhoea

numbness and tingling in the feet and hands

muscle weakness

depression

Your low Vitamin D will also "contribute" toward some of your symptoms.

As Gambit62 said last night

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 am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.

I wish you well

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With those levels it is no wonder you feel bad!!!

Your doctor needs to address, b12, folate, iron, and D.

D needs magnesium to work!!!

Looks like an absorbtion issue unless you are vegetarian.

You can look into betatine hcl. These aid in digestion until you can produce your own stomach acid. Also know your body needs zinc to produce stomach acid on its own. If you are already taking a multivitamin you are already getting your daily copper so just a straight zinc suppliment of 30mg daily to aid in producing stomach acid.

Zinc is linked to brain fog, low stomach acid, reduced taste, smell, vision, and hair, eyebrow, and eyelash growth

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I don't take a multivitamin. Thanks

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I also have low levels of folate, ferritin, vitD, B12 vitamins (not quite as low as yours) and have found one of the causes to be gut problems. Many parasites including H.Pylori (the most well known one) which prevented the nutrients from being absorbed. Could this also be an issue for you, with levels like that, no wonder you have symptoms? I wish you well with your Dr appointment who needs to take notice.

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Negative for H pylori in 2015. Thanks

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