Could I have PA? Any advice on testing etc

[Helbo123]

hi all. I have hashimotos, currently on NDT, T4 and T3 at the bottom of the range but have an endo who is quite fixated on TSH and as that is suppressed doesn’t want me to increase dose. I have an appointment with her in a few weeks so will discuss again with her as I’ve been feeling quite rough. I’ve been feeling very tired all the time, and I look it too! Feel very puffy around the eyes, have little strength in arms and legs, have a slight tremor in my hands, and lots more! I looked back at a blood test from last summer and my B12 was 295. The GP recorded it as being satisfactory. I have an appoinemtn with my GP next week as I want to discuss this further but was after your thoughts on my B12 level etc before I see them. Many thanks

[haggisplant]

certainly worth exploring but I feel similarly unwell with a fully suppressed tsh. Much better (as long as other things are in range - folate was low though not deficient and I felt unwell) at tsh 0.5-1.

[Nackapan]

If you've nog been supplementing with B12 it's useful to repeat the b12 test ftom the same lab as before .If through your G.p ig will be.

Always useful to give measurement used and In brackets on thd right the 'in range ' figure

It's usually done with folate .

Vit D

Ferritin

Iron also good to include.

Try and keep a symptom diary so then you may be able in time to work out what is what .

My serum B12 was 106pg/ml( 200-900)

So clearly deficient.

On no other meds .

Unfortunately it was my first ever b12 test so I had nothing to compare it to.

Didn't know my tipping point!

We all operate at different levels.

I'm glad you have a baseline.

Sine are in range but symptoms dictate it's not reaching the cells .

Functional B12 deficiency is ususlly diagnosed with an MMA test .

I hope you get everything in balance soon. and start to feel better soon.

[Helbo123 in reply to Nackapan]

Thank you for replying. I should have included the following:

TSH 0.16 (0.3 - 5.5) dec 24

T4 13.4 (12 - 22) dec 24

T3 4.4 (3.1 - 6.8) dec 24

Folate 5.5 (3.8 - 26.8) taken last summer

Ferritin 22 (18-150). GP didn’t want to treat as still in range. Have managed to get that up to 69 myself with ferrous fumerate.

I’m not supplementing B12 at the moment. Was going to and then wondered if it might be worth holding off until I see the GP. I’m neither vegan or vegetarian.

[Nackapan in reply to Helbo123]

So good to get another B12/folate level done. And vit D

[Hockey_player in reply to Helbo123]

Hold off on taking B12 until you get your blood tested again. But maybe try to get that blood test done sooner instead of later? Also test for intrinsic factor anti-bodies. Side note: people can have enough B12 on the test but because not enough is active B12, it is still possible to be deficient.

[JMN2017 in reply to Helbo123]

Looking at your results, they don't make much sense to me. Your T3 and T4 levels are low within the range but your TSH is also very low, which don't correlate, with my (non-expert) knowledge.

So, I'm wondering what time of day you're doing your blood test? As the day goes on, your TSH lowers (I believe) therefore, the best time to have thyroid tests is before taking any thyroid meds, before 9am and before any food/drink, apart from water. This will then show your TSH at it's highest. (Patient to patient tip )

Maybe that might explain why your TSH is low, when your T3 & T4 are both at the bottom of the range ... ??? Just a thought ...

[Helbo123 in reply to JMN2017]

Thanks for your reply. That’s my concern also, I don’t know what it means. My endo tends to focus more on the TSH and last time I saw her she wanted me to reduce my dosage! I didn’t reduce it, with her agreement. I’m due to see her in a few weeks and I’m going to query why I might be getting these results. This pattern seems to be fairly consistent with me. I’ve been having my tests done as early in the morning as I can 🤷🏻‍♀️

[Oneash]

For B12 to be healthy you want it above 500pmol/mL. If you were in Japan, you would be treated at your level. B12 is water soluble, you just pee out any excess.

Igennus Healthcare do a Super B12-Complex you could try, with the 3 most readily absorbed forms. See if that improves your blood test AND symptoms. If not, injections are the only way to guarantee it's in you.

Ask for homocysteine and methylmalonic acid tests, which should show how well B12 is functioning for you.

[Helbo123 in reply to Oneash]

Thank you so much!!

[Bellabab]

You might want to rule out type 2 diabetes as the symptoms are very similar to yours. An HbA1C blood test will give you the average blood glucose concentration for the last 12 months.

[Helbo123 in reply to Bellabab]

I’ve looked back, my result for that test last summer was 29mmol. (20 - 41)

[Bellabab in reply to Helbo123]

Not familiar with that range. Mine source says <48 mmol/mol = not diabetic

[Helbo123 in reply to Bellabab]

Ah yes. It did mention greater than 48 for diabetes. Thank you for messaging

[Bellabab in reply to Helbo123]

That is good news then as managing both is very difficult.